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22 Cards in this Set
- Front
- Back
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what does an advanced, complicated atherosclerotic lesion look like?
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- macrophage accumulation, formation of necrotic core, fibrous cap
- filled with debri & lipids |
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what are acute coronary syndromes?
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- rupture of fibrous cap exposing thrombogenic material leading to thrombosis
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what does progressive narrowing of the vessel lumen lead to?
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- chronic CAD & peripheral vascular disease
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what is the major determinant of O2 consumption of the heart?
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- HR
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if diastolic pressure decreases due to something like tachycardia how do you autoregulate the coronary artery perfusion?
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- decrease coronary vascular resistance via vasodilation
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at what % do you start seeing decreases in coronary perfusion during exercise? at rest?
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- exercise around 60%
- rest usually above 80% |
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the majority of plaques that lead to MI & rupture are what percent occluded?
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- 50%
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what is the order of the ischemic cascade?
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- biochemical changes --> diastolic dysfunction (can't relax) --> systolic dysfunction (can't contract) --> elevated filling pressures --> ECG changes --> pain --> MI
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when does collateral circulation develop?
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- when you have a slower growing plaque, can form neovascularization that circumvent the narrowing
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what is hibernating myocardium?
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- when you have 80-90% occlusion the heart will rest, EF will go down, but it's ok, when you do angioplasty EF will go back up
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what is stunned myocardium?
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- next to dead heart, chunk of myocardium necrosed irreversibly, but gets better with time = stunned
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what is a myocardial aneurysm?
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- dyskinesis of the myocardium (wall goes out when rest of wall going in) --> HAS TO CONTAIN 3 LAYERS
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is someone with longer standing CAD or rapidly progressive CAD more likely to die?
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- younger, more rapidly progressive
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can hibernating myocardium occur in acute MI?
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- no, has to be long standing impaired perfusion, not acute MI
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what are the two types of ACS?
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- unstable angina & MI (STEMI & NSTEMI)
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what is silent ischemia?
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- typically seen in diabetics b/c of neuropathy, poor prognosis do not feel angina
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what causes sudden cardiac death?
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- VF
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what is the difference between the management of STEMI vs NSTEMI?
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- STEMI responds better to thrombolytic agents than NSTEMI
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what has to be present for an acute MI to be present?
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- Rise in cardiac enzymes (CK-MB/Troponin) AND
- One of the following: Typical ischemic symptoms, ST-segment changes. Q waves, Imaging evidence loss of myocardial or regional wall abnormality |
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what has a bigger change of dying: stable angina or angina/NSTEMI?
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- angina/NSTEMI
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what is a pseudoaneurysm?
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- not all 3 layers --> rupture contained w/in the pericardium, not actually an aneurysm
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what is the most common cause of CHF?
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- CAD
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