CVS Present

Cardiovascular system
. .
. .
. 5206535
. 5406797
History
A 65-year-old man presented to the emergency room with a
recent (6-hour) history of severe chest pain radiating to his left

arm. He was suspected to have had a "heart attack." Coronary
angiography revealed a complete occlusion of the left anterior
descending branch about 2 cm from its origin. He was given a
therapeutic dose of recombinant human tissue plasminogen
activator (t-PA). This treatment restored coronary artery blood
flow, and his chest pain improved. Simultaneously, he was
started on one tablet of aspirin per day.
2
Seven days later, he noted swelling of both legs
and feet and was found to have pitting edema of

the legs; his liver was somewhat enlarged; and his
neck veins (jugular) appeared full. He was given
diuretics and salt-restricted diet.
A few days later, he developed dypsnea,
orthopnea, cough with pink frothy sputum. He
became very breathless and died suddenly.
3
Section I
severe chest pain radiating to his left

arm.
complete occlusion of the left anterior
descending branch
tissue plasminogen activator (t-PA).
one tablet of aspirin
Section II
swelling of both legs and feet

liver was somewhat enlarged
neck veins (jugular) appeared full
4
Blood supply of the heart
Coronary angiography
LCA
LAD
Normal Left anterior coronary artery
LAD
Blockage
6
Cardiac enzyme investigation

Time Course for Serum marker
in acute MI
Cardiac enzyme can help you to prove

7
ECG
He was given a therapeutic dose of

recombinant human tissue plasminogen
activator (t-PA). This treatment restored
coronary artery blood flow, and his chest
pain improved. Simultaneously, he was
started on one tablet of aspirin per day.
Plasminogen
Tissue
plasminogen
activator (tPA)
Plasmin
Fibrin
Fibrin Degradation
Products
10
Aspirin
Arachidonic acid
Cyclooxygenase1
Prostaglandin G2
Thromboxane
synthase
Thromboxane A2
decreased platelet
activation and
aggregation
12
Medical use
Pulmonary embolism
Myocardial infarction
Stroke
17
22
He was given diuretics and saltrestricted diet.
23
Diuretics
Loop diuretics are diuretics that act at the

ascending loop of Henle in the kidney
Furosemide
The progression of heart failure
30
31
Question
At the time of admission, What is the

histopathologic finding in this patient?
Fibrosis and collagen deposition

B. Plasma cells and caseous necrosis
C. Abundant neutrophils and monocytes
D. Monocyte infiltration and
neovascularization
E. Coagulation necrosis with few
A.
Copyright2010 Companyname | Free

template by Investintech PDF Solutions
34
SEQUENCES OF PATHOLOGIC CHANGES
35
At the time of admission, What is the

histopathologic finding in this patient?
Fibrosis and collagen deposition

B. Plasma cells and caseous necrosis
C. Abundant neutrophils and monocytes
D. Monocyte infiltration and
neovascularization
E. Coagulation necrosis with few
A.
36
He was given diuretics and saltrestricted diet.
37
Diuretics
Loop diuretics
Furosemide
Which of the following mechanisms

is the most likely inhibition of
aspirin ?
A. ADP pathway
B. cAMP activation
C. Plasmin metabolism
D. Thromboxane A2 synthesis
E. glycoprotein IIb/IIIa receptor

aspirin ?
A. ADP pathway
B. cAMP activation
E. glycoprotein Iib/IIIa receptor
44

aspirin ?
A. ADP pathway
B. cAMP activation
E. glycoprotein Iib/IIIa receptor
45
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
Coronary Circulation
Coronary circulation is the functional
blood supply to the heart muscle itself
Collateral routes ensure blood
delivery to heart even if major vessels
are occluded
Chapter 18, Cardiovascular System
70
Coronary Circulation: Arterial

Supply
Chapter 18, Cardiovascular System
Figure 18.7a71
Table Slide
Table
Data

72
Table Slide
Table
Data

73
Table Slide
Table
Data

74
Table Slide
Table
Data

75
Table Slide
Table
Data

76
Table Slide
Table
Data

77
Table Slide
Table
Data

78
Table Slide
Table
Data

79
Table Slide
Table
Data

80
Table Slide
Table
Data

81
Table Slide
Table
Data

82
Table Slide
Table
Data

83
Table Slide
Table
Data

84
Table Slide
Table
Data

85
Table Slide
Table
Data

86
Table Slide
Table
Data

87
Table Slide
Table
Data

88
Table Slide
Table
Data

89
Table Slide
Table
Data

90
Table Slide
Table
Data

91
Table Slide
Table
Data

92
Table Slide
Table
Data

93
Table Slide
Table
Data

94
Table Slide
Table
Data

95
Table Slide
Table
Data

96
Table Slide
Table
Data

97
Table Slide
Table
Data

98
Picture Title
Picture Description

99

CVS Present

Transféré par

Informations du document

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

CVS Present

Transféré par

Droits d'auteur :

Formats disponibles

Cardiovascular system

recent (6-hour) history of severe chest pain radiating to his left

Seven days later, he noted swelling of both legs

and feet and was found to have pitting edema of

severe chest pain radiating to his left

swelling of both legs and feet

Blood supply of the heart

Normal Left anterior coronary artery

Cardiac enzyme investigation

Cardiac enzyme can help you to prove

He was given a therapeutic dose of

He was given diuretics and saltrestricted diet.

Loop diuretics are diuretics that act at the

The progression of heart failure

At the time of admission, What is the

Fibrosis and collagen deposition

Copyright2010 Companyname | Free

SEQUENCES OF PATHOLOGIC CHANGES

At the time of admission, What is the

Fibrosis and collagen deposition

He was given diuretics and saltrestricted diet.

Which of the following mechanisms

Which of the following mechanisms

Which of the following mechanisms

Chapter 18, Cardiovascular System

Coronary Circulation: Arterial

Chapter 18, Cardiovascular System

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Copyright2010 Companyname | Free

Vous aimerez peut-être aussi