Term
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Definition
ischemia - temporary imbalance between O2 supply and demand
infarction - necrosis, death - sustained imbalance between O2 supply and demand |
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Term
| initiating event of acute coronary syndrom |
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Definition
| plaque rupture - fibrous cap dysfunctions -> blood is exposed to lipids, monocytes, foam cells, collagen, etc inside plaque -> platelet activation and aggregation -> clot |
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Term
| vulnerable plaques susceptible to rupture |
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Definition
| lipid rich (young, immature) |
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Term
| Why would patients with acute coronary syndrome not have history of angina? |
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Definition
| Younger plaques that have more lipid are more vulnerable to rupture - they wouldn't have been big enough to fully obstruct and cause angina. |
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Term
| What causes clots to either dissolve or not? |
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Definition
tPA = plasminogen activator = clot dissolver
vs
PAI = plasminogen activator inhibitor = clot promoter
low-dose aspirin - inhibits platelet activation - less likely to clot |
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Term
| What determines whether a patient with plaque rupture will have unstable angina vs MI? |
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Definition
If flow in coronary artery is restored promptly, myocytes don't die, and the pt gets unstable angina pectoris;
If coronary artery occlusion is sustained, myocytes die, and pt gets MI |
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