11f. CV Health - Ischaemic Heart Disease Flashcards
What is IHD?
Imbalance between myocardial oxygen supply and demand
Associated with inadequate arterial supply via coronary arteries
What is the common cause of IHD?
Atherosclerosis
What are the two syndromes of IHD?
Angina
Myocardial infarction
What is angina?
Chest pain caused by insufficient supply of oxygenated blood supply to the myocardium via the coronary arteries
What are the two types of angina?
Stable angina
Unstable angina
What is stable angina?
Predictable transient chest pain during exertion or emotional stress
Symptoms resolve once O2 balance is restored
What is unstable angina?
Unpredictable
Occurs at rest
Plaque disruption initiates platelet aggregation, thrombus formation and vasoconstriction
Signs and symptoms of stable angina
Constricting chest pain
Worsened by exertion
Relieved by rest
SOB
Sweating
Causes/risk factors for angina
General CVD risk factors
Cigarette smoking
Vit D deficiency
Family history
Why is smoking a risk factor for angina?
Endothelial dysfunction
Vessel wall injury
OS
Elevates fibrinogen
Elevates platelet activation
Elevates inflammation
Why is vit D deficiency a risk factor for angina?
Vit D improves endothelial function by signalling for the transcription of eNOS
Modulates RAAS to lower BP
How is angina usually diagnosed?
ECG
Angiography
Cardiac stress testing
Examples of allopathic approaches to supporting angina
GTN spray (nitrates)
Ca channel blockers
Beta blockers
Revascularisation (stents, bypass)
What is myocardial infarction?
Acute blockage of a coronary artery usually due to a thrombus, resulting in the death of myocardial tissue
What happens to create a MI?
Prolonged ischaemia leads to myocardial necrosis
Ischaemic myocardial cells release adenosine and lactate onto nerve endings causing pain
Infarcted areas produce scar tissue
The remaining tissue hypertrophies, resulting in cardiac dysfunction
Causes/risk factors for MI
General CVD risk factors
Gender
Physiological factors
Why is gender a risk factor for MI?
Men 3x more likely to experience MI
High androgen levels contribute to development of atherosclerosis
What physiological factors are a risk factor for MI?
Stress
Sudden life events
Signs and symptoms of MI
Severe, prolonged crushing retrosternal chest pain
Pain radiates to left shoulder/jaw/arms
How is MI diagnosed?
ECG
What is the allopathic approach to treating MI?
Morphine
Nitrates
Beta blockers
O2 therapy
Natural approach to supporting IHD
Apply approach to CVD, with a focus on supporting blood flow
Optimise vit D status - promotes vasodilation
Warming herbs/spices - ginger, cayenne
Increasing movement - gentle exercise
Address stress
Nutrients to support IHD
L-carnitine
Mg
Hawthorn
CoQ10
L-arginine
Ginkgo biloba
Why is L-carnitine good for supporting IHD?
Improves FA utilisation
Improves myocardial ATP production
Dosage of L-carnitine for supporting IHD
1000mg 2/day
Why is Mg good for supporting IHD?
Deficiency shown to produce coronary artery spasms
Mg controls movement of Ca into smooth muscle cells, leading to smooth muscle contraction
Why is hawthorn good for supporting IHD?
Flavonoids shown to inhibit enzyme thought to be responsible for dilating coronary arteries
Dosage of hawthorn to support IHD
100-1500mg/day
Why is CoQ10 beneficial for IHD?
Increases eNOS and NO
Anti-inflammatory effects
Why is L-arginine beneficial for IHD?
Promotes vasodilation by increasing NO
Increases SOD levels
Dosage of L-arginine to support IHD
1000-2000mg 3/day
Why is ginkgo biloba good for IHD?
Enhances microcirculation and tissue perfusion
Scavenges ROS
Dosage of ginkgo biloba to support IHD
60-120mg/day
