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22 Cards in this Set
- Front
- Back
A reversible imbalance in the myocardial oxygen demand-to-supply ratio is called: |
Ischemia |
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At what percent cross sectional obstruction does the blood flow can't keep up with demands from exercise, pharmacologic interventions, and mental stress? |
70% |
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What are the consequences of myocardial ischemia? |
1) coronary artery occlusion/obstruction 2) diastolic dysfunction 3) impaired relaxation & decreased compliance 4) increased LVEDP 5) decreased left ventrical ejection fraction 6) LV dilation 7) large infarctions |
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A <40% increase in wall thickening is called: |
Hypokinesis |
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A <10% increase in wall thickening is called: |
Akinesis |
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When the wall moves outward in ventricular systole and has wall thinning its called: |
Dyskinesis |
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A subendocardial MI involves: |
Only the inner layer of the myocardium |
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A subepicardial MI involves: |
Both the inner and middle layers |
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A transmural MI involves: |
All three layers of the myocardial walls |
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What are the EKG findings of an MI? |
1) T-wave inversion 2) elevated ST segment (acute) 3) peaked T-waves (acute) 4) pathological Q-waves ("old" MI) 5) may see ventricular arrhythmias |
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Symptoms of an MI include: |
1) may be normal if uncomplicated 2) chest pain (not angina) 3) shortness of breath 4) nausea 5) vomiting |
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What are other names for CK and its lab values? |
1) Total CK, creatine phosphokinase, CPK, creatine kinase 2) levels rise 4-6hrs after MI, highest 18-24hrs, and returns to normal in 2-3 days. 3) can also be seen with skeletal muscle damage |
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What are the other names for CK-MB and its lab values? |
1) CK MB, CPK MB, creatine kinase-MB 2) can be used to tell if clot dissolving drugs are working 3) a CK-MB to total CK index higher than 2.5 - 3 indicates heart muscle damage 4) some severe skeletal muscle injuries can raise CK-MB levels |
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What are the other names for Troponin and its lab values? |
1) Tn1, TnT, cardiac specific Troponin 1 and T 2) troponin stays elevated 1-2 weeks after MI 3) levels not affected by damage to other muscles |
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Important echo findings for MI: |
wall motion abnormalities always seen (may or may not be at site of ischemia) |
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Complications with MI include: |
1) pericarditis 2) Dressler's Syndrome (delayed form of pericarditis 1-12wks after MI) 3) RV infarction 4) mitral regurgitation 5) LV aneurysm (most common at anterior wall or apex) 6) LV thrombus 7) LV psuedoaneurysm 8) VSD or rupture 9) LV free wall rupture |
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What is a pseudoaneurysm? |
Myocardial rupture contained by parietal pericardium; had small communicating neck that creates a gradient |
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What are the differentials for LV pseudoaneuryms? |
1) loculated pericardial effusion 2) pericardial cyst |
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A rare congenital cardiac malformation that could be confused with an aneurysm ( small, circular echo-free space with all three layers intact) is called: |
LEFT VENTRICAL DIVERTICULOSIS |
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What are the predisposing factors for a LV free walk rupture? |
1) large MI 2) elderly 3) post MI hypertension 4) no prior coronary artery disease |
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LV free wall rupture: |
1) seen within 48hrs of acute MI 2) rupture site usually at hingepoint 3) cardiac tamponade can develope 4) survival is rare |
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What are the symptoms of Dressler's Syndrome? |
1) fever 2) pleuropericardialvpain 3) malaise 4) pericarditis 5) pleuritis |