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25 Cards in this Set
- Front
- Back
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Myocardial Infarction 1 |
The first muscle to die is at the end of the coronary vascular supply: the subendocardial muscle. If small branch of CA involved |
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Myocardial Infarction 2 |
•The infarct gardually enlarges for several hours until it is complete. Transmural MI if large CA branch involved.
•Prompt therapeutic intervention to re-establish coronary flow may stop Necrosis while the infarction is small. |
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Myocardial Infarction |
•Onset and first several hours -Subendocardial Injury and myocardial ischemia. No cell death (Infarction) yet |
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Myocardial Infarction |
•Before coronary occlusion: -Heart muscle normal |
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Myocardial Infarction |
•First Day -Ischemia and Injury extend to epicardial surface. Subendocardial muscle dying in area of most severe Injury. |
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Myocardial Infarction Zone of ischemia |
•Myocardial ischemia causes ST segment depression with or without. T wave inversion as result of altered repolarization |
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Myocardial Infarction Zone of Injury |
•Myocardial Injury causes ST segment elevation with or without loss of R wave |
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Myocardial Infarction Zone of Infarction |
•Myocardial Infarction causes deep. Q waves as result of absence of depolarization current from dead tissue and receding currents from opposite side of heart. |
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Myocardial Infarction |
•Mural (wall) scarring at different levels (cross sections) of heart. |
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MI: Anatomic Complications of Transmural MI |
•Mitral valve papillary muscle connection damaged = mitral valve regurgitation •Necrotic myocardium oozes substances across endocardium attracting platelets = mural thrombus, cerebral emboli & stroke |
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MI: Anatomic Complications of Transmural MI |
•Blood dissects through and ruptures soft dead myocardium = hemopericardium & cardiac tamponade (smothering) |
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Myocardial Infarction: Clinical Features |
•Electrocardiogram abnormalities (acute, subacute, resolved). •Blood, total creatine kinase (CK), cardiac creatine kinase (CK-MB), and cardiac troponin are increased. •Magnitude of increase is related to size of MI. |
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True |
•The most common cause of instantaneous death is ischemic Heart Disease |
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Hypertensive Heart Disease |
•HTN - hypertrophy, Q decrease •HTN - atherosclerosis •HTN - increase shearing forces on endothelium |
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Hypertensive Heart Disease |
•Hypertrophic myocardium -Stiff & high Metabolic requirements, hard to perfuse •Now susceptible to CHF, MI, Arrythmias |
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Valvular Heart Disease |
Caused by: •Valvular (Aortic) stenosis -Incomplete obstructed flow, usually from stiff or fused valve leaflets or age related calcification & degeneration. |
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Valvular Heart Disease |
•Valvular (Aortic) insufficiency -Regurgitation or backflow, usually associated with valves that do not close properly because they are stiff or be deformed by inflammation, or eaten away by bacterial infection. |
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Valvular Heart Disease
Valvular (Aortic) Insufficiency |
-Caused by: •Syphilitic aortitis •Papillary muscle Infarction causing mitral valve Chodae tendon tear •LV heart failure (LV dilation) •Rheumatic fever (inflamed thick valves) •Myxomatous degeneration of mitral valve |
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Valvular Heart Disease Valvular (Aortic) Stenosis |
•Often age-related changes •Valvular Fibrosis •Calcification •Valve deformity °Causes -Systolic murmur (Lub-Dub-Swish) -LVH & Syncope •Treatment -Valve replacement |
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Rheumatic Disease |
•Streptococcal pharyngitis (not all strep locations) stimulates production of anti streptococcal antibodies and T cells, which attack the microbe but also attack similar antigens in heart muscle cells, valves (autoimmune) & joints. -May be chronic and silent resulting in chronic rheumatoid valvulitis |
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Rheumatic Heart Disease |
•Inflammation and scarring produces a stiff, thick valve and short, thick chordae tendineae. Such valves may be stenotic or regurgitant. |
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Endocarditis Non-infective thrombotic Endocarditis (Non-bacterial endocarditis) |
•Platelets & fibrous material on valve leaflets •Can embolize causing brain Infarction -Linked to: Cachexia, DVT, Hypercoagulable blood, malignancy or adenocarcinoma |
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Endocarditis Infective Endocarditis |
•Bacterial Infection •More Serious -Erosion of leaflets -Catastrophic valve insufficiency -Systemic Infection |
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Pericarditis |
•Viral Infection -Atypical chest pain -Audible friction rub -Can constrict heart and decrease diastolic filling -EKG changes look like diffuse myocardial Injury |
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Primary Myocardial Disease |
•Myocarditis -Viral Infection (Coxsackie A or B), Or Rheumatic fever (Autoimmune) •Cardiomyopathy (Intrinsic Myocardial Disease) •Either can progress to Dilated Cardiomyopathy |
