Cardiac
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What is CHD
Coronary Heart Disease
What is IHD
Ischemic Heart Disease
What exactly is CHD (4)
The atherosclerosis of the arteries that supply the heart The arteries which start out smooth and elastic get plaque on their inner walls which can make them more rigid and narrowed This restricts blood flow to your heart, which can then become starved of oxygen The plaque can rupture, leading to a heart attack or sudden cardiac death When this occurs, immediate emergency treatment is necessary to stop the injury from widening, killing additional heart cells, and increasing the risk of complications or death
What are the 5 steps to a heart attack
Plaque rupture Coronary thrombus Reduced blood flow Myocardial ischaemia Myocardial infarction
What are the steps of progression in CHD?
Angina -> unstable angina -> AMI -> sudden cardiac death
What is ACS
Acute coronary syndrome
What does acute coronary syndrome encompass?
Unstable angina [UA] Non-ST-segment elevation myocardial infarction (NSTEMI) ST-segment elevation myocardial infarction (STEMI)
What is NSTEMI
Non-ST-segment elevation myocardial infarction
What is STEMI
ST-segment elevation myocardial infarction
What is stable angina?
Transient episodic chest pain due to myocardial ischaemia, reproducible, frequency constant over time, usually relieved with rest/Nitroglycerin
What is left ventricular hypertrophy [LVH]?
Enlargement and thickening (hypertrophy) of the walls of your heart’s main pumping chamber (left ventricle)
What might cause left ventricular hypertrophy?
High blood pressure or a heart condition that causes the left ventricle to work harder
What is the cardiac muscle cell called?
Myocyte
Comment on myocardial proteins as biomarkers
Size and subcellular distribution of myocardial proteins determines time course of biomarker appearance in the general circulation
Classify laboratory tests used in cardiac disease (4)
Markers of cardiac tissue damage Markers of myocardial function Cardiovascular risk factor markers Genetic analysis for candidate genes or risk factors
Describe how cardiac markers are used
Ischemia -> hypoxia -> decreased ATP -> cell damage Reperfusion within 15 to 20 minutes
What is the clinical definition of myocardial infarction?
Myocardial infarction denotes presence of acute myocardial injury detected by abnormal cardiac biomarkers in the setting of evidence of acute myocardial ischemia
What is the laboratory definition (4th Universal Definition) of myocardial infarction?
The detection of a rise and/or fall of cardiac biomarker values, with at least one of the values being elevated i.e. > 99th percentile upper reference limit In addition at least one abnormal change in ECG or imaging changes
What is the preferred biomarker used in detection of Myocardial Infarction?
cTn
Write about cTN (3)
Cardiac specific form of Troponin (T or I) The preferred cardiac biomarker of necrosis It is highly sensitive and specific
What is myocardial injury
Patients with elevated blood troponin levels but without clinical evidence of ischemia
What is ischemia
Diminished blood supply to any tissue or organ of the body, causing a shortage of oxygen
In your own words what is myocardial infarction
Elevated blood troponin levels AND clinical evidence of ischemia
What specific type of cTn is used in investigation of MI
High-sensitivity cardiac troponin