Topics included :- ISCHEMIC HEART DISEASE - Introduction, symptoms, risk factors, medication, surgical procedures and diagnosis. ANGINA PECTORIS - Introduction, symptoms and diagnosis.

1. ISCHEMIC HEART DISEASE AND
ANGINA PECTORIS
SUBJECT : CLINICAL BIOCHEMISTRY
BY :
S. DASH

2. INTRODUCTION
ISCHEMIC HEART DISEASE
• It is a condition of recurring chest pain or discomfort that occurs when a part of the
heart does not receive enough blood.
• This condition occurs most often during exertion or excitement, when the heart
requires greater blood flow.
• Ischemic heart disease, also called Coronary Heart Disease (CHD).
• It develops when cholesterol particles in the blood begin to accumulate on the walls
of the arteries that supply blood of the heart.
• Eventually, deposits narrow the arteries and eventually block the flow of blood. This
decrease in the blood flow reduces the amount of oxygen supplied to the heart
muscle.
• The signs and symptoms of ischemic heart disease may develop slowly as arteries
gradually become blocked, or they may occur quickly if an artery suddenly becomes
blocked.

3. SYMPTOMS
 The common symptoms include chest pain, chest pressure or shortness of breath
that :-
• May feel as if the pain starts in the chest spreads to the arms, back or other areas.
• May feel like gas or indigestion (more common in women).
• Occurs repeatedly; episodes tend to be alike.
• Occurs when the heart must work harder, usually during physical exertion
• Usually lasts a short time (five minutes or less).
• It is relieved by rest or medicine.

4. RISK FACTORS
 Risk factors for ischemic heart disease include :-
• Diabetes.
• Family history of heart disease.
• High blood cholesterol.
• High blood pressure.
• High blood triglycerides.
• Obesity.
• Physical inactivity.
• Smoking and other tobacco use.

5. MEDICATIONS USEDTO TREAT ISCHEMIC
HEART DISEASE
 Drug therapy is commonly used for treatment of ischemic heart disease and
includes :-
• Angiotensin converting enzyme (ACE) inhibitors, which relax the blood vessels
and lower blood pressure.
• Angiotensin receptor blockers (ARB’s),which lower blood pressure.
• Anti-ischemic agents such as Ranexa (Ranolazine).
• Anti-platelet drugs, which prevent the formation of blood clots.
• Beta-blockers, which lower the heart rate.
• Calcium channel blockers, which reduce workload on the heart muscle.
• Nitrates, which dilate the blood vessels.
• Statins, which lower cholesterol.

6. SURGICAL PROCEDURES USED TO TREAT
ISCHEMIC HEART DISEASE.
 Severe symptoms that are not relieved by medication alone are treated with
surgical procedures including :-
• Angioplasty and stent placement (procedure to remove plaque and restore blood
flow in clogged arteries)
• Coronary Artery Bypass graft (Procedure that helps restore blood flow to the heart
by routing the flow through transplanted arteries)

7. DIAGNOSIS :-
 CARDIAC CATHETERIZTION AND ANGIOGRAM
• ECHOCARDIOGRAM
• ELECTROCARDIOGRAM
• ELECTRON BEAM (ULTRAFAST) CT SCAN
• EXERCISE STRESS TESTS

11. ANGINA PECTORIS
Angina Pectoris or angina is temporary chest pain or discomfort as a result of
decreased blood flow to the heart muscle.
Angina is not a heart attack, but it is a sign of increased risk for heart attack.
Angina may be stable (develops during physical activity, lasts five minutes or less
and is relieved with rest) or unstable (occurs during periods of rest, lasts longer, and
symptoms may be more severe).

12. SYMPTOMS :
• Chest pain or discomfort, such as tightening of the chest.
• Discomfort in the jaw, neck, arms, upper abdomen, shoulder or back.
• Fatigue.
• Sweating.
• Nausea.
• Dizziness

13. DIAGNOSIS :
ELECTROCRDIOGRAM
STRESS TEST WITHOUT IMAGING
BLOOD TESTS
Additionally…..
CHEST X-RAY
CT OF THE CHEST
CORONARY COMPUTED TOMOGRAPHY (CT) ANGIOGRAPHY
MAGNETIC RESONANCE (MR) IMAGING
CATHETER ANGIOGRAPHY
ECHOCARDIOGRAM
MYOCARDIAL SINGLE PHOTO EMISSION COMPUTED TOMOGRAPHY
(SPECT)

17. REFERENCES :
• www.radiologyinfo.org
• www.healthgrades.com
• www.heart.org
• www.webmd.com

18. THANK YOU