Ischemic Heart Disease Flashcards Preview

Cardiovascular > Ischemic Heart Disease > Flashcards

Flashcards in Ischemic Heart Disease Deck (16):
1

4 causes of decreased blood flow

1. Fixed atherosclerotic narrowing (stable plaque)

2. acute plaque change

3. thrombosis overlying ruptured plaque

4. vasospasm

2

__% narrowing causes ischemia with exercise

 

___% narrowing causes ischemia with rest

70%

 

90%

3

most dangerous acute plaque change lesions

moderately stenoic (lipid rich atheromas with soft lipid cores)

4

4 syndromes of IHD

Angina pectoris

MI

Chronic ischemic HD

Sudden cardiac death

5

3 patterns of angina pectoris

stable - physical activity or excitement (chronic stenoising of CAs)

Prinzmetal - CA spasm at rest

Unstable - via disruption of plaque with superimposed partial thrombosis, progressive

6

___% MI due to aacute plaque change > thrombosis

___% due to vasospasm, emboli, or unexplained

90%

10%

7

Transmural MI

full thickness of ventricular wall

one vessel's distribution

fixed coronary obstruction AND acute plaqye change > complete obstructive thrombosis

8

Subendocardial MI

necrosis limited to inner 1/3

may extend beyond distribution of 1 vessel

Fixed CA obstruction w/acute plaque change 

but nonocculisive thrombus or lysis of thrombus or HTN

9

loss of contractility occurs at ___% ischemia

60%

10

irreversible damage occurs at ___min

20-40 minutes

11

order of commonly occluded CA

LAD

RCA

LCA

12

progression of MI gross morphology

<12 hour not apparent (tertazolium stain at 3hr)

12-24hr - dark redblue mottling

1-14d - yellow tan area > yellow centrally with hyperemic periph

>2wks scar formation

13

histo progression MI

4-12hr - wavy fibers

12hr-7d - coagulative necrosis (acute inflam > phagocytosis)

7-14d granulation tissue and collagen depo

>14d - scar > dense fibrous scar

14

reperfusion injury micro

necrosis with contraction bands due to influx of Ca

15

MI clinical presentation

Chest Pain

Rapid weak pulse

diaphoresis

dysnea (due to pul edema)

16

Sudden cardiac death due to

lethal arythmia