Ischaemic Heart Disease Flashcards
Define ischaemic heart disease?
IHD, or Coronary Artery Disease is decreased blood supply (insufficient - ischaemia) resulting in angina pectoris (chest pain).
What two ways can Coronary Artery Disease present?
Acute Coronary Syndrome or Stable Angina
What are the different types of Acute Coronary Syndrome?
STEMI
NSTEMI
Unstable Angina
What causes IHD?
atheromatous plaque in the coronary arteries caused by atherosclerosis
What is atherosclerosis?
Endothelial injury followed by migration of monocytes into subendothelial space and differentiation into macrophages. Macrophages accumulate LDL lipids insudated in the subnedothelium and become foam cells. They release growth factors which stimulate smooth muscle proliferation, production of collagen and proteoglycans - leading to the formation of atheromatous plaque.
What is angina?
sever pain in the chest often radiating to the shoulders, arms, or neck, owing to inadequate blood supply to the heart
IHD - figures & facts - epidemiology
largest killer 2013 w/ 7 million deaths
more common in males (over 50 similar risk between genders however)
IHD (the same thing as coronary artery disease (the same thing as coronary heart disease)) is responsible for 1 in 6 male deaths & 1 in 10 female deaths in the UK
South-Asia predicted to have 60% cardiovascular disease in future despite only 20% population
What was the second biggest killer in 2013?
Stroke.
similar risk factors to IHD
What are the risk factors of coronary heart disease? (the same thing as ischaemic heart disease, the same thing as coronary artery disease)
Smoking Hypertension Dyslipidaemia Diabetes Atherosclerosis (hx of angina, MI, stroke, TIA, PVD) FHx of premature CAD Age (>65 years) Obesity Physical Inactivity Chronic Kidney Disease Comorbidities (rheumatoid arthiritis, systemic lupus errythamatous) Stent thrombosis or restenosis Cocaine Use Depression/Stress
what does PVD stand for?
peripheral vascular disease
what are symptoms of ischaemic heart disease?
Stable angina: brought on by exertion and relieved by rest
ACS: angina pectoris pale SOB (dyspnoea (difficulty breathing) tightness in chest) sweating restless presence of RFs physical exertion weakness abdominal pain
anxiety cardiogenic shock (hypotension, oliguria, cold peripheries)
Why would you test for amylase when suspecting MI?
Pancreatitis presents similarly to MI. Need to exclude when you can.
What are the key symptoms of ACS?
dyspnoea sweating pallor angina restlessness & anxiety
What are the signs of ACS?
low-grade pyrexia
restless
check both radial pulses
What must you exclude when examining for ACS?
Aortic Dissection
(take both radial pulses. are they unequal? is there tearing pain between scapulae? haemodynamically unstable?
