RESPIRATORY DISEASE(MYOCARDIAL INFRACTION & ANGINA

1. Ischemic heart disease
Myocardial infraction
Mohammad Muztaba Khan
Assistant professor(Jr.)
Department of Pharmacology
Bhavdiya institute sibar Sohawal
Ayodhya
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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
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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. 3/19/2019 4MOHAMMAD MUZTABA

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)
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6. Tobacco smoking
Hypertension
Drug abuse
 Obesity
Stress
 Alcohol
ETIOLOGY
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7. Age
Gender
 Diabetes
 Hyperlipoproteinaemia
Family history of Ischaemic
Heart Disease
 Hyperhomocysteinemia
 Chronic kidney disease
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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.
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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
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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)
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11. 3.ECG changes:
ST segment
elevation
 T wave inversion
appearance of
wide deep Q waves.
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12. MAGNETIC
RESONANCEIMAGING
(MRI)
ANGIOGRAPHY
POSITRON
EMISSION
TOMOGRAPHY (PET
scan):
CHESTX- RAY
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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. 2.PHARMACOLOGICAL:
Thrombolytic agents
Anticoagulants
Antiplatelet agents
Antihypertensive agents
Lipid lowering drugs
Vasodialators
Others
i) Analgesics
ii) Antiulcer drugs
iii) Antidepressants
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15. PERCUTANEOUS
TRANSLUMINAL
CORONARY
ANGIOPLASTY (PTCA)
STENT PLACEMENT
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16. ATHERECTOMY
CORONARY ARTERYBYPASS
GRAFT (CABG)
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