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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

At what percent cross sectional obstruction does the blood flow can't keep up with demands from exercise, pharmacologic interventions, and mental stress?

70%

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

A <40% increase in wall thickening is called:

Hypokinesis

A <10% increase in wall thickening is called:

Akinesis

When the wall moves outward in ventricular systole and has wall thinning its called:

Dyskinesis

A subendocardial MI involves:

Only the inner layer of the myocardium

A subepicardial MI involves:

Both the inner and middle layers

A transmural MI involves:

All three layers of the myocardial walls

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

Symptoms of an MI include:

1) may be normal if uncomplicated


2) chest pain (not angina)


3) shortness of breath


4) nausea


5) vomiting

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

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

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

Important echo findings for MI:

wall motion abnormalities always seen (may or may not be at site of ischemia)

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

What is a pseudoaneurysm?

Myocardial rupture contained by parietal pericardium; had small communicating neck that creates a gradient

What are the differentials for LV pseudoaneuryms?

1) loculated pericardial effusion


2) pericardial cyst

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

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

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

What are the symptoms of Dressler's Syndrome?

1) fever


2) pleuropericardialvpain


3) malaise


4) pericarditis


5) pleuritis