Ischaemic Heart Disease

Question 1

What is ischaemic heart disease?

Answer 1

Imbalance between supply and demand of the heart for oxygenated blood. Not only decrease oxygen, but also decreased nutrients, substrates and inadequate removal of metabolites.

Question 2

What are the causes of ischaemic heart disease?

Answer 2

Decreased flow/no flow of oxygenated blood (atheroma, embolism, spasm).
Increased demand for oxygen (thyrotoxicosis, myocardial hypertrophy)

Question 3

What are the risk factors of ischaemic heart disease?

Answer 3

Positive family history, male, age, genetic factors (e.g. ACE gene deletion).
Also: hyperlipideamia, smoking, hypertension, diabetes, lack of exercise, obesity, heavy alcohol consumption

Question 4

Signs and symptoms of ischaemic heart disease

Answer 4

CHEST PAIN, (radiating to left arm or into jaw), SOB, palpitations, syncope, nauseous, pale, sweating

Question 5

Clinical presentations of ischaemic heart disease

Answer 5

Angina, Non-ST Elevation Myocardial Infarction (NSTEMI), STEMI, sudden death

Question 6

Complications of MI

Answer 6

Cardiac arrest, arrhythmias, pericarditis, valvular defects, ventricular wall rupture, DVT, pulmonary embolus

Question 7

Treatment of ischaemic heart disease

Answer 7

Immediate: oxygen, pain relief aspirin
Angina: lifestyle, nitrates, B-blockers
ACS: thrombolytic therapy, angioplasty/stent, coronary artery bypass graft (CABG)