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44 Cards in this Set
- Front
- Back
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IHD is caused by ___
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ischemia due to coronary atherosclerosis
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5 syndromes of IHD
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stable angina
unstable angina MI sudden cardiac death chronic IHD with HF |
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3 most important factors in IHD
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severity of coronary atherosclerosis
plaque disruption coronary thrombosis |
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T/F: there is no strong correlation between degree of atherosclerosis and symtpoms of IHD
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true
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a fixed coronary obstruction usually causes a ___% reduction of lumen
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75
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most IHD patients have ___
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fixed coronary obstruction
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FCOs by themselves can cause ___ (2)
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stable angina
subendocardial MI |
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3 kinds of plaque disruption
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hemorrhage into plaque
plaque rupture plaque erosion |
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hemorrhage into plaque causes
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abrupt enlargement
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plaque rupture causes
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exposure of atheroma
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plaque erosion causes
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exposure of fibrous tissue
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plaque disruption with partial thrombus causes ___ (3)
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unstable angina
microinfarction sudden death |
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MI from plaque disruption is due to
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thromboembolism
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plaque disruption with total thrombosis causes (2)
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transmural MI
sudden death |
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whereas acute transmural MI, unstable angina and sudden death depend on ___ (2), stable angina and subendocardial MI don't
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plaque disruption
formation of thrombus |
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in MI, ischemic changes are reversible during first ___. After ___, some cardiomyocytes start dying. These are located in ___.
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20 minutes
40 minutes subendocardium |
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T/F: some subendocardial myocytes can get O2 from diffusion from blood in heart lumen
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true
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subendocardial MIs affect ___ part of heart. in most cases they are caused by ___ without ___ (2)
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inner 1/3 of ventricle
coronary stenosis plaque disruption thrombosis |
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appearance of heart at autopsy depends on ___
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how long patient survived after MI
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if patient survived <12 h, you will see (2)
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no obvious gross changes
early histological changes |
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if patient survived 12-24 h, you will see
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recent necrosis
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if patient survived 1-3 d, you will see
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advanced necrosis
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if patient survived 3-7 d, you will see
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necrosis with disintegration and softening
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if patient survived 7d- 3 weeks, you will see
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evolving granulation tissue
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if patient survived 3 weeks-2 months you will see
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evolving fibrosis
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if patient survived >2 months you will see
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scar
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complications of MI (5)
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rupture of wall, septum or papillary muscle
tamponade pericarditis mural thrombus ventricular aneurysm |
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ruptures occur ___ days after ___ MI
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3-7
transmural |
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ruptures in ___ can cause a ___ shunt
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IV septum
L to R |
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___ is a late complication of MI, because
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ventricular aneurysm
depends on scar formation |
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layers of medium/large muscular arteries (6)
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endothelium
intima elastica interna media elastica externa adventitia |
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atherosclerosis is chracterized by ___ of ___ arteries. this sets it apart from ___ (2)
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atheromas in intima
medium/large medial calcific sclerosis arteriolosclerosis |
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atheromas are typically ___ in diameter
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0.3-1.5 cm
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atheromatous plaque is composed of ___ and is covered by ___
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lipid
fibrous cap |
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fibrous cap is composed of ___ (2). the latter is composed of ___
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smooth muscle
CT collagen proteoglycans |
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the core of the plaque may be ___ and contain ___ (7)
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necrotic
lipid cholesterol cellular debris foam cells fibrin plasma proteins Ca2+ deposits |
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foam cells derive mostly from ___ but also from ___
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macrophages
smooth muscle |
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activated platelets in plaque release ___ (3)
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PDGF
FGF TGFa |
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smooth muscle cells migrate to ___ and ___
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intima
secrete ECM |
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top 6 locations for atherosclerotic plaques in descending order
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abdominal aorta
coronary artery popliteal artery descending thoracic aorta internal carotid artery circle of willis arteries |
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the ___ of an arterial branch is more prone to plaquing
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ostium
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the precursor of a plaque is ___
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fatty streak
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in ___ arteries, you typically have ___ before ___. this causes ___. in large arteries like ___, you have ___ which can cause ___
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medium sized
occlusion of lumen destruction of wall ischemia aorta destruction of wall aneurysm |
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effects of aneurysm (3)
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rupture
mural thrombus embolism |
