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Flashcards in ischemic heart disease Deck (40)
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1

Treatable risk factors for CAD

smoking
hypertension
Dyslipidemia/cholesterol

2

Treatable questionable risk factors for CAD:

diabetes
obesity
inflammation
psychological stress
sedentary lifestyle

3

Not treatable risk factor for CAD

male gender
age
genetics

4

Smoking causes a ______ tendency, promotes _____ by aryl hydrocarbon

thrombogenic
atherosclerosis

5

Smoking causes adverse effect on ____, ___ decrease O2 delivery, and causes ___dysfunction

lipoproteins (decrease DHL)
CO
Endothelial

6

HTN increases shear stress on arterial wall that cause direct ____

endothelial cell injury

7

HTN: Increased arterial wall stress initiates pathologic cell signaling program causing ____

oxidant stress, cellular proliferation

8

Diabetes and insulin resistance are associated with ________

inflammation, oxidative stress, dyslipidemia that predispose to atherosclerosis.

9

dyslipidemic triad includes ___

high LDL
low HDL
high Triglycerides

10

Oxided LDL becomes ___

pro inflammatory/atherogenic

11

Oxidized LDL effects:(4)

1. injure vascular endothelium = impaired endothelial function
2. Deposite in arterial wall = plaque volume/foam cell
3. Activate inflammatory cell = progression/instability of lesion
4. Activates platelet/prothrombotic

12

Roles of HDL (5)

1. inhibit LDL oxidation
2. Inhibit TF
3. Enchance reverse cholesterol transport
4. Stimulate endothelial NO production
5. Inhibit endothelial adhesion molecules

13

DHL Overall function is to oppose ____

atherothrombosis

14

Inflammation plays a key role in ___ and ___

initiation and progression of atherosclerosis

15

Lipid laden macrophages in arterial walls are highly ____

pro-inflammatory

16

Extravascular inflammation (ex: ____) increase risk of _____ ____events

dental diseases
atherosclerotic CV events

17

Circulating markers of inflammation provides _____ about CV ___; ie: ___ (which is released by liver upon ___signal)

info
risk
C-reactive protein
IL6

18

stable CAD causes _____

myocardial ischemia

19

myocardial ischemia is:

tissue blood flow insufficient to meet oxygen requirement

20

Cardinal symptoms of myocardial ischemia is ___

chest pain/agina pectoris

21

coronary circulation is unique in ___ metabolism for energy supply, extract ___% of O2, perfused during ____

aerobic
near 100%
diastole ony

22

If O2 demands increase, supply will increase by ___ in heart

increase blood flow

23

Myocardial O2 supply determined by:

Coronary blood flow rate
Oxygen content of blood

24

Coronary blood flow rate determined by (4)

1. perfusion pressure
2. perfusion time
3. vascular resistance

25

Autoregulation range implies

heart will provide constant coronary flow within moderate change in perfusion pressure

26

_____ can compromise coronary flow by intramural coronary vessel compression

tachycardia

27

O2 supply compromised by:

anemia (less hemoglobin)
Hypoxemia (incomplete O2 sat)

28

Treatment of:
1. perfusion pressure
2. Diastolic time
3. Coronary resistance
4. O2 content

1. prevent HTN
2. rate control drugs
3. Vasodilator/coronary agnioplasy/bypass surgery
4. treat anemia/hypoxemia

29

Determinants of Mycoardial O2 demand

1. heart rate
2. wall tension
3. inotropic state

30

Treatment of:
1. systolic pressure
2. HR
3. Wall tension
4. Inotropic state

1. antihypertensive drug
2. rate slowing drug
3. limit LV - diuretic/nitrate
4. negative inotropes (beta/Ca blocker)