Exam 4: Coronary Artery Disease (Lecture 4)

Atherosclerosis is the most common cause of _____________________, which is defined as any vascular disorder that _____________________ or occludes the coronary arteries

coronary artery disease

narrows

Traditional risk factors of coronary artery disease include dyslipidemia, _____________________, smoking, _____________________, obesity, and _____________________ lifestyle

hypertension

diabetes

sedentary

Other risk factors of coronary artery disease are markers of _____________________ and/or thrombosis, such as protein _______, _____________________, C-reactive protein, etc, infection, _____________________-homocyteinemia

inflammation

C

fibrinogen

hyper

Local, temporary deprivation of the coronary blood supply is called _____________________

myocardial ischemia

What are the types of myocardial ischemia?

stable

prinzmetal

silent

What is angina pectoris?

chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood; usually an indication of CAD

What abnormality occurs in the ECG of a myocardial ischemia?

ST shift

Causation of myocardial ischemia?

acute mental stress > central and autonomic nervous activity > physiologic responses > cardiac effects > pathologic results > cardiac event

Physiologic responses of myocardial ischemia include increases in catecholamines, _____________________, _____________________, coronary _____________________, and _____________________ activity

heart rate

blood pressure

constriction

platelet

Cardiac effects of myocardial ischemia include increased _____________________ instability and _____________________; decreased _____________________ (in reference to O2)

electrical

demand

supply

Myocardial ischemia can be due to ventricular arrythmias, _____________________, plaque _____________________, and coronary _____________________

ischemia

rupture

thrombosis

Cardiac events of myocardial ischemia include sudden cardiac _____________________ or _____________________

death

infarction

Occlusion of the _____________________ coronary artery causes posterior/_____________________ myocardial infarction

right

inferior

Occlusion of the _____________________ coronary artery causes lateral myocardial infarction

left

Occlusion of the LAD artery causes _____________________ myocardial infarction

antroseptal

Occlusion of the _____________________ coronary artery causes _____________________ anterolateral myocardial infarction

left

massive

Acute coronary syndrome encompasses _____________________ ischemia, _____________________ angina, sustained ischemia, _____________________, and myocardial _____________________ with necrosis

transient

unstable

myocardial infarction

inflammation

Sustained ischemia causes myocytes to be _____________________ or _____________________

stunned

hibernating

_____________________ and necrosis leads to myocardial _____________________

myocardial infarction

remodeling

Myocardial infarction is the sudden and extended _____________________ of myocardial blood supply

obstruction

Subtypes of myocardial infarction include _____________________ infarction and _____________________ infarction

subendocardial

transmural

Myocardial infarction causes cell death and _____________________, structure/_____________________ changes, and eventually _____________________

injury

function

repair

Changes from myocardial infarction include myocardial _____________________, hibernating _____________________, and remodeling

stunning

myocardium

Disorders of the pericardium include:

acute pericarditis

pericardial effusion

constrictive pericarditis

Acute pericarditis is _____________________ to the pericardium

inflammation

Pericardial effusion is fluid in/around the pericardium, which can lead to ____________________ when that fluid puts pressure on the heart

tamponade

_____________________ occurs when the pericardium thickens and scars, making it less elastic and more rigid.

constrictive pericarditis

Disorders of the myocardium include:

dilated/congestive cardiomyopathy

hypertrophic cardiomyopathy

restrictive cardiomyopathy

What are the 2 types of hypertrophic cardiomyopathy?

asymmetric septal

hypertensive/valvular hypertrophic

Disorders of the endocardium include:

stenosis

regurgitation

mitral valve prolapse

Stenosis is _____________________ of the _____________________ or _____________________ valves

narrowing

aortic

mitral

Regurgitation is _____________________ of the _____________________, _____________________, or _____________________ valves

leakage

aortic

mitral

tricuspid

Valves are open with _____________________ pressure and close due to _____________________ pressure

forward

backward

_____________________ valves are thin/filmy. Prolapse is prevented by _____________________ and the tension is maintained by _____________________ muscles

AV

chordae tendinae

papillary

_____________________ valves have stronger construction.

semilunar

Infective endocarditis is _____________________ of endocardium. It is caused by _____________________, _____________________, fungi, rickettsiae, and _____________________

inflammation

bacteria

viruses

parasites

Mechanism of infective endocarditis includes "_____________________" endocardium, _____________________ microorganism adherence, and proliferation of the organism

prepared

blood-borne

Rheumatic fever is a diffuse inflammatory disease caused by _____________________ immune response to infection by _____________________ hemolytic strep

delayed

Group AB

If untreated, rheumatic fever could lead to _____________________

rheumatic heart disease

AIDS complications could lead to:

myocarditis

endocarditis

pericarditis

cardiomyopathy

_____________________ is a general term used to describe cardiac dysfunction that results in inadequate _____________________ of tissues with blood-borne nutrients

heart failure

perfusion

_____________________ heart failure is the inability of the heart to _____________________ blood

systolic

pump

_____________________ heart failure is the inability of the heart to _____________________/_____________________ blood. It can lead to _____________________ congestion

diastolic

stretch

fill with

pulmonary

Right-sided heart failure is commonly caused by diffuse _____________________ pulmonary disease

hypoxic

Right sided heart failure is increased _____________________ filling pressure reflected back into _____________________ circulation

left ventricle

pulmonary

_____________________ heart failure is inability of the heart to supply nutrients despite adequate blood volume and normal/elevated contractility

high-output