1 / 16

Ischemic Heart Disease

Ischemic Heart Disease. Dr. Fletcher. Week 3/ CVS module 9-11-2003. Ischemia heart disease. Restriction of blood supply, relative to demands of the heart. Ischein = to restrict. Recall: Heart has high : - Work load. - Metabolic Rate. - Aerobic metabolism.

Olivia
Download Presentation

Ischemic Heart Disease

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Ischemic Heart Disease Dr. Fletcher. Week 3/ CVS module 9-11-2003

  2. Ischemia heart disease • Restriction of blood supply, relative to demands of the heart. • Ischein = to restrict. Recall: • Heart has high : - Work load. - Metabolic Rate. - Aerobic metabolism. - Oxygen demands.

  3. Features of Ischemia heart disease : • Coronary Obstruction. • Cardiac Pain. • Cardiac Ischemia lesions.

  4. 1) Coronary Obstruction: • Obstruction of coronary arteries  decrease blood to heart.

  5. 2) Cardiac Pain: Common Characteristics : • Sever pain  gripping, crushing, arresting. • Chest  “Retrosternal”, behind the sternum • Radiating to left arm, neck and jaw.

  6. Coronary obstruction/Cardiac pain/Cardiac Ischemia lesion Obstruction: Impediment. Stenosis  Narrowing of blood vessle Pain : Angina Pectoris Cardiac lesions Ischemia fibrosis. Narrow lumen I) Obstruction II) Occlusion Cardiac lesions Infarct (necrosis). Pain : Infarct Pain Occlusion: Closed vessel Closure of the lumen

  7. I) Stenosis: • It is narrowing without complete closure  this is a gradual process. • As a result of slow gradual changes  it will give chance for adaptation by forming anastomosis ( other area feed the Ischemic area) Partial Ischemia. • Lesions: Occasional cell atrophy. It is not a vacuum, because fibrous tissue replace the space ( Fibrosis intravenous).

  8. Pain Angina Pectoris: • General chest pain. • Its specific characteristic are: 1) Induced by exertion. 2)Paroxysmal (~ 15 minutes) (to differentiate between it and other chest pain). 3) Relieved by rest. 4) Relieved by Nitroglycerin  vasodilatations.

  9. II) Occlusion: • Sudden onset ( due to thrombosis, plaque rupture) • Complete Ischemia to the area of heart. • Give area of infarction sizable.

  10. Pain of infarct type: (Important for distinguishing) 1) Very sever. 2) Prolonged pain - at least 30 min (not 15 min) - often 1 hours. - Some cases 6 hrs ( have to be controlled byopiates). 3) Not induced by exertion. 4) Not relieved by rest. 5) Not relieved by nitroglycerin.

  11. 3) Cardiac Lesions: • Ventricle lesions ( 97%). • Right ventricle lesion  extensions in the left or septal.

  12. 1. Functional disruption of the heart:  Arrhythmia due to Ischemia ( local) of conducting system.  it can be picked up by ECG  & might end up with sudden death.

  13. 2. Diffuse ischemic fibrosis: • It is Patchy muscle fiber atrophy • There is a replacement fibrosis ( strengthens). • Post Mortem examination: We see – Grayish-white sheen. - ill defined  Vague

  14. 3. Infarction: due to Occlusion • Post mortem Features : • Inapparent until >18 hrs survival. • They become Apparent after 24 hrs. • Infarct site are Yellow due to Autolysis at 37C (viable muscle). • When tissue necrosis occur • The tissue release many substances such as LDH, CPK and Troponin • Induce inflammatory reaction  migration of neutrophils to the site of necrosis and Increase phagocytosis. • Electrolyte imbalance (increase Na and decrease K)

  15. Summary: Angina vs. MI

  16. Sudden Death: Causes: 1) Arrhythmia  Ventricular fibrillation. 2) Ischemia : a) re-entrant circuit b) damaged conducting system, coronary lesions (hard to find). 3) Massive Acute infarct: infarct is not visible but coronary thrombosis easily found.

More Related