Ischemic Heart Disease Lecture Review

Comprehensive vocabulary flashcards covering the pathophysiology, symptoms, types of angina, diagnostic criteria, and treatments for ischemic heart disease based on lecture notes.

Ischemic heart disease

A condition characterized by an imbalance between myocardial oxygen supply and demand, most frequently caused by atherosclerosis of the coronary arteries.

Ischemia

The condition where the demand for oxygenated blood in the heart muscle (myocardium) is higher than the supply.

Stenosis

A partial or complete blockage in the coronary arteries that prevents blood from flowing to the heart muscle.

Coronary Perfusion Timing

Unlike other arterial systems, the predominance of coronary flow occurs during diastole because the relaxed myocardium does not compress the coronary vasculature.

Inotropic state

A term for contractility; increased contractions result in higher oxygen consumption and higher demand.

Stenosis narrowing $< 60 \, \%$

Narrowing that leads to adequate blood flow in response to exertion.

Stenosis narrowing $> 70 \, \%$

Narrowing where resting blood flow is normal, but maximum blood flow is reduced even with fully dilated vessels, resulting in myocardial ischemia.

Stenosis narrowing $> 90 \, \%$

Narrowing where blood flow may be inadequate to meet basal requirements even with maximal dilatation, potentially leading to ischemia at rest.

Hypovolemia

A condition characterized by a decrease in the volume of blood plasma or other body fluids, often due to blood loss or severe dehydration.

Septic shock

A life-threatening condition arising from an extreme immune response to infection (sepsis), characterized by dangerously low blood pressure.

Marked anemia

A significant reduction in red blood cell count or hemoglobin levels, causing a deficiency in oxygen delivery to body tissues.

Stunned myocardium

Tissue that demonstrates prolonged systolic dysfunction after an episode of severe acute, transient ischemia, even after normal blood flow returns.

Hibernating myocardium

Tissue manifesting chronic ventricular contractile dysfunction due to persistently reduced blood supply (usually multivessel CAD) that can improve if blood flow is restored.

Myocardial Infarction (MI)

A region of myocardial necrosis usually caused by a prolonged cessation of blood supply.

Angina Pectoris

The most common manifestation of ischemic heart disease, meaning "strangling in the chest," which may radiate to the left shoulder, arms, or jaw.

Stable angina

Also called exertional or effort angina; occurs with physical exercise or emotional upset, is predictable, and is relieved by rest or medication within $1-5 \, \text{minutes}$.

Unstable angina

Chest pain occurring suddenly and unexpectedly at rest; it is more severe, prolonged, or frequent than previous episodes and is a strong indicator of acute Myocardial Infarction.

Variant angina (Prinzmetal angina)

Typical anginal discomfort, usually at rest, caused by coronary artery vasospasms rather than an increase in myocardial demand.

Silent Ischemia

Asymptomatic episodes of myocardial ischemia without pain, diagnosed through abnormalities on Echo or Stress Echo testing.

STEMI

ST-segment elevation myocardial infarction; indicates a complete blockage of a coronary artery leading to transmural ischemia and significant muscle death.

NSTEMI

Non-ST-segment elevation myocardial infarction; typically involves a partial blockage or temporary clot, often resulting in subendocardial ischemia (ST depression or T-wave inversion).

Target Heart Rate (Stress Testing)

Achieving $85 \, \%$ of the maximal predicted heart rate (MHR), where MHR is calculated as $220 \, \text{beats/min} - \text{patient\u2019s age}$.

Coronary Angiography

The most direct means of identifying coronary artery stenosis by injecting radiopaque contrast dye through a catheter to visualize lesions via fluoroscopy.

Beta 1 receptors

Receptors located in the cardiac muscle that, when acted upon, increase heart rate and contraction.

Beta 2 receptors

Receptors that, when acted upon, dilate bronchial smooth muscle.

Ca++ Channel Blockers

Pharmaceuticals that act on the vasculature to block $Ca^{++}$ entry, causing vasodilation.

PCI (percutaneous coronary intervention)

A procedure involving a catheter with a balloon to widen a narrowed artery, often followed by placement of a mesh stent to keep it open.

CABG (coronary artery bypass graft)

A surgical treatment involving grafting a healthy blood vessel to bypass a blockage and restore blood flow.

Myocardial enzyme markers

Biochemical indicators used for diagnosis including Creatine kinase, Troponin, and C Reactive Protein.

Septal rupture

A complication of ischemia where a rupture in the septum results in an acute VSD (Ventricular Septal Defect).