HLB-Case 2

amymed's version from 2015-10-13 22:05

Section 1

Question Answer
Name the main branches of the left coronary arteryLeft circumflex, (left marginal branches off circumflex), left anterior descending (diagonals branch off LAD)
Name the main branches from the right coronary arteryRight marginal, Posterior descending artery.
Which parts of the heart does the right coronary artery supply?Right atrium, right ventricle, bottom portion of the left ventricle and back of septum
What does the LAD supply?Front and bottom of left ventricle, front of septum
What does the (left) circumflex artery supply?Left atrium, side and back of left ventricle
What venous vessel do most cardic veins drain into before returning to the chambers of the heart?Coronary sinus
What are the major venous vessels of the heart?Coronary sinus, great cardiac veins, left & right marginal veins, posterior veins of the left venticle, middle cardiac vein, small cardiac vein

Section 2

Question Answer
What are the risk factors for MI?Smoking, hypertension, being male, ageing, high cholesterol, family history of premature CAD, chronic renal insufficiency, diabetes, being of southern Asian ethnicity
What causes an MI?An athersclerotic plaque rupture, leading to clotting, which blocks off the artery. Sometimes coronary spasm, chest trauma or spontaneous coronary/aortic dissection.
Pathological difference between a STEMI and an NSTEMI?STEMI is generally the result of a fully occluded artery and NSTEMI is usually near-complete occlusion
What are the 3 different classifications of acute coronary syndrome?STEMI, NSTEMI, unstable angina pectoris.
What biomarkers suggest MI?Rise and gradual fall of troponin, or more rapid rise and fall of CK-MB.
Key factors in presentation of MI?Chest pain, dysopnea, diaphoresis, pallor, cardiogenic shock
How might an echocardiogram show a recent MI?There may be hypokinesis, dyskinesis or akinesis.
How long does it take CK-MB to rise, peak and fall back to baseline?Initial 4-12 hours, peak 10-24 hours and fall 18-24 hours
How long does it take for Troponin T to rise, peak and fall to baseline?Initial 3-12 hours, peak 12-48 hours, fall 5-14 days
The 4 most common complications of MI are? Congestive heart failure, ventricular arrhythmias, recurrent ischaemia and infarction and depression.
What drugs are most often given after a STEMI?Dual antiplatelet, ACE-I. Beta blocker, statin, eplerenone