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20 Cards in this Set
- Front
- Back
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define ischemic heart disease
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generic designation for a group of closely related syndromes which result from ischemia. Ischemia 2° to an imbalance between supply and demand of the myocardium for oxygenated blood.
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what are the 2 pathogenic causes of ischemia?
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reduced coronary blood flow
increased myocardial demand exceeding vascular supply (tachy and hypertrophy) |
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what are the 3 patterns of angina pectoris?
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stable, Prinzmetal, unstable. U
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what is angina pectoris
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paroxysmal substernal or precordial pain resulting from ischemia without infarction
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you have an 80 woman who has severe multivessel coronary atherosclerosis who has now devolped CHF. The CHF may be secondary to postinfarction cardiac decompensation.
What does she have? |
Chronic ischemic heart disease
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what are the two types of MI? describe
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transumural: full thickness of ventricular wall
subendocardial: limited to inner 1/3 to 1/2 of ventricular wall, usually in area of diminished perfusion |
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this MI is limited to the inner 1/3 to 1/2 of the ventricular wall - - - usually in an area normally of diminished perfusion
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subendocardial
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this MI is full thickness of the ventricular wall, usually 2° to severe coronary atherosclerosis with plaque disruption & superimposed occlusive thrombosis
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Transmural
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what normally causes transmural MI?
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90% are 2° to coronary atherosclerosis with one or more stenosing & subsequently disrupted plaques.
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in transmural MI what chamber of the heart is most commonly affected
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LV
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for MI what is the time between onset and irreversible inury?
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20-40 minutes
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what causes subendocardial MI?
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Diffuse coronary atherosclerosis and global border line perfusion made transiently critical by demand, vasospasm or hypotension but without thrombosis
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please describe the gross changes of MI for the following time frames:
6-12 hrs 18-24 hrs 1st week 7-10 days **TEST |
6-12: see nothing
18-24: pale to cyanotic 1st week: yellow and soft tissue 7-10 days:rim of hyperemic granulation tissue 6 weeks: white fibrous scar is well established |
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how long does it take to see a white fibrous scar post MI?
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6 weeks
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when do you see a yellow tan and soft area post MI (time)
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1 week after MI
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6-12 hours post MI what would you see as far as gross change in the heart grossly?
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nothing! NOTHING!!!!!!!!!
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1 hr post MI what micro changes would you see?
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nothing really
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12-72 hours post MI what micro changes will you see?
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hrs neutrophilic infiltration into the necrotic tissue -->myocyte coagulative necrosis; dead myocytes become hypereosinophilic with loss of nuclei
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3-7 days post MI what micro changes will you see?
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dead myocytes begin to disintegrate and are resorbed by macrophages
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7-10 days post MI what micro changes will you see?
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granulation tissue progressively replaces necrotic tissue -->dense fibrous scar
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