Flashcards in CH8 - Cardiac Pathology Deck (288)
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1
What is ischemic heart disease (IHD)?
Group of syndromes related to myocardial ischemia
2
What is the leading cause of death in the US?
ischemic heart disease (IHD)
3
What is ischemic heart disease (IHD) usually due to?
atherosclerosis of coronary arteries, which decreases blood flow to the myocardium
4
What are the risk factors for IHD?
They are similar to those of atherosclerosis; incidence increases with age.
5
What is stable angina?
chest pain that arises with exertion or emotional stress.
6
What is stable angina due to?
atherosclerosis of coronary arteries with > 70% stenosis;
7
Why does stable angina arise with exertion?
decreased blood flow is not able to meet the metabolic demands of the myocardium during exertion
8
What does stable angina represent?
reversible injury to myocytes (no necrosis)
9
How does stable angina present?
As chest pain lasting < 20 minutes that radiates to the left arm or jaw, diaphoresis, and shortness of breath
10
What does the EKG show in stable angina?
ST-segment depression due to subendocardial ischemia
11
What is stable angina relieved by?
rest or nitroglycerin
12
What is unstable angina?
chest pain that occurs at rest.
13
What is unstable angina usually due to?
rupture of an atherosclerotic plaque with thrombosis and incomplete occlusion of a coronary artery
14
What does unstable angina represent?
reversible injury to myocytes (no necrosis)
15
What does the EKG show in unstable angina?
ST-segment depression due to subendocardial ischemia
16
What is unstable angina relieved by?
Nitroglycerin
17
In unstable angina there is a high risk of what?
progression to myocardial infarction
18
What is prinzmetal angina?
episodic chest pain unrelated to exertion.
19
What is prinzmetal angina due to?
coronary artery vasospasm
20
What does prinzmetal angina represent?
reversible injury to myocytes (no necrosis)
21
What does the EKG for prinzmetal angina show?
ST-segment elevation due to transmural ischemia.
22
What is prinzmetal angina relieved by?
nitroglycerin or calcium channel blockers
23
What is myocardial infarction?
Necrosis of cardiac myocytes
24
What is myocardial infarction usually due to?
rupture of an atherosclerotic plaque with thrombosis and complete occlusion of a coronary artery
25
In addition to atherosclerotic plaque what are some other causes of myocardial infarction?
coronary artery vasospasm (due to Prinzmetal angina or cocaine use), emboli, and vasculitis (e.g., Kawasaki disease).
26
What are the clinical features for myocardial infarction?
include severe, crushing chest pain (lasting > 20 minutes) that radiates to the left arm or jaw, diaphoresis, and dyspnea; symptoms are not relieved by nitroglycerin.
27
In myocardial infarction what does the infarction usually involve?
the left ventricle (LV); right ventricle (RV) and both atria are generally spared.
28
What artery is most commonly involved artery in MI?
LAD; left anterior descending artery ? 45% of cases
29
What does occlusion of the left anterior descending artery (LAD) lead to?
infarction of the anterior wall and anterior septum of the LV
30
