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Flashcards in Ischemic heart disease Deck (42)
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1

what is angina

paroxysmal and usually recurrent attacks of substernal or precordial chest discomfort or pressure secondary to transient myocardial ischemia without infarction.

2

is there infarction in angina

no, it is ischemia without infarction

3

what are the 3 types

stable unstable prinzmetal

4

Stable angina =

Myocardial oxygen demand exceeds ability to increase oxygen delivery

5

Precipicating factors for stable angina

Precipitating factors include causes of increased cardiac workload Generally relieved by rest or nitroglycerin

6

what is unstable angina also known as

preinfarction angina

7

what kind of angina has frequent pain and longer duration

unstable

8

what is the characteristic of prinmetal angina

it is due to a cornnary artery spasm and it is not associate with physcial activity heart rate or bp

9

what is chronic ishcemic heart disease

progressive heart failure secondary to previous small MI with scarring or myocardial hypertrophy with decompensation.

10

what does a persons heart look like that has chronic ischemic heart disease

Enlarged due to hypertrophy and dilatation Scar tissue may be seen Mural thrombi may be seen Microscopic Myocardial hypertrophy Fibrosis

11

what is the clinical feature of chronic ischemic heart disease

heart failure

12

what are 4 risk factors for MI

Hypertension - Smoking - Diabetes - Elevated cholesterol

13

What are 3 findings that would raise your suspicion for an MI

Hypertrophy: greater heart weight or ventricular thickness Dilation: enlarged chamber size Cardiomegaly: increase in heart size and/or weight

14

what arteries lie on the surface of the heart

epicardial coronary arteries

15

what are 2 of the main causes of ischemic heart disease

decreased o2 supply increased o2 demand

16

at what percent occlusion do you expect to see a pt having symptoms at rest

90%

17

pts with progressive ischemic damage are at risk for ...

mi

18

where is the most vulnerable region for ischemic necrosis

subendocardium

19

look at slide that i made for areas at risk!!!!!!!

neow

20

what are differnt things we use to diagnose a an Mi

hx, ekg,cardiac marker, coronary angiography

21

what is the most specific marker for myocardial infarction or heart damage and why

troponin I, rises 3-6 hrs and returns to base line within 7 -10 days

22

What is a flipped LD

when LD2 is higher than LD1

23

What is sudden cardiac death

unexpected death of cardiac origin in persons without symptomatic heart disease or occurring soon after symptom onset (within 1hr) there could still be risk factors we just dont know

24

what does it look like the first 4-12 hrs after infarction

wavy fibers and contraction band necrosis

25

what are the microscopic changes that occur 12-24 hrs after an MI

dead or necrotic with lots of rbcs and myocytes without nuclei

26

what does it look like 1-3 days post mi

infiltration of PMN's - pink long strands with neutrophils

27

what does it look like 7-10 days post MI

more macrophages

28

scar tissue is seen in the heart when did this mi occurr

at least 7-10 days out

29

you see notning but white scar tissue how long ago did mi occur

at least 2 weeks

30

what parts of the heart experience damage must more quickly

subendocardial