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Ischemic heart disease by mohammad muztaba

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RESPIRATORY DISEASE

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Ischemic heart disease by mohammad muztaba

  1. 1. Mohammad Muztaba Khan Assistant professor(Jr.) Department of Pharmacology Bhavdiya institute siwar Sohawal Ayodhya Ischemic heart disease Angina & MI 3/19/2019 1MOHAMMAD MUZTABA
  2. 2. Ischemic heart disease Also known as Coronary Artery Disease (CAD) It's the term given to heart problems caused by narrowed heart arteries. When arteries are narrowed, less blood and oxygen reaches the heart muscle. This is also called coronary artery disease and coronary heart disease. This can ultimately lead to heart attack. • Ischemic heart disease (IHD) is a condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium • Imbalance between myocardial oxygen supply and demand. • Caused mainly by Atherosclerosis of Coronary Artery • It includes – Angina: Stable & Unstable – Myocardial infarction – Heart failure & Arrhythmia 3/19/2019 2MOHAMMAD MUZTABA
  3. 3. • A type of chest pain • Not a disease, its a symptom of an underlying heart problem specially IHD • Ischemia often causes chest pain or discomfort known as angina pectoris. Angina Angina or ankhon = Pain/Stragling Pectis = chest 3/19/2019 3MOHAMMAD MUZTABA
  4. 4. MOHAMMAD MUZTABA3/19/2019 4 Knowing the types of angina and how they differ is important.  Stable Angina / Angina Pectoris.  Unstable Angina.  Variant (Prinzmetal) Angina.  Refractory/Microvascular Angina.
  5. 5. Types of Angina contt………  Stable Angina: occurs when increased physical activity (e.g., hurrying across a street or climbing a long stairs) which creates a greater demand for oxygen-rich blood to reach heart tissue • Pain is relieved by rest and medicine  Unstable angina : Pain is not relieved by rest or medicine •Arterial blockage by plaque and blood clots •Pain occurs during rest or physical effort, and is unpredictable • This type usually is caused by the formation of a blood clot at the site of a ruptured plaque in a coronary artery. 3/19/2019 5MOHAMMAD MUZTABA
  6. 6. • Variant (Prinzmetal’s) angina: Prinzmetal’s angina almost always occurs when a person is at rest, usually between midnight and early morning. These attacks can be very painful. • Causes of Variant (Prinzmetal) Angina: The pain from variant angina is caused by a spasm in the coronary arteries (which supply blood to the heart muscle). Types of Angina (cont.) 3/19/2019 6MOHAMMAD MUZTABA
  7. 7. • Refractory angina/microvascular : Spasms within the walls of these very small arterial blood vessels causes reduced blood flow to the heart muscle leading to a type of chest pain referred to as microvascular angina. • Pain is longer in duration and is not relieved by medicine or rest Types of Angina (cont.) 3/19/2019 7MOHAMMAD MUZTABA
  8. 8.  Atherosclerosis  Coronary artery spasm  Use of cocaine  Blockage of coronary artery by blood clot or compression  Inflammation or infection of coronary artery  Injury to coronary artery  Poor functioning of tiny blood vessels  Family history of premature coronary artery disease  DM, systemic HTN.  Cigarette smoking.  Hypercholesterolemia.  Others as obesity, increase levels of lipoprotein, fibrinogen, Causes of angina 3/19/2019 8MOHAMMAD MUZTABA
  9. 9. Symptoms of angina Gastrointestinal: heartburn, indigestion, or nausea Respiratory: rapid breathing or shortness of breath Chest pain or discomfort, possibly described as pressure, squeezing, burning or fullness. Pain in your arms, neck, jaw, shoulder or back accompanying chest pain. Nausea. Fatigue. Shortness of breath. Sweating. Dizziness. 3/19/2019 9MOHAMMAD MUZTABA
  10. 10. Pathophysiology • Myocardial ischemia develops when coronary blood flow becomes inadequate to meet myocardial oxygen demand. • This causes myocardial cells to switch from aerobic to anaerobic metabolism, with a progressive impairment of metabolic, mechanical, and electrical functions. • Studies have shown that adenosine may be the main chemical mediator of anginal pain. During ischemia, ATP is degraded to adenosine, which, after diffusion to the extracellular space, causes arteriolar dilation and anginal pain. 3/19/2019 10MOHAMMAD MUZTABA
  11. 11. Pathophysiology Cont…… 3/19/2019 11MOHAMMAD MUZTABA
  12. 12. Diagnosis  Electrocardiogram (ECG or EKG) Stress test. Echocardiogram. Chest X-ray Blood tests Coronary angiography. Cardiac computerized tomography (CT) scan. Cardiac MRI. coronary CT angiography, Other treatment options may include medication, surgery, or angioplasty and vascular stenting. 3/19/2019 12MOHAMMAD MUZTABA
  13. 13. 3/19/2019 13MOHAMMAD MUZTABA

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