Ischaemic Heart Disease

Question 0

Risk factors for coronary atherosclerosis

Answer 0

1) age> 40
2) sex m>f
3) DM with hyperinsulinism
4) hyperlipidemia increase LDL
5) obesity
6) dietary factors { diet deficient in fruit, vegetable and polyunsaturated FA / low in vit. C , E and other antioxidant – oxidized LDL / low folate and Vit. B12 elevate homocysteine }
7) stress
8) high { homocysteine , fibrinogen , CRP } chlamydia pneumoniae
9) smoking, heavy alcohol consumption, Contaceptive pills, COX-2 NSAID

Question 1

Ischemic heart disease (IHD)
Def ?
Causes ?

Answer 1

• Definition : state of imbalance between the supply of oxygen and the myocardial demands
• causes :
  1) decrease coronary blood flow by mechanical obstruction { atherosclerosis - coronary spasm - coronary thrombosis / embolism - vasculitis - syphilitic coronary osteal obstruction }
  2) decrease the flow of oxygenated blood to myocardium { hypoxia - anemia - hypotension - decreased COP }
  3) increase oxygen demand { left ventricular hypertrophy * HTN * AS }

Question 2

Hazards of smoking

Answer 2

Chest { chronic bronchitis - bronchogenic carcinoma- emphysema}

CVS { HTN - Arrhythmia’s - coronary heart disease }

GIT { peptic ulcer ( D. U.) - reflux esophagitis - esophagus carcinoma - increase incidence of crohn’s, decrease incidence of ulcerative colitis}

Urinary { cancer prostate - cancer bladder}

Passive smoker { fetus small for date- bronchitis - cough}

Question 3

Prevention of IHD

Answer 3

Do not smoke

No more than 30% of energy intake from fat

Regular exercise

Fruits and vegetables in diet

Ideal body weight

Question 4

Presentation of IHD

Answer 4

Asymptomatic

Sudden death

Angina pectoris

Myocardial infarction

Heart failure

Arrhythmia