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Common Congenital Heart Lesions - page 40 / 126

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  • Ventricular Remodeling: involves ventricular expansion (dilation) of both the infarcted and non-infarcted areas to increase CO; however, this bad b/c it can lead to:

    • Increased wall stress (Remember: Wall Stress=P*r/2h)

    • Increased susceptibility to wall rupture

    • Heart failure

    • Ventricular arrhythmias

Clinical Features of ACS

Because ACS encompass a continuum, there’s overlap in their clinical features. Since they result in different outcomes and warrant different therapies, distinctions are made based on:

  • 1.

    Clinical Presentation

  • 2.

    ECG findings

  • 3.

    Presence of serum biomarkers of myocardial necrosis

*The most important distinction to be made is b/t ACS that causes ST elevation (STEMI) from those that do not (NSTEMI & UA)!

Unstable Angina

Please refer to Noel’s Review on Ischemic Heart Diseases…although I have yet to go over those notes, there’s no doubt in my mind that she’s done a fantabulous job with

that section!

  • Presents in 1 of 3 ways:

    • Increase in frequency, duration, & intensity of ischemic episodes in a person with chronic, stable angina

    • Angina that occurs @ rest

    • New onset angina occurring in a person with no previous history of CAD

  • Although not as severe, UA can progress to STEMI & NSTEMI if left untreated

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