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| Question | Answer |
| How does hypercholesterolmia result in CAD? | Elevated cholesterol level >> changes in structure and function in cell membranes >> Affects myocardial conduction, excitability and contractility >> Additional smooth muscle and endothelial dysfunctions, enzyme activity, ion balance |
| What is the cause and timeline of atherosclerosis? | Trauma in intima of the arterial wall. 1. Cholesterol build up and fatty deposit (LDL) on smooth muscle of media 2. Macrophage infiltration 3. Single or multiple lipid cores 4. Fibrotic plaque 5. Inflammation 6. Possible thrombosis |
| How can HBP become a risk factor of atherosclerosis? | 1. Increased pressure 2. Increased likelihood for turbulence to damage the endothelial wall 3. Damaging the intima, exposing the media, which is the primary site of atherosclerosis. |
| How is smoking a potential risk factor of atherosclerosis? | 1. Cigarette smoke is high in carbon monoxide and hydrocarbon 2. Carbon monoxide and hydrocarbon bind to RBC and can be deposited on endothelial walls 3. Increased likelihood of endothelial trauma |
| How is diabetes a risk factor of atherosclerosis? | 1. Reduced contractility of the heart 2. Reduced calcium handling in the sarcoplasmic reticulum of the muscles |
| What are the results of atherosclerosis on oxygen delivery? | 1. decreased blood flow (ischemia) 2. decreased oxygenation (hypoxia) 3. complete lack of blood flow and oxygen (anoxia) |
| Clinical consequences of atherothrombosis are __________, ________, and _________. | 1. acute coronary disease 2. ischemic stroke 3. peripheral arterial disease |
| Why do people with hypothyroidism have higher risk of cardiac dysfunctions? | 1. T3 can induce relaxation of the vascular smooth muscle, reducing resistance and diastolic BP. 2. Hypothyroidism = less T3 available = increased vascular resistance. 3. Hypothyroidism also results in reduced cardiac contractility and CO. |
| What are some modifiable risk factors of atherosclerosis? | 1. hypertension 2. hyperlipidemia 3. obesity 4. smoking 5. abnormal glucose tolerance/ diabetes 6. stress level 7. activity level |
| What is angina pectoris? | Chest pain that is related to ischemia of the myocardium. |
| What are some referral patterns of angina? | left shoulder, neck, jaw, between shoulder blades |
| Which two factors are the most likely to cause onset of stable angina? | 1. physical exertion 2. stress |
| What are the differences between stable and unstable angina in terms of clinical presentation | Unstable angina is usually: 1. more frequent 2. Longer than 15 min duration 3. more intense 4. less responsive to rest and sublingual nitrates |
| If pain is intense, prolonged and sometimes accompanied with dysrhythmia, the patient is more likely having ____ angina. | Variant |
| What is an MI? | MI (myocardial infarction) is a necrosis of a portion of the myocardium, as a result of ischemia or anoxia. |
| Which main vessels are involved in the blood supply to the heart? | 1. Right and left coronary arteries 2. Their anterior and posterior descending branches. |
| Where does the RCA supply? | 1. Posterior section and part of the inferior section of the LV. 2. Right atrium and ventricle 3. AV bundle |
| What does the LCA perfuse? Which arteries does the LCA branch into, and their respective perfusion? | LCA itself: left atrium and primary portions of the conduction pathway 1. circumflex artery (lateral portion of LV) 2. anterior descending artery (anterior portion of LV) |
| Complicated MI involves one or a combination of the following: | 1. dysrhythmia 2. heart failure 3. thrombosis 4. damage to the heart structures |
| Heart failure is a condition when _________. | The heart is weakened by myocardial damage and is unable to provide cardiac output to meet the body's metabolic demand. |
| T/F: heart failure is ALWAYS a result of ischemia and infarction. | F. There is also congestive heart failure. |
| DVT is usually in the ________. It may have effect on the ______ system. | LE. Pulmonary system. |
| T/F: Thrombosis in the mural wall may result in embolus in the brain, intestine, kidney, artery to the extremities, or any location in the systemic arterial circulation. | T. |
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