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52 Cards in this Set
- Front
- Back
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What parts of the body does atherosclerosis occur?
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Coronary
Cerebral Limbs Aorta |
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Atheromas are composed of what components?
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Lipids
Cells Necrotic Debris |
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Difference between ischemia and infarction
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With infarction, you have tissue necrosis
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How fast does irreversible cell injury occur?
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After 30 mins
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Wavy muscle fibers indicate
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MI
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What is contraction band necrosis?
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Calcium influx and hypercontraction of sarcomeres after REPERFUSION
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Most common complication of MI
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Arrhythmia
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Complications after first 2 hrs after MI
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Arrhythmia
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Complications after 2-3 weeks after MI (5)
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Cardiogenic Shock
Ventricular Rupture Arrhythmia Mural thrombus Heart failure |
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Complications later than 3 weeks after MI (3)
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Mural thrombus
Ventricular aneurysm Heart failure |
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Aortic valve regurgitation murmurs best heard at
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Left sternal border
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Aortic valve ejection murmurs best heard at
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Right second ICS
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PV valve best heard at
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Left 2-3 ICS
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Tricuspid valve best heard at
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Left parasternal border
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Mitral valve best heard at
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Apex
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Increased pre-load causes
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Eccentric hypertrophy
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Consequences of ventricular hypertrophy (3)
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1- Heart failure
2- S4 3- Angina |
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S4 heart sound caused by
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Blood entering non-compliant ventricle
-Ventricular hypertrophy or volume overload |
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Kerley lines indicate
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Lung septal edema and CHF
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S3 indicates
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First cardiac sign of LHF
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Increased BNP indicates
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Left heart failure
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Why does PND occur at night?
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Increased venous return to right side of heart at night
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First drug for Tx of SYSTOLIC dysfunction
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ACE inhibitors
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High-output heart failure caused by
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1- Increased stroke volume- hyperthyroidism
2- Decreased TPR 3- Arteriovenous fistula- trauma from knife wound |
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Coronary vessels FILL in DIASTOLE!
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Notes
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Which artery is most common site of coronary artery thrombosis?
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LAD
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Major cause of death in the US
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Ischemic heart disease
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Most common manifestation of CAD
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Angina pectoris
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4 causes of stable angina
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1- CAD caused by AS
2- aortic stenosis or hypertension with concentric LVH 3- HCM 4- Cocaine-induced coronary artery vasoconstriction |
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Subendocardial ischemia with ST depression
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Stable angina
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Angina at rest is called
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Unstable angina
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What is Prinzmetal's angina?
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Intermittent coronary vasospasm with ST elevation
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Pathogenesis of AMI
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Rupture of disrupted plaque-->Platelet thrombus-->AMI
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Subendocardial infarction- ECG
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No Q waves
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Transmural infarction
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Q wave
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Contraction band necrosis caused by
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Reperfusion- hypercontraction of myofibrils due to calcium influx
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Retrosternal pain, radiation to left arm, shoulder, jaw, diaphoresis
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AMI
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Substernal chest pain is relieved by leaning forward and aggravated by leaning backward- what disease?
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Fibrinous pericarditis
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Most common cause of death of ventricular aneurysm
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CHF
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Gold standard for diagnosis of AMI
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cTnI and cTnT (Troponin I and T)
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ECG findings in AMI
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Inverted T waves
Elevated ST segment New Q waves |
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Excellent marker for disrupted fibrous plaques
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C-reactive protein
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Complications of atherosclerosis (3)
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1- Aneurysms
2- Thrombosis 3- Ischemia |
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Malignant hypertension can cause
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Hyperplastic arteriolosclerosis
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2-3 days after MI
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Acute inflammation- neutrophils
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5-10 days after MI
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Macrophages remove necrotic tissue
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2-4 weeks after MI
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Vascularized granulation tissue
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4-6 weeks after MI
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Scar tissue
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Cardiac enzymes after acute MI
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CK-MB and Troponins
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Rupture of myocardium after MI most common when?
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3-7 days after
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Familial hypercholesterolemia physical findings
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Increase in LDL, cholesterol
NORMAL tricglycerides Plasma is clear Autosomal dominant usually |
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Remember on heart tissue, ischemia is yellow and fibrotic areas are white
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Notes
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