Week 9 Part 2 - Framingham Heart Study and Myocardial Infarctions

Lack of physical activity leads to high blood __________, vascular injury, inflammation, endothelial destruction, and obesity.

cholesterol

__________ causes endothelial injury due to high blood pressure (HBP), vascular inflammation, and an increase in LDL buildup in arteries.

hypertension

High levels of __________ from long-term stress can increase blood cholesterol, blood sugar, and blood pressure through vasoconstriction.

cortisol

Increased blood pressure promotes endothelial dysfunction and plaque formation, raising ___________ and ____________.

TPR and BP

__________ heart disease is often caused by coronary artery disease, which results from plaque buildup.

ischemic

The most common occlusion in coronary artery disease occurs in the __________ artery.

Left Anterior Descending (LAD)

Right coronary artery occlusions may cause ischemia of the __________, leading to bradycardia and arrhythmias.

nodes

Stable or exertional __________ occurs with activity and disappears with rest, typically when blockage is less than 70%.

angina pectoris

__________ angina pectoris occurs with more severe blockage, and it may happen even during sleep.

unstable

__________ occurs with total occlusion of a coronary artery, resulting in heart attack and irreversible loss of muscle mass.

myocardial infarction

__________ angina is a type of chest pain that occurs at rest and is caused by a coronary artery spasm.

Prinzmetal's

The spasm in Prinzmetal's angina may occur at or near __________.

plaque deposits

A coronary artery spasm in Prinzmetal's angina can also occur in __________ vessels.

normal

Prinzmetal's angina is typically managed with __________.

nitroglycerin

Acute Coronary Syndrome refers to a range of conditions in which blood flow to the heart __________.

decreases

_____________ includes myocardial infarction, unstable angina, and sudden cardiac arrest.

Acute Coronary Syndrome

Acute Coronary Syndrome occurs due to abrupt plaque changes, such as __________ or __________, followed by thrombosis.

erosion, rupture

Acute plaque erosion is caused by __________ injury.

endothelial

Acute plaque eruption involves an unstable plaque with a __________ fibrous cap.

thin

Many patients suffering from Acute Coronary Syndrome are often __________ before plaque rupture.

asymptomatic

A large number of asymptomatic adults are at significant risk for __________, and it is impossible to predict __________.

acute coronary syndrome, plaque rupture

Less than 50% of heart attacks are __________.

fatal

A patient with a heart attack usually has a history of __________.

angina

A common description of the pain during a heart attack is "I feel like an __________ was standing on my chest."

elephant

Pain referral patterns in a heart attack can include the left or right shoulder, medial arm, neck, and __________.

jaw

Most of the time, heart attacks are missed in women because they have __________ symptoms.

different

A common symptom of a heart attack in women is unexplained __________ and fatigue

shortness of breath

Women may experience __________, nausea, high anxiety, rapid pulse, and color/temperature changes during a heart attack.

diaphoresis

Heart attacks can also occur in __________, but this is rare and often associated with congenital heart disease.

children

After a heart attack, muscle is replaced by __________ over several days.

scar tissue

Scar tissue in the heart won't conduct, which can lead to __________.

arrhythmia

Scar tissue won't contract, which can lead to ___________.

congestive heart failure

If scar tissue blows out, it can lead to a transmural infarct, which may result in ______________.

cardiac tamponade

____________ is characterized by a sudden loss of consciousness associated with a loss of postural tone.

syncope

____________ syncope occurs when the heart doesn't pump enough blood to the brain.

cardiac

Cardiac syncope may be the first symptom of __________ due to arrhythmia or pump failure.

acute coronary syndrome

A ____________ is characterized by a sudden loss of postural tone without the loss of consciousness.

drop attack

Drop attacks can be a symptom of vertebrobasilar insufficiency, a type of _______________.

transient ischemic attack

The __________ wave represents atrial depolarization, which occurs due to Na+/Ca2+ influx.

P

The __________ complex represents ventricular depolarization and also covers the atrial repolarization.

QRS

The __________ is flat because the ventricles have fully depolarized.

ST segment

The __________ wave represents ventricular repolarization, which occurs due to K+ efflux.

T

__________ infarction involves the full thickness of the ventricles and results in ST segment elevation, pathological Q waves, and T wave inversion.

transmural

A transmural infarction is also called __________.

ST segment elevated MI (STEMI)

__________ infarction involves the inner third of the ventricle wall and does not exhibit ST segment elevations or pathological Q waves. It may exhibit ST segment depression or T wave inversion.

subendocardial

A subendocardial infarction is also called __________.

non ST segment elevated MI (NSTEMI)

The most common symptoms of ischemic heart disease are associated with __________ referral patterns.

pain

An abnormal EKG or ECG may show___________ and ___________, suggesting ischemia due to insufficient oxygen for electrical conduction.

ST segment shifts and inverted T waves

When myocardial cells are damaged, __________ are released into the bloodstream.

enzymes

One common biomarker for myocardial infarction (MI) is __________, which rises within 2-4 hours of MI, peaks at 24-48 hours, and returns to normal in 72 hours.

Creatine kinase

The most sensitive biomarker for MI is __________, which is detectable within 2-4 hours of MI, peaks at 48 hours, and remains elevated for 7-10 days.

Troponin

An __________ is used to inject dye into the coronary artery to visualize blood flow and identify blockage areas.

angiogram