Case Study of Ischemic Heart Disease

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CVS Case Study 1 Ischemic Heart Disease Learning Objectives 1. Understand the normal function of endothelium and medial smooth muscle cells, and the role their dysfunction plays in the disease processes. 2. Define arteriosclerosis and know the three main patterns. 3. Atherosclerosis: know its morphology, the vessels affected, its effects and complications, the progression of the disease process (from normal vessel to complicated plaques), the components of a plaque, and the four major modifiable and non-modifiable risk factors in its development. 4. Understand the role that constitutional factors and non-genetic (modifiable) risk factors play in the development of atherosclerosis. 5. Understand the roles of endothelial injury, inflammation, lipids, and smooth muscle in the development of atherosclerosis. 6. Heart failure a. Define heart failure. List the two most frequent causes of systolic dysfunction; list four causes of diastolic dysfunction. b. Compare and contrast the causes and consequences of right and left heart failure. 7. Ischemic heart disease a. Review the blood supply of the heart. Know what myocardial regions are supplied by each coronary artery and how to determine which coronary artery is dominant. b. Define ischemia. c. List the clinical manifestations associated with ischemic heart disease and know which of the three are acute coronary syndromes. d. Understand the pathogenesis (diminished coronary perfusion with increased demand) of ischemic heart disease; and know the roles of the following: i. Fixed coronary artery obstruction ii. Acute plaque change iii. Inflammation iv. Coronary thrombus v. Vasoconstriction e. Know the morphologic changes associated with: i. Stable angina ii. Unstable angina iii.

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