Ischaemic Heart Disease Flashcards
what are the presenting symptoms of Ischaemic Heart Disease (IHD)?
MI, angina pectoris, chronic ischaemic heart disease, sudden death
What are the causes of IHD?
- blood supply to heart is insufficient for its metabolic demand: coronary artery disease, reduced coronary artery perfusion- shock or aortic valve stenosis
- excessive demand: pressure overload due to hypertension and valve disease, volume overload due to valve disease
what are the main arteries where coronary atherosclerotic lesions occur?
- LAD
- left circumflex artery
- right coronary artery
what causes atheromatous coronary artery disease?
- progressive stenosis
- haemorrhage into plaque, evasion and eruption
- thrombosis
- emboli from inflamed aortic valve- endocarditis
- vasculitis
Define MI
area of ischaemia necrosis of the heart muscle caused by occlusion of coronary blood supply
what are some key causes of MI?
- coronary artery thrombosis
- haemorrhage into coronary plaque
- increase in demand in the presence of ischaemia
what areas are affected when any of the 3 coronary arteries commonly affected are occluded?
LAD- anterior wall of the left ventricle near apex, anterior portion of inter ventricular septum
RCA- inferior posterior wall of LV, posterior position of ventricular septum
LCX- lateral wall of LV not apex
Macroscopic changes 24-48 hrs after MI?
Pale oedematous muscle
Microscopic changes 24-48 hrs post MI?
oedema, neutrophil infiltration , necrosis myocytes
3-4 days post MI macroscopic changes?
yellow rubbery centre
haemorrhagic border
3-4 days post MI microscopic changes that occur?
obvious necrosis and inflammation
what are the macroscopic changes 1-3 weeks post MI?
pale thin infarcted area
1-3 weeks post MI what are the microscopic changes?
granulation tissue, progressive fibrosis
what are macroscopic features of MI 3-6 weeks post MI?
silvery scar becoming tough and white
what are the microscopic changes 3-6 weeks post MI?
dense fibrosis
