Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
13 Cards in this Set
- Front
- Back
|
symptoms
|
angina - all types including microvascular
dyspnea CHF |
|
|
Physical assessment
|
S4, MR/TR murmur, T wave inversion for ischemia, peaked T wave for acute MI, ventricle arrythmias, conduction defects
|
|
|
end stage ischemia disease secondary effects
|
LV/RV systolic dysfunction
CHF LV thrombus |
|
|
Ischemia Changes Cascade
|
perfusion defect, diastolic function abnormality, segmental wall motion abnormality, ecg changes, chest pain, myocaridal infarction.
|
|
|
LV diastolic dysfunction
|
impaired relaxation, reduction in early diastolic filling, reduced compliance, increased end diastolic presssure
|
|
|
segmental wall motion abnormalities
|
normal - increase in thickness for systolic
ischemic - not thicken, may be thin |
|
|
Wall motion scoring - normal and hypokinetic
|
Normal - endocardial motion and wall thickening normal
Hypokinetic - reduced endocardial motion and wall thickening during systole, <40% |
|
|
Wall motion scoring: akinetic, dyskinetic and aneurysmal
|
Akinetic - absence of inward endocardial motion or thickening, <10%
Dyskinetic - outward motion or bulging of endocardium during systole Aneurusmal - fixed defect during systole and diastole |
|
|
Wall motion scoring
|
normal 1
hypo 2 akinetic 3 dyskinetic 4 aneurysm 5 |
|
|
coronary supply
|
LAD - anterior wall and septum, LV apex
Circumflex - lateral wall, posterior wall RCA - RV apex, RV free wall, inferior wall, inferior septum |
|
|
Myocardial ischemia
|
complete blockage occurs for
<4 hours ischemic >4 hrs infarcted necrosis, irreversible |
|
|
Ischemia - stunning and hibernating
|
Stunning - viable myocardium salvaged by reperfusion, recovery may not be immediate
Hibernating - ischemic myocardium supplied by narrow coronary, prolonged post ischemia dysfunction |
|
|
Ventricular remodeling
|
after cokmplete occlusion and infarction, necrotic myocardium becomes fibrous and scarred. thinner and dense. may cause ventricular arrhythmias, CHF, diastolic dysfunction
|
