Systems Pathology - The heart pg 51-75

congenital narrowing of aorta

aortic coarctation

who is most likely to get an aortic coarctation?

males, turner syndrome

what type of aortic coarctation is associated with PDA and causes shunting of blood from pulmonary trunk to aorta

infantile (pre-ductal)

infantile aortic coarctation causes what?

cyanosis, hypoxia, R ventricular hypertrophy

what type of aortic coarctation is associated with the ligamentum arteriosum, MC asymptomatic, and causes increased BP in head/upper extremities but lower BP in lower extremities/kidneys

adult (post-ductal)

how does aortic coarctation occur?

narrowing restricts flow to lower extremities

group of conditions following ischemia

ischemic heart disease

ischemia to heart causes infarction after how long?

20-40 minutes

what is associated with 90% of IHD cases?

CAD

progression of IHD causes what?

fatty streaks, atheroma, luminal stenosis, thrombosis

acute cardiac syndromes (caused by sudden and significant ischemia)

angina pectoris, acute MI, sudden cardiac death, chronic IHD->CHF

(stable) cardiac chest pain that is a result of ischemia associated with a 70% occluded coronary artery with exertion substernal chest pain, back, jaw, left arm and shoulder pain which responds to rest and vasodilators

stable angina pectoris

how does stable angina pectoris occur?

slow growing atherosclerotic plaques causing stenosis

risk associated with developing angina pectoris (both types)

poor diet, ↓ exercise, dyslipidemia, smoking

(unstable) cardiac chest pain that is a result of ischemia associated with 90% occluded coronary artery with or without exertion, not improved by rest or vasodilating meds

unstable angina pectoris

how does unstable angina pectoris occur?

acute plaque disruption with significant and acute clotting of vessel

what is associated with angina pectoris in females?

nausea, dizziness, back pain, "discomfort" in lower chest/epigastric region, dyspnea and fatigue

myocardial cell death due to ischemia

myocardial infarction (MI)

how does someone get a MI?

acute plaque disruption with significant/acute clotting of vessel

artery MC involved in a MI

left anterior descending

risk associated with myocardial necrosis

HTN, smokin, CHF, diabetes, males age 40-60, postmenopausal females, sickle cell disease, amyloidosis

symptoms of MI

"crushing" pain, intense pressure, thready pulse, dyspnea, nausea, sweaty

cardiac markers

troponin, CK-MB, myoglobin