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19 Cards in this Set
- Front
- Back
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with elevated cholesterol which endothelial vascular injury is most likely to occur?
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- insudation of lipid in foam cells
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what are the major risk factors for CAD?
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- HTN, elevated cholesterol, smoking
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what is the first visible evidence of an atheroma?
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- fatty streak
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what is a fatty streak?
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- foamy macrophages in a fatty streak
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where does atherosclerosis occur?
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- intima is way too thick, see cholesterol clefts in the intima
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where coronary obstruction usually occur?
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- LAD & circumflex arteries or entire length of RCA
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what is ACS?
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- coronary atherosclerotic plaque rupture or disruption
- platelet-fibrin thrombus |
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what is a transmural MI?
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- extends from endo --> epicardium
- usually involves LV, most common type - LAD --> RCA --> LCA |
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what is a subendocardial MI?
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- usually affects inner 1/3-1/2 of left ventricle, usually circumferential, not necessarily distributed to one CA
- usually due to hypoperfusion states (AS, shock, bypass) |
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what happens in the first 20-30 minutes of MI macroscopically?
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- irreversible ischemia
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what happens 24 hours post-MI macroscopically? microscopically?
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- macroscopically: cut surface pallor
- microscopically: non-contractile ischemia "wavy fibers", contraction band necrosis, eosinophilic, wavefront waveform = subendo-->eli |
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what happens 1-3 days post-MI macroscopically? microscopically? what are you at risk for?
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- macroscopically: mottling with yellow-tan infarct
-Microscopic: PMNs, Karyorrhexis, Edema, hemorrhage, Myocytes necrotic - at risk for arrythmias |
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what happens 3-7 days post-MI macroscopically? microscopically? what are you at risk for?
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- macroscopically: sharply outlined (hyperemic border) w/ central pale, yellowish, necrotic region
- Microscopic: Few PMNs, Macrophages phagocytose dead muscle fibers, Fibroblast proliferation w/ collagen deposition. Lymphocytes & pigment-laden macrophages - at risk for rupture |
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what happens 10 days-2 weeks post-MI macroscopically? microscopically?
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- macroscopically: depressed, soft, gelatinous area
- microscopically: granulation tissue, Fibrotic changes |
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what happens 2 months post-MI macroscopically?
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- macroscopically: fibrotic healed infarct
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what are you at risk for post MI?
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- cardiogenic shock, arrhythmias (highest risk 1-3 days after), myocardial rupture (highest risk 3-7 days after)
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what is dressler syndrome?
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- delayed pericarditis 1-2 weeks after MI
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what is reperfusion injury?
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- morphology of tissue within cells already lethally injured at time of reflow leading to new injury
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what does chronic ischemic heart disease look like?
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- myocardial atrohpy & interstitial fibrosis
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