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1. Which vessel is being dissected at the start of the video?
2. How occluded by plaque is this vessel?
3. How does the extent of coronary artery disease differ with inherited high cholesterol vs. diet-related high cholesterol, if at all?
4. What do the terms “right dominant,” “left dominant” and “bi-dominant” mean?
5. What type of dominance is most common?
6. What dominance does this patient have?
7. What is the clinical impact of a right coronary artery occlusion in a right dominant patient?
8. What is the clinical impact of right coronary artery occlusion in a left dominant patient?
9. What is the impact of a left circumflex coronary artery occlusion in a right dominant patient?
10. What is the impact of a left circumflex coronary artery occlusion in a left dominant patient?
11. Inventory (or sketch) the location of this patient’s blockages. (What vessels are involved? Where is the blockage located in each vessel? How severe are the blockages?)
12. Make a prediction about the significance of each blockage given the patient’s dominance.
13. What is the overall plaque “load” in this patient (e.g., is most of each vessel involved by plaque or just short areas of certain vessels?).
14. A 38 year old man dies with an autopsy-confirmed blockage of the left anterior descending coronary artery. The blockage is complete but only fills a short length of the vessel (approximately 3 mm). There is no coronary artery disease in any other area of the left anterior descending coronary artery or in any other coronary artery. Does the patient have an inherited condition? Why or why not?
15. Do you think this patient had an inherited condition based on the pattern of blockage in the video? Do you think patterns of blockage can predict an inherited condition? Why or why not? Or under what circumstances?
16. What does “clot on top of plaque” refer to? Why does this happen?
17. What is plaque rupture? Why does this happen?
18. Are most myocardial infarctions caused by plaque with superimposed coronary thrombosis? Or from progressive occlusion by plaque (without thrombosis)?