Pathoma: Chapter 8- Questions and Answers
How do you relieve unstable angina Correct Ans-Nitroglycerin
What is the risk of unstable angina Correct Ans-Progression to MI
Prinzmetal angina definition Correct Ans-Episodic chest pain unrelated to exertion but
caused by coronary artery vasospasm (artery clamps down and cuts blood supply)
Is prinzmetal angina reversible or irreversible injury in myocytes? Correct Ans-Reversible
What does EKG show in unstable angina and why? Correct Ans-ST-segment elevations due
to transmural ischemia
What relieves unstable angina Correct Ans-Nitroglycerin or Ca channel blockers (to relieve
vasospasm)
Myocardial infarction definition Correct Ans-Necrosis of cardiac myocytes
What usually causes MI? Name three lesser causes Correct Ans-Rupture of atherosclerotic
plaque with thrombosis and complete occlusion of a coronary artery
Other causes: prinzmetal angina, vasculitis, emboli
, Pathoma: Chapter 8- Questions and Answers
Is it complete or incomplete occlusion of a coronary artery in MI? Correct Ans-Complete
Clinical features of MI Correct Ans-Crushing chest pain for more than 20 minutes that
radiates to left arm or jaw, diaphoresis, dyspnea, symptoms not relieved by nitroglycerin
Does nitroglycerin relieve MI symptoms? Correct Ans-No
What ventricle is usually involved in MI and what ventricles are usually spared? Correct
Ans-LV involved usually
RV and both atria are generally spared
What are the three most commonly involved coronary arteries in MI and what areas of the
heart do they affect? Correct Ans-LAD: affects anterior LV wall and anterior septum
Right Circumflex: affects posterior LV wall and posterio septum and LV papillary muscles
Left Circumflex: affects lateral wall of LV
What part of the myocardial wall does the initial phase of infarction involve? Correct Ans-
Subendocardial necrosis involving less than 50% of the myocardial thickness (ST depressions)
What does continued or severe ischemia in MI cause on EKG, and why? Correct Ans-ST
segment elevations due to transmural infarction
, Pathoma: Chapter 8- Questions and Answers
What are the two laboratory tests to detect MI? Correct Ans-Troponin I (peaks 2-4 hours
after infarction and returns to normal 7-10 days later)
CK-MB (reinfarction, returns to normal by 72 hours)
Ischemic Heart Disease Definition Correct Ans-Group of syndromes related to myocardial
ischemia
Ischemia Correct Ans-Decreased blood flow to an organ
What is the leading cause of death in US? Correct Ans-Ischemic heart disease
What usually causes IHD? Correct Ans-Atherosclerosis of coronary arteries, decreasing
blood flow to myocardium
What are risk factors for IHD? Correct Ans-Similar to those for atherosclerosis; incidence
increases with age
Stable angina definition Correct Ans-chest pain that arises with exertion or emotional
stress
What causes stable angina? Correct Ans-Atherosclerosis of coronary arteries with over
70% stenosis, so decreased blood flow can't meet metabolic demands of the myocardium on
exertion
, Pathoma: Chapter 8- Questions and Answers
Does stable angina represent reversible or irreversible injury to myocytes? Correct Ans-
Reversible
What is the hallmark of reversible cell injury? Correct Ans-Cellular swelling
How does stable angina present? Correct Ans-Chest pain lasting less than 20 minutes that
ratiates to left arm/jaw, perhaps with diaphoresis and shortness of breath
What does an EKG in stable angina show? Correct Ans-ST segment depression due to
subendocardial ischemia
What area of the heart is most susceptible to damage with coronary atherosclerosis?
Correct Ans-Subendocardium
Name the three layers of the heart; in which layer do the coronary arteries begin? Correct
Ans-Epicardium; myocardium; endocardium; coronary arteries begin in the epicardium
How do you relieve stable angina Correct Ans-Rest or nitroglycerin
What is nitroglycerin's mechanism of action? Correct Ans-Vasodilation of arteries and
veins
How do you relieve unstable angina Correct Ans-Nitroglycerin
What is the risk of unstable angina Correct Ans-Progression to MI
Prinzmetal angina definition Correct Ans-Episodic chest pain unrelated to exertion but
caused by coronary artery vasospasm (artery clamps down and cuts blood supply)
Is prinzmetal angina reversible or irreversible injury in myocytes? Correct Ans-Reversible
What does EKG show in unstable angina and why? Correct Ans-ST-segment elevations due
to transmural ischemia
What relieves unstable angina Correct Ans-Nitroglycerin or Ca channel blockers (to relieve
vasospasm)
Myocardial infarction definition Correct Ans-Necrosis of cardiac myocytes
What usually causes MI? Name three lesser causes Correct Ans-Rupture of atherosclerotic
plaque with thrombosis and complete occlusion of a coronary artery
Other causes: prinzmetal angina, vasculitis, emboli
, Pathoma: Chapter 8- Questions and Answers
Is it complete or incomplete occlusion of a coronary artery in MI? Correct Ans-Complete
Clinical features of MI Correct Ans-Crushing chest pain for more than 20 minutes that
radiates to left arm or jaw, diaphoresis, dyspnea, symptoms not relieved by nitroglycerin
Does nitroglycerin relieve MI symptoms? Correct Ans-No
What ventricle is usually involved in MI and what ventricles are usually spared? Correct
Ans-LV involved usually
RV and both atria are generally spared
What are the three most commonly involved coronary arteries in MI and what areas of the
heart do they affect? Correct Ans-LAD: affects anterior LV wall and anterior septum
Right Circumflex: affects posterior LV wall and posterio septum and LV papillary muscles
Left Circumflex: affects lateral wall of LV
What part of the myocardial wall does the initial phase of infarction involve? Correct Ans-
Subendocardial necrosis involving less than 50% of the myocardial thickness (ST depressions)
What does continued or severe ischemia in MI cause on EKG, and why? Correct Ans-ST
segment elevations due to transmural infarction
, Pathoma: Chapter 8- Questions and Answers
What are the two laboratory tests to detect MI? Correct Ans-Troponin I (peaks 2-4 hours
after infarction and returns to normal 7-10 days later)
CK-MB (reinfarction, returns to normal by 72 hours)
Ischemic Heart Disease Definition Correct Ans-Group of syndromes related to myocardial
ischemia
Ischemia Correct Ans-Decreased blood flow to an organ
What is the leading cause of death in US? Correct Ans-Ischemic heart disease
What usually causes IHD? Correct Ans-Atherosclerosis of coronary arteries, decreasing
blood flow to myocardium
What are risk factors for IHD? Correct Ans-Similar to those for atherosclerosis; incidence
increases with age
Stable angina definition Correct Ans-chest pain that arises with exertion or emotional
stress
What causes stable angina? Correct Ans-Atherosclerosis of coronary arteries with over
70% stenosis, so decreased blood flow can't meet metabolic demands of the myocardium on
exertion
, Pathoma: Chapter 8- Questions and Answers
Does stable angina represent reversible or irreversible injury to myocytes? Correct Ans-
Reversible
What is the hallmark of reversible cell injury? Correct Ans-Cellular swelling
How does stable angina present? Correct Ans-Chest pain lasting less than 20 minutes that
ratiates to left arm/jaw, perhaps with diaphoresis and shortness of breath
What does an EKG in stable angina show? Correct Ans-ST segment depression due to
subendocardial ischemia
What area of the heart is most susceptible to damage with coronary atherosclerosis?
Correct Ans-Subendocardium
Name the three layers of the heart; in which layer do the coronary arteries begin? Correct
Ans-Epicardium; myocardium; endocardium; coronary arteries begin in the epicardium
How do you relieve stable angina Correct Ans-Rest or nitroglycerin
What is nitroglycerin's mechanism of action? Correct Ans-Vasodilation of arteries and
veins
