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Myocardial infractionby mohammad muztaba

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RESPIRATORY DISEASE(MYOCARDIAL INFRACTION & ANGINA

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Myocardial infractionby mohammad muztaba

  1. 1. Ischemic heart disease Myocardial infraction Mohammad Muztaba Khan Assistant professor(Jr.) Department of Pharmacology Bhavdiya institute sibar Sohawal Ayodhya 3/19/2019 1MOHAMMAD MUZTABA
  2. 2. CONTENTS: 1. Definition 2. Types of infarcts 3. Epidemiology 4. Etiology 5. Etiopathogenesis 6. Pathophysiology 7. Clinical manifestations 8. Diagnosis 9. Management: Non-pharmacological Pharmacological 3/19/2019 2MOHAMMAD MUZTABA
  3. 3. MYOCARDIAL INFARCTION Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle.. Myocardial infarction, commonly known as a heart attack, is the irreversible necrosis of heart muscle secondary to prolonged ischemia.3/19/2019 3MOHAMMAD MUZTABA
  4. 4. 3/19/2019 4MOHAMMAD MUZTABA
  5. 5. TYPES OF INFARCTS 1. According to anatomic region of left ventricle invoved:  Anterior  Posterior  Lateral  Septal  Circumferential  Combinations- Anterolateral, Posterolateral,Anteroseptal 2. According to degree of thickness of ventricular wall involved:  Transmural (full thickness)  Laminar (subendocardial) 3. According to age of infarcts:  Newly formed (acute, recent, fresh)  Advanced infarcts (old, healed, organised) 3/19/2019 5MOHAMMAD MUZTABA
  6. 6. Tobacco smoking Hypertension Drug abuse  Obesity Stress  Alcohol ETIOLOGY 3/19/2019 6MOHAMMAD MUZTABA
  7. 7. Age Gender  Diabetes  Hyperlipoproteinaemia Family history of Ischaemic Heart Disease  Hyperhomocysteinemia  Chronic kidney disease 3/19/2019 7MOHAMMAD MUZTABA
  8. 8. CLINICAL MANIFESTATIONS/SYMPTOMS • Chest pain / chest discomfort • Dyspnea • Fatigue • Other symptoms include: Increased sweating Weakness Nausea Vomiting Light-headedness Palpitation •Anxiety, sleeplessness, hypertension or hypotension, arrhythmia. •Chest pain is less in women, their common symptoms are weakness, fatigue & dyspnea. 3/19/2019 8MOHAMMAD MUZTABA
  9. 9. PATHOPHYSIOLOGY Atherosclerosis Arterial spasm Atherosclerosis+Plaque split+Thrombus gradual Obstruction sudden not usually reversible occlusionsudden reversible obstruction ISCHAEMIA Hypoxia Reduced oxygen demand Angina Thrombolysis Unstable angina Permanent thrombus Necrosis MYOCARDIAL INFARCTION 3/19/2019 9MOHAMMAD MUZTABA
  10. 10. DIAGNOSIS: 1.Clinical features: Pain Indigestion Apprehension Shock Low grade fever 2.Serum cardiac markers: Creatinine phosphokinase (CK) Lactic dehydrogenase (LDH) Cardiac specific troponins (cTn) 3/19/2019 10MOHAMMAD MUZTABA
  11. 11. 3.ECG changes: ST segment elevation  T wave inversion appearance of wide deep Q waves. 3/19/2019 11MOHAMMAD MUZTABA
  12. 12. MAGNETIC RESONANCEIMAGING (MRI) ANGIOGRAPHY POSITRON EMISSION TOMOGRAPHY (PET scan): CHESTX- RAY 3/19/2019 12MOHAMMAD MUZTABA
  13. 13. MANAGEMENT: 1.NON-PHARMACOLOGICAL: Counselling and education of patients Life style measures Smoking cessation Avoid Alcohol intake Diet and nutrition Salt restriction3/19/2019 13MOHAMMAD MUZTABA
  14. 14. 2.PHARMACOLOGICAL: Thrombolytic agents Anticoagulants Antiplatelet agents Antihypertensive agents Lipid lowering drugs Vasodialators Others i) Analgesics ii) Antiulcer drugs iii) Antidepressants 3/19/2019 14MOHAMMAD MUZTABA
  15. 15. PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA) STENT PLACEMENT 3/19/2019 15MOHAMMAD MUZTABA
  16. 16. ATHERECTOMY CORONARY ARTERYBYPASS GRAFT (CABG) 3/19/2019 16MOHAMMAD MUZTABA

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