Ischemic heart disease Flashcards
What is the definition of ischaemic heart disease?
An imbalance between myocardial O2 demand and supply from the coronary circulation
Which parts of the heart does the LAD supply?
The anterior wall of LV, apex and septum
40-50% of thrombuses occur here
Which parts of the heart does the RCA supply?
The posterior wall of the LV, RV, SA and AV nodes
30-40% of thrombuses occur here
Which parts of the heart does the circumflex artery supply?
the lateral LV
15-20% thrombuses occur here
What are the main types of ischaemic heart disease?
Angina pectoris (most common)
Chronic ischaemic heart disease
Sudden cardiac death
Acute myocardial infarction
What are the risk factors for ischaemic heart disease?
Age most important Family history Lipid abnormalities Smoking Hypertension Diabetes
What are the causes of stable angina?
The most common cause is fixed atherosclerotic disease in coronary arteries
AV stenosis or hypertension with concentric left ventricular hypertrophy
hypertrophic cardiomyopathy
Cocaine induced coronary vasoconstriction
What are the causes and clinical findings in unstable angina?
It is caused by severe fixed multivessel plaques that regularly rupture and cause frequent bouts of chest pain
What diagnostic tests are done for angina?
Resting ECG
excercise ecg test
Stress ecg test
Coronary angiography
What are the treatments for angina?
Non pharmacological:
-losing weight
-smoking cessation
-low cholesterol diet
Pharmacological:
Uses antiischaemic agents
-nitrates cause vasodilation and reduces afterload
-beta blockers decrease the cardiac O2 comsumption through decreased HR and blood pressure
-Calcium channel blockers cause vasodilation
-Aspirin inhibits platelet aggregation
-clopidogrel also inhibits platelet aggregation
-Heparins plus aspirin are used for unstable angina
What are the risk factors of sudden cardiac death?
Ischaemic heart disease
Obesity, hyperlipidaemia, LVH, hypertension, NSTEMI
