Ischemic Heart Disease
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| What is "critical stenosis" | when the coronary flow is decreased by >75% and there is decreased coronary flow at rest
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| What is Prinzmetal angina | Angina due to coronary artery spasm
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| What are the four ischemic syndromes of ischemic heart disease | Myocardial Infarction, Angina, Sudden Cardiac Death, Chronic Ischemic Heart Disease
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| The acute event of a myocardial infarction is due to ? in 80-90% of cases | a fresh thrombus overlying an ulcerated or fissured atherosclerotic plaque
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| What is more common a RV or LV infarction | LV (a RV infaction may occur as part of a massive LV infarct but rare as an isolated primary event)
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| What Coronary is most likely affected LCCA, RCA or LAD? | LAD
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| What part of the heart is affected when there is a lesion in the LAD | Ant wall LV, Ant. 2/3 of the septum
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| What part of the heart is affected when there is a lesion in the RCA | Post. Wall LV, post 1/3 septum
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| What part of the heart is affected when there is a lesion in the LCCA | Lateral wall LV
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| Gross findings 12 hours after Occlusion | No change/pallor
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| Gross findings 24-48 hours after occlusion | pallor-tan yellow
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| what gross changes are noted 3-5 days after occlusion | tan yellow soft center, hyperemic borders
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| what gross changes are noted in the heart 6-10 days after occlusion | tan yellow depressed central infarct, tan-red margins
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| what gross changes are noted 10-14 days after occlusion | grey-red borders infiltrating central tan-yellow infarct if large
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| what gross changes are noted 2-8 weeks after occlusion | gelatinous to grey white scar greater healing at border zone
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| what does granulation tissue form following a MI | 10-14 days
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| when do PMNs show up at the borders of the infarcted area following an MI | 24-48 hours
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| when does collagen deposition start following an MI | 2-8 weeks
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| what biochemical changes can be looked for with markers during an MI | increased Ck-MB, LDH-1, and cardiac troponin
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| what are some ECG changes noted during an MI | Inverted T wave, Elevated ST segment, and abnormal Q waves
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| What cardiac arrythmia results in a large number of deaths in MI patients | Vfib
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| AV node block is common after what type of MI | posterior MI (RCA supplies SA and AV nodes)
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| Ischemia/necrosis of anterioseptal infarcts (LAD) can result in what type of heart block | Bundle Branch Block (especially the bundle of His and LBB)
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| When would you typically see Pericarditis following an MI? | within the first 2-3 days of a transmural infarct
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| when is the maximum cardiac wall weakness following an MI (concern for rupture) | maximum weakness is 5-7 days following the MI
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| when do you worry about ventricular aneurysms following an MI | 2 weeks to several months
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| how is unstable angina defined | progression or increased frequency and intesity of angina pain or occuring at rest
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| What is the cause of an angina that occurs at rest with ST elevation and negative enzymes | coronary artery spasm (prinzmetal angina)
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