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Heart Pathology I
Exam 4
20
Medical
Graduate
10/19/2010

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Cards

Term
The Left Coronary Artery is responsible for perfusing what 3 regions of the heart?
Definition
The anterior wall, the anterior 2/3 of the interventricular septum, and the distal end or apex of the heart.
Term
What separates right dominant heart from left dominant heart?
Definition
The source of supply for the posterior 1/3 of the interventricular septum (Rt. Dominant = RCA; Lft. Dominant = Branch of the Circumflex)
Term
What are the 3 components of the endothelium in the heart?
Definition
The inner part consists of collagen (fibrosa); there is a central part known as the spongiosa, which contains loose connective tissue for shock absorption; and then there is the elastin layer (ventricularis or atrialis)
Term
How many patients in the US, each year, suffer from congestive heart failure?
Definition
5 million
Term
What are the two common causes of systolic dysfunction leading to heart failure?
Definition
Ischemia, hypertension
Term
What are the common causes of diastolic dysfunction, leading to heart failure?
Definition

1. Left ventricular hypertrophy

2. constrictive pericarditis

3. Amyloidosis

4. Myocardial fibrosis

Term
When is right-sided heart failure not associated with left-sided heart failure?
Definition
When there is a primary pulmonary process
Term
Cardiac hypertrophy to more than 3x the normal size raises the possiblity of what diseases?
Definition
Aortic regurgitation and hypertrophic cardiomyopathy
Term
Hypertrophy to 2x the normal size of the heart points to what possibilities?
Definition
Ischemic heart disease, pulmonary hypertension
Term
What are heart failure cells?
Definition
Hemosiderin-laden macrophages in the alveoli due to left-sided heart failure that causes pulmonary congestion and extravasation of red cells into the lungs
Term
Right-sided heart failure consists of what two processes?
Definition

right ventricular hypertrophy and dilatation

engorgement of systemic and portal systems

Term
90% of IHD involve what pathological process
Definition
development of obstructive atherosclerotic lesions in the coronary arteries
Term
What are the four possible clinical manifestations of ischemic heart disease?
Definition

1. angina pectoris

2. myocardial infarction

3. sudden cardiac death

4. chronic ischemic heart disease

Term
What is chronic ischemic heart disease often seen as the "silent killer"
Definition
Often times there is collateral circulation protecting against chronic fixed obstruction, so that the patient may not even know something is wrong until he has a heart attack.
Term
What the 3 areas of the coronary supply that are susceptible to symptomatic stenosis?
Definition
proximal left anterior descending artery, proximal circumflex artery, the entire right coronary artery
Term
What is the common cause of acute coronary syndrome?
Definition
An acute change in atherosclerotic plaque associated with thrombosis.
Term
What are some of the external influences on acute plaque change?
Definition
vasopasm, stress, systemic hypertension
Term
What is the mechanism of death in sudden cardiac death?
Definition
Lethal arrhythmia
Term
What are the two methods of dealing with stable angina?
Definition

1. rest

2. vasodilators (nitroglycerin)

Term
What is unstable angina also referred to as?
Definition
preinfarction ischemia
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