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Tp2. Cardiovascular System > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

What is the main cause of the ischemias

A

Atherosclerotic plaques

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2
Q

What is part of the acute coronary syndrome

A

Unstable angina
STEMI
NSTEMI

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3
Q

What wid be seen in the stable angina

A

Normal ecg
Normal bio markers
Subendocardial ischemia (demand ischemia)

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4
Q

What would be the unstable angina

A

Ruptured plaque
ST depression and the T inversion
Normal bio markers

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5
Q

What would be seen in the STEMI

A

ST elevation and hyper acute T waves
Damage to the tissue/cells, troponin would be elevated
Trans mural infarct

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6
Q

What would be seen in the NSTEMI

A

ST depression and t-wave inversion
Troponin elevated
Subendocardial infArct

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7
Q

What are the bio markers used

A

Troponin
Myoglobins
CK-MB

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8
Q

What markers would show the reoccurring infarct and what would not

A

The CK-MB as would go back to normal fast
Troponin not as would remain high for many days

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9
Q

What would the myoglobins show

A

The immediate infarct
Not specific to the heart muscle however

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10
Q

What else can be used to show the infarct

A

ECG
Cardiac catheter (Percutaneous coronary intervention) or the fibrolytic therapy

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11
Q

What are the normal symptoms of ischemic chest pain

A

Dull and crushing pain, not sharp
Elevated with rest
Provoked with exercise and activity
Nausea and sweating

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12
Q

What would be the features of a right ventricle MI

A

jugular venous distension (blood would back flow to the jugular vein)
Hypertension
Clear lungs
Bradycardia
Edema (lower extremities)

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13
Q

What would be the features of the left ventricle MI

A

Hypotension
Reflex tachycardia
Pulmonary edema (as blood backflows and fluid is more able to leave)
S4 Heart sound

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14
Q

What is the S4 sound heard with the LV MI

A

Atrial gallop
Happens in diastole
Blood would try to flow to the LV but would be stiff due to the infarct

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15
Q

What would be the features of the pericarditis

A

Inflammation of the pericardial layers
Frictional rub of the layers
Sharp and localised chest pain
Cone shaped ST elevation (not round like normal)
Happens 24hrs to 3days after

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16
Q

What happens 3-14 days after the MI

A

Rupture syndrome
Fibrosis of the tissue
Rupture of the ventricular septum
Ruptured papillary muscles (so would not be able to have the proper closing of the valves, mitral regurgitation)

17
Q

What wall would be effected when have the ST elevation of the V1,2 and 3 leads

A

The anterior wall

18
Q

What area is effected when have ST elevation of the lead 2,3 and the aVF

A

The inferior wall

19
Q

What area would be effected when have the ST elevation in lead 1 and aVL

A

The lateral wall

20
Q

What is the TIMI score

A

Would show the risk of the MI
High - need the catheter
Low - medical attention

21
Q

What is the stress test

A

Do activity or exercise or can give drugs that would increase the heart activity
Shows the likelihood of the MI
High - cardiac Cather
Low - medial intervention

22
Q

What is the cardiac catheterisation

A

Catheter through the radial or the femoral artery’s
Goes to the aorta and then can go to the coronary artery
Release a dye, can see which vessels occluded

23
Q

When would you not do the catheter and do the fibrosis therapy

A

When the person is allergic or unable to have the dye or the Cather pass through the body

24
Q

What is fibrolytic therapy

A

Lysis of the clots
Stops the occlusion

25
Q

What are the management principles

A

M - morphine (vasodilation, low after load, less heart pressure, stops pain)
O - oxygen (only when hypoxic as can make the free radicals)
N - nitroglycerin (vasodilation, less pain)
A - aspirin (no clots, thins blood, less chance reinfarction)

26
Q

Why would the beta blockers be used as intervention

A

Would show the heart, reduce the force of beating
So would lead to a low chance of the reinfarct, the embolisms

27
Q

How many hours would it take for the CK-MBS to be released

A

6 hours

28
Q

How long would it take for the troponin to show

A

Up to 24hours

29
Q

What is the difference between the STEMI and the NSTEMI

A

STEMI - transmural INFARCT
NSTEMI - subendocardial infarct

30
Q

How would unstable angina and the stable angina be similar

A

Both would be subendocardial ischaemia

Tp2. Cardiovascular System (13 decks)

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