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And neurohumoral factors forms brous cap underneath

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Unformatted text preview: descending (LAD) artery occlusion causes extensive infarcDon •  Right coronary artery (RCA) occlusion causes moderate infarcDon ComplicaDons of Acute MI •  LAD occlusion causes extensive infarcDon associated with: –  –  –  –  –  –  LV failure Arrhythmias High grade heart block Apical aneurysm formaDon Thrombo ­embolic complicaDons Mechanical complicaDons such as rupture of free wall; rupture of papillary muscle/mitral regurgitaDon; rupture of intraventricular septum •  RCA occlusion causes moderate infarcDon associated with: –  RV failure –  Bradyarrhythmias Atherosclerosis •  •  •  •  •  •  Atherosclerosis affects large, proximal epicardial arteries Once narrowed (stenoDc), resistance increases unless distal, small arterioles are able to dilate and adapt to compensate Fajy streak present in most of us Complex interacDon with circulaDng cells (platelets, macrophages) and neurohumoral factors Forms fibrous cap, underneath an ECM keeps cells together (stable plaque) Unstable plaque involves cytokines that disrupt fibrous cap, leading to rupture and thrombus formaDon 7 4/9/13 Pathophysiology of Acute Coronary Syndromes Acute Ischemia Impairs ContracDlity •  Decreased mi...
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