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33 Cards in this Set
- Front
- Back
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What branches originate from the right coronary artery? |
The marginal and posterior descending arteries |
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What does the right coronary artery supply? |
The right atrium, SA and AV node, right ventricle, posterior portion of the septum and inferior part of the left ventricle |
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What branches originate from the left coronary artery? |
Circumflex and the anterior descending artery |
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What does the left coronary artery supply? |
The left atrium, ventricle and anterior interventricular septum |
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What are coronary anastomoses? |
Small vessels that connect projections of the left and right coronary arteries (connect small vessels that originate from these larger structures, do not occur right from the beginning) |
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What is the functional role of the anastomoses? And what is the term for this function? |
Supply blood to regions of the heart supplied by the right or left coronary in the event of a blockage (Collateral Circulation) |
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What is arteriosclerosis? |
Is a general term that describes stiffening of the arteries, loss of elasticity, and thickening of the arterial wall |
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What does arteriosclerosis result in? |
Narrowing of the arterial lumen and reduced blood flow |
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What is atherosclerosis? |
Most common form of arteriosclerosis that involves fatty plaques that build up below the endothelium (atheromas) |
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What are non-controllable and controllable risk factors of atherosclerosis? |
Non-controllable: Age, male-gender, and history Controllable: Obesity, Physical inactivity and smoking |
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What diseases can lead to atheroslcerosis? |
Diabetes mellitus, hyperlipidemia, and hypertension |
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What are the steps to atherosclerosis? |
1. Endothelial damage 2. Fatty streaks (macrophage invasion and lipid migration) 3. Plaque Formation (fibrous tissue forms under the endothelium to trap the lipid) - functions like a granuloma to contain the injury 4. Complicated lesion/thrombus formation (Where the collagen cap can no longer contain the lipid buildup and inflammation causing it to burst and lead to thrombus formation) |
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What is the result of atherosclerosis in the heart, what happens when it forms a full occlusion? |
Angina pectoris, or myocardial infarction |
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What happens in the brain? |
Carotid and cerebral artery partial occlusion causes an ischemic event, meanwhile a full occlusion causes a cerebrovascular accident (stroke) |
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How is atherosclerosis diagnosed? |
High serum lipid levels |
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What is a drug intervention for Atherosclerosis? |
Statins and fibrates which are anti-hyperlipidemic drugs |
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What are complications of CAD? |
Angina pectoris, myocardial infarction, dysrhythmias, or sudden death |
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What is angina pectoris? |
Sudden onset of pain, due to myocardial ischemia |
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What are the two forms of angina and what causes them? |
Typical (exertional): occurs after exercise and is caused by atherosclerosis Variant: occurs at rest, and is caused by coronary vaspospam (sudden constriction of CA) |
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What factors can aggravate CA? |
Cold weather (constriction), exertion, stress and heavy meals (extra lipids etc.) |
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What can relieve CA? |
Nitrates and stress |
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What are standard treatment practices for angina? |
Antianginal drugs: B-blockers (prevent epinephrine action), nitrates and calcium channel blockers (reduce work of heart) |
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What is the best way to prevent angina? |
Use nitroglycerin, which is a vasodilator and acts fast |
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What drug is favoured in variant angina? |
calcium channel blocker |
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What drug is avoided in variant angina? |
B-blocker |
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Why are anti platelet drugs used in treating angina? |
In order to prevent clots from forming (break off from the atheroma) |
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Myocardial Infarction |
The necrosis of part of the heart muscle because of reduced blood flow to a region because of artery occlusion |
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What is the pathophysiology of myocardial infarction? |
Can be a product of atherosclerotic thrombus or an embolus that occludes an artery and prevents blood flow Or vasospasm that also occludes the vessel |
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What ventricle is most effected by MI? |
The left ventricle |
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What are the effects of necrosis? |
Cell death resulting in the leakage of cytoplasmic enzymes etc. that stimulates inflammation and can lead to wider spread necrosis Necrotic tissue is healed by fibrotic tissue that can't contract the same etc. |
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What are the symptoms of MI? |
Similar to angina (pain, just more severe and lasting) Pale skin, sweating, laboured breathing Hypotension Slight fever |
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How is MI diagnosed? |
ECG Release of cardiac myocyte enzymes - Creatine Kinase - Myoglobin - Troponin - AST and LDH Echocardiography (video of heart contractions) Cardiac angiography (enables visualization of the blockage or plaque buildup) |
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What is the treatment goal for MI? |
Restore blood flow to the heart and salvage as much of the myocardium as possible |
