Abstract: . . .  classmate. n Identify the types of angina and arrhythmias associated with myocardial ischemia and infarction. n Compare and contrast the etiology of right & left sided heart failure and explain to a classmate the different signs and symptoms. 3 Arteriosclerosis n Chronic disease of the arterial system n Characterized by an abnormal thickening and hardening of the vessel walls. Smooth muscle cells and collagen fibers move into the tunica intima causing stiffening Inhibits the arterys ability to change lumen size n Structural changes may be due to the normal aging process Changes in lipid, cholesterol, and phospholipids are contributing factors Page 2 4 Atherosclerosis Plaque Formation n A form of arteriosclerosis in which . . .
. . .  Ischemia with death to myocardium d/t lack of blood supply from the occlusion of coronary artery and its branches (Hartshorn, 1997) n imbalance between myocardial oxygen supply and demand n imbalance is result of atherosclerosis, coronary artery vasospasm, thrombus, or dysrhythmias n prolonged ischemia is called an infarction evolves over 3 hours & causes irreversible cellular damage and muscle death (necrosis) 23 Myocardial Infarction Clinical Symptoms n > Cardiac Enzymes d/t myocardial ischemia n CK: creatine kinase onset = 2-6 hrs after MI n LDH: lactate dehydrogenase = 12 hrs after MI n AST: asparate transaminase + 6-8 hrs after MI n Troponin: protein marker for early detection of MI n MI: 20 - 60% are silent (signs and symptoms)  . . .
. . .  Vessel damage: trauma, IV medications > Coagulation: pregnancy, oral contraception, some cancers, coagulation disorders n Prevention: ambulation following surgery! 18 Cardiac Inflammation n Myocarditis: forms scar tissue n inflammation & injury of myocardium without ischemia n caused by an infection with virus or bacterial protein that triggers an autoimmune attack on myocardial cells n CMV, HIV, Hep B, coxsackievirus n TB, B-hemolytic strep, slamonella, lyme disease n fungi: candidiasis, histoplasmosis, chalmydia n S&S: n flu like symptoms; fatigue; dyspnea; chest pain, IDC (idiopathic dilated cardiomyopathy), cardiac death n decreases ejection fraction (15%) Page 7 19 Cardiac Inflammation n  . . .
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