Term
| the interelastic membrane is found in what layer of the vessel |
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Definition
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Term
| atherosclerosis is caused by plaque build up from accumulation of ? |
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Definition
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Term
| what are the three things composing the pathological progression of atherosclerosis |
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Definition
| 1. fatty streak 2. fibrous plaque formation 3. complicated lesion |
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Term
| The most common cause of HTN is? Name for this type of HTN |
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Definition
| 90-95% of patients with HTN have no direct cause (Essential HTN aka primary HTN) |
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Term
| If there is a dysfunction of the vascular tone it is from something that affects what three components of the cardio system |
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Definition
1. SNS
2. Renin-Angiotensinogen Activating system
3. Natriuretic peptides |
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Term
| what system in the body has a direct effect on the vascular resistance |
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Definition
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Term
| what are the two types of aneurysms |
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Definition
1. degenerative
2. dissecting |
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Term
| Which type of aneurysm is a tearing of the vessel wall |
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Definition
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Term
| the most common type of aneurysm is |
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Definition
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Term
| aneurysm come from a greek word which translates as |
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Definition
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Term
| Name five common causes of aneursyms |
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Definition
1. HTN & Atheriosclerosis
2. syphilis
3. marfan syndrome
4. post MI
5. Trauma |
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Term
| elective repair of an aneurysm is at what cm |
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Definition
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Term
| which aneurysm form bulges on all sides |
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Definition
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Term
| sacular aneurysms can be described as |
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Definition
| dilation on only one side of the vessel. |
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Term
| what is Virchow's triad. Describe the three in it. |
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Definition
It describes a hemodynamic state which increases exponentially the risk for deep vein thrombosis
1. venous stasis (CHF)
2. Venous endothelial damage (Trauma/meds)
3. Hypercoagulable state (malignancy, pregnancy, cancer) |
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Term
| What are the three things in ACS |
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Definition
1. UNSTABLE angina
2. ST elevation
3. ST depression |
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Term
| In order for a diagnosis of MI and not unstable angina what would you need to have |
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Definition
| A ST elevation or ST depression with positive cardiac markers. Whether or not the q wave is depressed is trivial. |
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Term
| CAD changes more than just the function of the vessels but also effects the ___ of vessels |
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Definition
| function and structure of vessels! |
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Term
| The first part in the etiology of CAD is the dysfunction of what in the coronaries |
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Definition
| Dysfunction to the endothelial cells. After that the dysfunction of the endothelial cells can lead to coronary vasospasm, impaired relaxation, formation of clots. HENCE WHY WE TREAT WITH VASODILATORS - nitro, with CCB, With opioids for decrease MO2consumption, ASA to decrease platelet plugs or clot formation |
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Term
| what causes chronic stable angina |
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Definition
| from long term narrowing of the coronaries due to atherosclerosis |
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Term
| What is prinzmetal's angina? What is its etiology? How is it different than normal angina? |
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Definition
| Prinzmetal's angina is from coronary spasms and not as result of pathological vessel narrowing due to atherosclerosis. |
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Term
| Causes of prinzmetal's angina |
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Definition
1. hyperactive SNS
2. calcium +
3. prostaglandins
4. throboxane abnormalities. |
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Term
| Unstable angina is most likley the result of |
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Definition
| a transient thormbus formation in a coronary |
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Term
| Silent Ischemia is most often seen in what patient population |
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Definition
| Pts who have denervation of their hearts (Transplant patients) or those with diabetes who have neuropathies making it less likely to feel pain associated with myocardial ischemia are MOST AT RISK. |
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Term
| Would a subendocardial MI or transmural MI result in a Non-stemi? Which one would result in a STEMI |
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Definition
Subendocardial only: means only inner part of myocardium is effected = NSTEMI
Transmural = all of myocardium effected resulting in a STEMI |
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Term
| Troponins rise within how many hours? Peak within? |
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Definition
| Rise in 3-6 hours and peak in 24 hours. |
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Term
| Prehypertension is a bp of |
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Definition
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Term
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Definition
|
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Term
| what is intermittent claudication? |
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Definition
| An intermittent burning pain in the legs more commond during walking and goes away with rest. More common in men. Its related to decrease arterial flow to legs. Temporarily from vasospasms or permanently damaged from atherosclerosis |
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Term
| Blood cardiac markers will be high in what types of ACS |
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Definition
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Term
| Need a healthy endothelium in the coronaries to prevent thrombus and MI. So what exactly is in a healthy endothelium that prevents occlusions |
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Definition
1. Prostacycline - vasodilatory
2. NO - vasodilatory
3. Anti-thrombin - Prevents clots |
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Term
| What two EKG signs indicate mostly ischemia |
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Definition
1. T wave inversion
2. ST Depression |
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Term
| what zones of an MI will recoveR? And how long does it take |
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Definition
| Zone of injury and Zone of ischemia will recover typically in 2-3 weeks post MI. Zone of infarcted will not recover. |
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Term
| What is the rise, peak, and duration of CK enzymes (CK and CK-MB) |
|
Definition
Rise: 4-6 hours
Peak: 18-24 hours
Duration: 2-3 days |
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Term
| What is the Rise, peak and duration of troponin enzymes |
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Definition
Rise: 3-6 hourse
Peak: 18-24 hours
Duration: Trop T: 10-14 days
Trop 1: 7-10 days. |
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Term
| inferior MI will involve what coronaries |
|
Definition
1. RCA*
2. left circumflex |
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Term
| Lateral wall MI will involve what coronary |
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Definition
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Term
| Anterior wall MI will involve what coronary |
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Definition
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Term
| Posterior wall MI will involve what coronaries |
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Definition
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Term
| Anteroseptal wall MI will involve what coronary |
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Definition
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Term
| Whats the difference between clinical classifications of MI |
|
Definition
Type 1: Spontaneous from plaque rupture, ulceration or dissection.
Type 2: all others, direct pathology of vessels, vasospasms, endothelial dysfunciton, demand ischemia,
Type 3: Cardiac arrest
Type 4/5: revascularization procuedures (CABG or PCI) |
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Term
| Sx of pericardial effusion resulting in tamponade |
|
Definition
1. decrease pulse pressure
2. tachycardia
3. Increase JVP |
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|
Term
| What type of cardiomyopathy is associated with aortic stenosis |
|
Definition
| hypertrophic cardiomyopathy |
|
|
Term
| what are the two types of hypertrophic cardiomyopathy |
|
Definition
1. Asymmetric septal hypertrophy
- outflow obstruction
2. Hypertensive or valvular hypertrophy
-Secondary to AS or Bad HTN |
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|
Term
| 3x causes of Aortic stenosis |
|
Definition
1. inflammation from Rheumatic heart disease
2. congenital malformation
3. degeneration, thickening or calcification of valve over time |
|
|
Term
| what are the three classical signs of aortic stenosis |
|
Definition
1. Angina
2. dyspnea on exertion
3. syncope |
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|
Term
| what type of hypertrophy does AS cause |
|
Definition
|
|
Term
| What is the echo findings for severe aortic stenosis |
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Definition
| Valve orifice < 0.5 cm^2 and valve pressure gradient 50 or higher. |
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Term
| Rheumatic heart disease is caused by |
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Definition
| Group A hemolytic streptococcus. IT is usually a delayed immune/inflammatory response to the bacteria. |
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Term
| What percentage of strep throat victims go on to get Rheumatic heart fever? What percetnage of those gets the disease |
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Definition
| 3% gets fever from Strep throat. Out of those 3% about 10% will develop the disease. |
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Term
| What are the Sx of Rheumatic heart disease/fever |
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Definition
1. febrile
2. joint pain
3. scarring of heart valves
4. involvement of skin and nervous system |
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Term
| who is at risk for infective endocarditis |
|
Definition
1. males
2. prosthetic valves
3. central lines
4. IV drug abuse
5. Cardiac Surgery |
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Term
| what pressor would be your first choice for a patient with aortic stenosis |
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Definition
| Phenyl because these patients hearts have been restructured to work best in high SVR environments. So given phenyl which will increase afterload and meet the needs of the AS |
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Term
| aortic regurgitation will lead to what kind of HF |
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Definition
| dilated cardiac myopathy which will result in eccentric hypertrophy |
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|
Term
| normal aortic valve orifice is |
|
Definition
|
|
Term
| how to treat severe Aortic regurgitaion |
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Definition
| decrease afterload, increase preload and increase HR so that you favor forward flow and longer systole and shorter diastole (the time when blood goes the wrong way) |
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Term
| clinical management of mitral prolapse would be to |
|
Definition
1. give digoxin to increase contraction and tighten those papillary muscles
2. beta blockers to increase diastole and large volumes that can pull tighter on papillary muscles
3. diuretics to decrease afterload but not too much because hypovolemia is really bad. |
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