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I’ve got severe pain in my chest - Coggle Diagram
I’ve got severe pain in my chest
Coronary blood flow and cardiogenic shock
Cardiogenic shock
occurs when
the heart is unable to pump as much blood as the body needs
Myocardial blood flow (MBF) = Myocardial oxygen consumption (MVO2)
factors control coronary blood flow
physical
coronary flow 70% diastole & 30% systole
because
The entrance to the coronary vessels is partially blocked by the open aortic valve
the coronary arteries are compressed by the contractile myocardium
metabolic
coronary vasodilators include
Adenosine
Decreased PO2
MI
Patterns of Infarction include:
Sudendocardial
Inner third of the myocardium is affected
Transmural
Full thickness
Diffuse microscopic
small-vessel occlusions
Complications include
left ventricular failure
Myocardial rupture
Arrhythmias
Thrombosis and embolism
Cardiogenic shock
Pericarditis
atherosclerosis pathogenesis
step4
activation of immune system
step2
damage of the endothelium
step5
plaque formation
step3
LDL-C deposite
step1
present of irritant event
Investigations
is done by checking
Biochemical Markers
They appear due to necrosis of the cells
these include
Troponin
The golden standard, has several types
Creatine Kinase-MB
assist in diagnosing re-infarction but Sensitivity and specificity are not as high
Myoglobin
Good for early admission but not specific
internal validity, and learning theories
internal validity
Examination of the following issues
Confounding
Biases
Information
Design related
Selection
learning theories
observational
mean that
Behavior is learned through watching others
Behavioral
theorist
watson
classical conditioning
theorist
skinner
operant conditioning
Pharmacology and Angiography
Drug classes
Beta-blockers
CCB
Dihydropyridine CCBs
Amlodipine
Nifedipine
Non-Dihydropyridine CCBs
Verapamil
Diltiazem
Sodium channel blocker
Ranolazine
Organic nitrates
Isosorbide dinitrate
Isosorbide mono-nitrate
Nitroglycerin
Types of Angiography
Cerebral
Coronary
Pulmonary
Angina Pectoris
types
Vasospastic
at midnight &
early morning
& cold weather
young pts <50 yrs
attack is 5-10 min
stable
pain with exertion
attack is <10 min
70% occlusion of coronary artery
nonstable
90% occlusion
pain at rest
attack >20 min
Coronary circulation
arteries
left coronary artery
circumflex artery
left marginal artery
anterior atrioventricular artery
lateral artery
right coronary artery
SA nodal artery
posterior IV artery
right marginal artery
AV nodal artery
venous system
middle cardiac vein
coronary sinus
great cardiac vein
small cardiac vein
anterior cardiac vein