Ischemic heart diseases..
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Ischemic heart diseases.. Presentation Transcript

  • 1. I schemic Heart Disease
  • 2.
    • Ischemia
    Demand Supply
  • 3.
    • Cause of Myocardial ischemia in
    • 90% cases is
    Atherosclerosis in Coronaries
  • 4. Clinical manifestations of IHD
    • It’s a s p e c t r u m
    • MI : Most severe ischemia
    • Angina pectoris : Ischemia Less ischemia
    • Chronic IHD
    • Sudden cardiac death
  • 5. Ischemic Heart Disease Atherosclerosis in Coronaries
  • 6.
    • Atherosclerosis
  • 7.
    • 
    • 
  • 8.
    • L ifestyle
  • 9.  
  • 10.  
  • 11.  
  • 12.  
  • 13. Obstructive lesion of 75% or greater causes symptomatic ischemia induced by exercise 90% Obstruction can cause Symptoms at rest
  • 14. Atherosclerosis Acute MI Sudden Cardiac Death Acute Plaque change
  • 15. Acute Plaque changes
    • Rupture
    • Erosion
    • Hemorrhage
  • 16.
    • Vulnerable Plaques
    • Plaques containing :
    • Large foam cells
    • High Lipid content
    • Thin Fibrous cap
    • Inflammatory cells
  • 17. Angina pectoris
    • A ttacks of substernal / precordial
    • chest discomfort causes by transient
    • myocardial ischemia that falls short
    • of infarction
  • 18. Constricting Squeezing  Knifelike
  • 19. Patterns of Angina pectoris
    • Stable / Typical
    • Prinzmetal / Variant
    • Unstable / Crescendo
  • 20. Myocardial Infarction
    • Heart Attack
  • 21.
    • Myocardial infarction – Death of cardiac
    • muscles due to ischemia
    • Transmural Infarcts – Involving full thickness
    • Of ventricular wall
    • Subendocardial infarcs – Involving inner
    • 1/3 area of ventricular wall.
  • 22.
    • Males > Females
    • (till menopause)
    • Risk factors :
  • 23. Pathogenesis
    • Sudden change in the Plaque
    • Adhesion of platelets to the exposed part
    • Platelets release : Thromboxane A2,
    • serotonin and Platelet factor 3 , 4
    • Vasospasm
    • Stimulation of Coagulation pathway
    • Thrombus blocks the coronary artery
    90 %
  • 24. In 10 % cases Vasospasm Emboli ?? Unexplained
  • 25. Effects of MI on the Heart
    • End of Aerobic glycolysis
    • Start of Anaerobic glycolysis
    • Lactic acid accumulation
    • Ischemia for 20 – 40 mins :
    • Irreversible damage to myocytes
  • 26.
    • Coagulation Necrosis is the Mechanism
    • of cell Death of Myocytes …
  • 27.