This document provides information on acute myocardial infarction (AMI), commonly known as a heart attack. It defines AMI as the irreversible necrosis of heart muscle due to prolonged lack of oxygen. AMI results from an imbalance in oxygen supply and demand, usually caused by a blockage in one of the coronary arteries. The document discusses the epidemiology, risk factors, pathophysiology, classification, signs and symptoms, diagnosis, management, and preventive measures for AMI. It emphasizes the importance of rapidly restoring blood flow to limit damage to heart muscle. Lifestyle modifications like quitting smoking, diet, exercise, and controlling conditions like high blood pressure and diabetes can help prevent AMI.
Acute myocardial infarction, or heart attack, results from prolonged ischemia due to a blockage in a coronary artery that supplies blood to heart muscle. Risk factors include increasing age, male sex, hypertension, dyslipidemia, diabetes, smoking, obesity, physical inactivity, excessive alcohol intake, and family history. Diagnosis involves electrocardiogram changes, elevated cardiac biomarkers, and symptoms like chest pain. Management focuses on oxygen, pain relief, antiplatelet/anticoagulant drugs, revascularization, and lifestyle changes to prevent future heart attacks.
Stable ischemic heart disease is typically caused by atherosclerotic plaques narrowing the coronary arteries and reducing blood flow to the heart muscle. It commonly manifests as chronic stable angina or silent ischemia. The goals of treatment are to eliminate chest pain, slow atherosclerosis progression, and prevent complications like heart attack. Treatment involves lifestyle modifications, risk factor control through medications, and sometimes revascularization. Pharmacologic options for management include antiplatelet agents, beta-blockers, calcium channel blockers, ACE inhibitors, and long-acting nitrates.
Myocardial infarction occurs when there is prolonged ischemia to the heart muscle due to reduced oxygen supply or increased oxygen demand. It is usually caused by formation of a blood clot within a coronary artery blocking blood flow. Diagnosis is made through symptoms, electrocardiogram changes, and cardiac biomarker levels. Treatment involves oxygen, aspirin, nitrates, beta blockers, fibrinolytics or percutaneous coronary intervention to restore blood flow, as well as long term medications like statins to prevent future heart attacks.
This presentation discusses acute myocardial infarction (AMI), also known as a heart attack. AMI occurs when an area of the heart muscle dies due to obstructed blood flow. The presentation covers the objectives, definition, classifications, risk factors, signs and symptoms, investigations, and treatment options for AMI. Key points include that AMI can be caused by a blockage in the coronary arteries, often due to a blood clot, and affects different areas of the heart. Risk factors include age, smoking, diabetes, hypertension, and high cholesterol. Diagnosis involves electrocardiograms, blood tests of cardiac markers, and imaging tests. Treatment involves medications like aspirin and beta blockers, thrombolysis if ST is elevated, and sometimes ang
This document discusses acute coronary syndromes and ischemic heart disease. It begins with an overview of heart anatomy and physiology. It then defines acute coronary syndrome and myocardial infarction, describing signs and symptoms. Risk factors for ischemic heart disease are outlined. The document concludes with descriptions of nursing assessments, diagnoses, and interventions for patients with acute coronary syndromes or ischemic heart disease, focusing on pain management, improving perfusion, and reducing anxiety through education.
ATHEROSCLEROSIS
Seminar Prepared by :-
Ali Abdulazeem
Shilan Adnan Abdulrahman
Alaa Shamil
Guldan Hameed
Internal Medicine
College of Medicine - University of Kirkuk
Coronary artery disease or Ischemic heart disease ANILKUMAR BR
Cardiovascular disease are becoming a leading cause of morbidity and mortality in developed countries and they are also emerging as prominent national health problem in developing countries.
Coronary artery disease has become the major cause of early death and disability in the population.
Coronary artery disease (CAD) can also be used interchangeably with the terms atherosclerotic heart disease or ischemic heart disease.
All of these terms imply insufficient perfusion of the coronary arteries from an abnormal narrowing of the vessels, leading to insufficient oxygen delivery to the myocardial tissue.
The term coronary heart disease, also known as coronary artery disease or Ischemic heart disease, is a condition refers to diseases of the heart that result from a decrease in blood supply to the heart muscle.
Non modifiable risk factors
Modifiable risk factors
Contributing risk factors
this article discusses about coronary artery disease, its symptoms, presentations, risk factors, pathophysiology in short and primary prevention. this article is intended to present to a group of physicians in various disciplines other than cardiology.
Acute myocardial infarction, or heart attack, results from prolonged ischemia due to a blockage in a coronary artery that supplies blood to heart muscle. Risk factors include increasing age, male sex, hypertension, dyslipidemia, diabetes, smoking, obesity, physical inactivity, excessive alcohol intake, and family history. Diagnosis involves electrocardiogram changes, elevated cardiac biomarkers, and symptoms like chest pain. Management focuses on oxygen, pain relief, antiplatelet/anticoagulant drugs, revascularization, and lifestyle changes to prevent future heart attacks.
Stable ischemic heart disease is typically caused by atherosclerotic plaques narrowing the coronary arteries and reducing blood flow to the heart muscle. It commonly manifests as chronic stable angina or silent ischemia. The goals of treatment are to eliminate chest pain, slow atherosclerosis progression, and prevent complications like heart attack. Treatment involves lifestyle modifications, risk factor control through medications, and sometimes revascularization. Pharmacologic options for management include antiplatelet agents, beta-blockers, calcium channel blockers, ACE inhibitors, and long-acting nitrates.
Myocardial infarction occurs when there is prolonged ischemia to the heart muscle due to reduced oxygen supply or increased oxygen demand. It is usually caused by formation of a blood clot within a coronary artery blocking blood flow. Diagnosis is made through symptoms, electrocardiogram changes, and cardiac biomarker levels. Treatment involves oxygen, aspirin, nitrates, beta blockers, fibrinolytics or percutaneous coronary intervention to restore blood flow, as well as long term medications like statins to prevent future heart attacks.
This presentation discusses acute myocardial infarction (AMI), also known as a heart attack. AMI occurs when an area of the heart muscle dies due to obstructed blood flow. The presentation covers the objectives, definition, classifications, risk factors, signs and symptoms, investigations, and treatment options for AMI. Key points include that AMI can be caused by a blockage in the coronary arteries, often due to a blood clot, and affects different areas of the heart. Risk factors include age, smoking, diabetes, hypertension, and high cholesterol. Diagnosis involves electrocardiograms, blood tests of cardiac markers, and imaging tests. Treatment involves medications like aspirin and beta blockers, thrombolysis if ST is elevated, and sometimes ang
This document discusses acute coronary syndromes and ischemic heart disease. It begins with an overview of heart anatomy and physiology. It then defines acute coronary syndrome and myocardial infarction, describing signs and symptoms. Risk factors for ischemic heart disease are outlined. The document concludes with descriptions of nursing assessments, diagnoses, and interventions for patients with acute coronary syndromes or ischemic heart disease, focusing on pain management, improving perfusion, and reducing anxiety through education.
ATHEROSCLEROSIS
Seminar Prepared by :-
Ali Abdulazeem
Shilan Adnan Abdulrahman
Alaa Shamil
Guldan Hameed
Internal Medicine
College of Medicine - University of Kirkuk
Coronary artery disease or Ischemic heart disease ANILKUMAR BR
Cardiovascular disease are becoming a leading cause of morbidity and mortality in developed countries and they are also emerging as prominent national health problem in developing countries.
Coronary artery disease has become the major cause of early death and disability in the population.
Coronary artery disease (CAD) can also be used interchangeably with the terms atherosclerotic heart disease or ischemic heart disease.
All of these terms imply insufficient perfusion of the coronary arteries from an abnormal narrowing of the vessels, leading to insufficient oxygen delivery to the myocardial tissue.
The term coronary heart disease, also known as coronary artery disease or Ischemic heart disease, is a condition refers to diseases of the heart that result from a decrease in blood supply to the heart muscle.
Non modifiable risk factors
Modifiable risk factors
Contributing risk factors
this article discusses about coronary artery disease, its symptoms, presentations, risk factors, pathophysiology in short and primary prevention. this article is intended to present to a group of physicians in various disciplines other than cardiology.
Coronary artery disease is caused by atherosclerosis which narrows the coronary arteries and reduces blood flow to the heart. Risk factors include family history, age, smoking, hypertension, diabetes and high cholesterol. Symptoms include chest pain known as angina which is relieved by rest. Diagnosis involves ECG, stress test and angiography. Treatment includes lifestyle changes, medications to relieve symptoms and open arteries, and procedures like angioplasty, stenting or bypass surgery. Nursing care focuses on pain relief, monitoring for complications, health education and cardiac rehabilitation.
This document provides an overview of coronary artery disease (CAD) and ischemic heart disease (IHD), including their definition, clinical manifestations, and pathophysiology. CAD/IHD results from an imbalance between the heart's oxygen supply and demand. It is most commonly caused by a narrowing of the coronary arteries. The two main clinical manifestations are: 1) Angina pectoris, which presents as chest pain that occurs with exertion and is relieved by rest, and 2) Myocardial infarction (MI), commonly known as a heart attack, which is caused by cell death in the heart muscle due to lack of oxygen. MI is a medical emergency and a leading cause of death worldwide.
This document defines myocardial infarction and provides epidemiological data. It begins by defining myocardial infarction as the irreversible necrosis of heart muscle due to prolonged ischemia resulting from a blockage in a coronary artery. It then notes that over 735,000 Americans have heart attacks each year. Risk factors include increasing age, male sex, hypertension, dyslipidemia, diabetes, smoking, obesity, physical inactivity, and excessive alcohol consumption. The pathophysiology involves rupture of an atheromatous plaque leading to thrombus formation and coronary artery occlusion, causing ischemia and eventual cell death.
The document provides information on myocardial infarction (MI or heart attack) including definitions, causes, pathophysiology, clinical manifestations, diagnostic tests, treatment, nursing management, and patient education. It defines MI as myocardial cell death due to prolonged ischemia. The main cause is sudden blockage of the coronary artery by a blood clot, causing irreversible damage to heart muscle. Clinical manifestations may include chest pain, shortness of breath, nausea, and changes in vital signs. Diagnostic tests include electrocardiogram, cardiac enzymes, and echocardiogram. Treatment focuses on reperfusion, reducing oxygen demand on the heart, and preventing complications. Nursing management involves monitoring for complications, relieving symptoms, promoting perfusion and respiratory function
This document discusses ischaemic heart disease and angina pectoris. It defines IHD as a condition where there is inadequate blood supply and oxygen to the myocardium. Angina pectoris is defined as a clinical syndrome characterized by precordial discomfort due to myocardial ischemia, typically brought on by exertion and relieved by rest. The document covers the epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis and treatment of these conditions. It emphasizes that risk factor identification and modification are important for managing patients with known or suspected IHD.
- Myocardial infarction is caused by the sudden blockage of arteries that supply the heart muscle, usually due to atherosclerosis where plaque builds up in the artery walls over time.
- Inflammation plays a key role in weakening the fibrous cap of plaque and increasing the risk of cap rupture, which can lead to complete blockage and a heart attack.
- Lifestyle factors like smoking, obesity, and diabetes can increase inflammation and thus heart attack risk, so reducing or eliminating these risk factors may help lower inflammation.
Ischemic heart disease (IHD) is caused by an inadequate blood supply to the heart muscle due to narrowed coronary arteries. The most common cause is atherosclerosis which develops over many years and is worsened by risk factors like smoking, high cholesterol, and hypertension. Symptoms include chest pain and shortness of breath during physical exertion. Diagnosis involves tests like electrocardiograms, stress tests, and cardiac catheterization. Treatment aims to improve symptoms, prevent heart attacks, and includes risk factor modification, medications like nitrates, beta blockers, and calcium channel blockers, and revascularization procedures like angioplasty and bypass surgery.
This document provides information about myocardial infarction (MI) or heart attack. It defines MI as death of heart muscle cells due to lack of oxygen, usually caused by a blockage in the coronary arteries. It lists risk factors for MI such as smoking, diabetes, hypertension, and family history. It describes the signs and symptoms of MI, diagnostic tests including ECG and cardiac enzymes, types of MI, and treatments including thrombolytics, angioplasty, medications, and lifestyle changes to prevent future heart attacks. The nursing management of MI focuses on reducing pain, improving perfusion, preventing complications, health education, and calling for help if symptoms worsen.
1. Myocardial infarction, also known as a heart attack, occurs when blood flow to part of the heart is blocked, damaging heart muscle.
2. It is usually caused by a buildup of fatty plaques in the coronary arteries that supply blood to the heart. When a plaque ruptures, a blood clot forms that blocks one of the arteries.
3. Symptoms of a heart attack include chest pain or discomfort that may travel to the arm, shoulder, or jaw. Early treatment is critical to reduce damage to the heart.
Coronary artery disease (CAD) refers to a group of diseases caused by narrowing of the coronary arteries due to atherosclerosis. It includes conditions like stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A survey found that residents of public housing in Charlotte had several risk factors for CAD such as high blood pressure, high cholesterol, diabetes, and smoking. Diagnosis involves tests like ECG, cardiac markers, stress echocardiography, and coronary angiography. Treatment includes lifestyle changes, medications, angioplasty, stents, and coronary artery bypass grafting. Nursing management focuses on pre-procedure teaching, post-procedure monitoring for bleeding or other complications, and managing post-surgical
The term ischemic heart disease (IHD) describes a group of clinical syndromes characterized by myocardial ischemia, an imbalance between myocardial blood supply and demand.
Because the fundamental pathophysiologic defect in the ischemic myocardium is inadequate perfusion, ischemia is associated not only with insufficient oxygen supply, but also with reduced availability of nutrients and inadequate removal of metabolic end products.
Ischemic heart disease (IHD) caused by atherosclerosis of the epicardial vessels leading to coronary heart disease (CHD) is the main etiology of IHD.
Leading cause of death
Resulting from myocardial ischemia—an imbalance between the supply (perfusion) and demand of the heart for oxygenated blood.
90% of cases, the cause of myocardial ischemia is reduced blood flow due to obstructive atherosclerotic lesions in the coronary arteries.
IHD is often termed coronary artery disease (CAD) or coronary heart disease.
There is a long period (up to decades) of silent, slow progression of coronary lesions before symptoms appear.
IHD are only the late manifestations of coronary atherosclerosis that may have started during childhood or adolescence
Myocardial infarction, the most important form of IHD, in which ischemia causes the death of heart muscle.
Angina pectoris, in which the ischemia is of insufficient severity to cause infarction, but may be a harbinger of MI.
Chronic IHD with heart failure.
Sudden cardiac death.
The dominant cause of the IHD syndromes is insufficient coronary perfusion relative to myocardial demand, due to • Chronic, progressive atherosclerotic narrowing of the epicardial coronary arteries, and • Variable degrees of superimposed acute plaque change, thrombosis, and vasospasm
Clinical manifestations of coronary atherosclerosis are generally due to • Progressive narrowing of the lumen leading to stenosis (“fixed” obstructions) or • Acute plaque disruption with thrombosis, both of which compromise blood flow.
A fixed lesion obstructing 75% or greater of the lumen is generally required to cause symptomatic ischemia precipitated by exercise (most often manifested as chest pain, known as angina)
Obstruction of 90% of the lumen can lead to inadequate coronary blood flow even at rest.
Cardiovascular diseases (CVDs) accounted for 17.9 million deaths worldwide in 2019, or 32% of all deaths. Heart attack and stroke caused 85% of CVD deaths. In low- and middle-income countries, over three quarters of deaths are due to CVDs. Addressing behavioral risk factors like smoking, diet, obesity, and alcohol can prevent the majority of CVDs. Early detection through screening and treatment management are also important for reducing CVD burdens.
Nursing care of client with Coronary Artery Disease Part 1 of 2 Carmela Domocmat
This document discusses nursing care for clients with acute coronary syndrome. It begins by defining coronary artery disease and its causes, including atherosclerosis. Major risk factors for coronary artery disease are then outlined, including nonmodifiable factors like age, gender and heredity, as well as modifiable factors such as smoking, hypertension, high cholesterol, diabetes, obesity, physical inactivity, and stress. The document emphasizes lifestyle modifications, medication adherence, and management of risk factors to prevent acute coronary events.
A blockage of blood flow to the heart muscle.
A heart attack is a medical emergency. A heart attack usually occurs when a blood clot blocks blood flow to the heart. Without blood, tissue loses oxygen and dies.
Symptoms include tightness or pain in the chest, neck, back or arms, as well as fatigue, lightheadedness, abnormal heartbeat and anxiety. Women are more likely to have atypical symptoms than men.
Treatment ranges from lifestyle changes and cardiac rehabilitation to medication, stents and bypass surgery.
1) Ischemic heart disease results from an imbalance between the heart's demand for oxygenated blood and the supply delivered by the coronary arteries, usually due to atherosclerotic plaque buildup.
2) It manifests as stable angina, unstable angina, myocardial infarction, or sudden cardiac death.
3) Myocardial infarction occurs when a blockage in a coronary artery results in prolonged ischemia and cell death in the heart muscle.
This document provides objectives and content about acute myocardial infarction (AMI) or heart attack. It begins with objectives of explaining AMI and its various aspects. It then defines AMI as reduced blood flow in a coronary artery due to atherosclerosis or thrombus. It discusses the incidence, classifications, risk factors like hypertension and smoking, etiological factors, pathophysiology of plaque buildup and thrombus formation blocking blood flow. It covers clinical features like chest pain, diagnostic evaluation including ECG, cardiac enzymes and angiography. It outlines management including pharmacological treatments, angioplasty, and other surgical procedures to reopen blocked arteries and restore blood flow to the heart.
The document discusses cardiovascular disease and cancer. It covers major risk factors for cardiovascular disease like smoking, high blood pressure, high cholesterol, and physical inactivity. It also discusses forms of cardiovascular disease like atherosclerosis, heart attack, and stroke. For cancer, it covers causes like genetic mutations, types of cancer, common cancer sites, risk factors, detection methods, and prevention strategies.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
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Coronary artery disease is caused by atherosclerosis which narrows the coronary arteries and reduces blood flow to the heart. Risk factors include family history, age, smoking, hypertension, diabetes and high cholesterol. Symptoms include chest pain known as angina which is relieved by rest. Diagnosis involves ECG, stress test and angiography. Treatment includes lifestyle changes, medications to relieve symptoms and open arteries, and procedures like angioplasty, stenting or bypass surgery. Nursing care focuses on pain relief, monitoring for complications, health education and cardiac rehabilitation.
This document provides an overview of coronary artery disease (CAD) and ischemic heart disease (IHD), including their definition, clinical manifestations, and pathophysiology. CAD/IHD results from an imbalance between the heart's oxygen supply and demand. It is most commonly caused by a narrowing of the coronary arteries. The two main clinical manifestations are: 1) Angina pectoris, which presents as chest pain that occurs with exertion and is relieved by rest, and 2) Myocardial infarction (MI), commonly known as a heart attack, which is caused by cell death in the heart muscle due to lack of oxygen. MI is a medical emergency and a leading cause of death worldwide.
This document defines myocardial infarction and provides epidemiological data. It begins by defining myocardial infarction as the irreversible necrosis of heart muscle due to prolonged ischemia resulting from a blockage in a coronary artery. It then notes that over 735,000 Americans have heart attacks each year. Risk factors include increasing age, male sex, hypertension, dyslipidemia, diabetes, smoking, obesity, physical inactivity, and excessive alcohol consumption. The pathophysiology involves rupture of an atheromatous plaque leading to thrombus formation and coronary artery occlusion, causing ischemia and eventual cell death.
The document provides information on myocardial infarction (MI or heart attack) including definitions, causes, pathophysiology, clinical manifestations, diagnostic tests, treatment, nursing management, and patient education. It defines MI as myocardial cell death due to prolonged ischemia. The main cause is sudden blockage of the coronary artery by a blood clot, causing irreversible damage to heart muscle. Clinical manifestations may include chest pain, shortness of breath, nausea, and changes in vital signs. Diagnostic tests include electrocardiogram, cardiac enzymes, and echocardiogram. Treatment focuses on reperfusion, reducing oxygen demand on the heart, and preventing complications. Nursing management involves monitoring for complications, relieving symptoms, promoting perfusion and respiratory function
This document discusses ischaemic heart disease and angina pectoris. It defines IHD as a condition where there is inadequate blood supply and oxygen to the myocardium. Angina pectoris is defined as a clinical syndrome characterized by precordial discomfort due to myocardial ischemia, typically brought on by exertion and relieved by rest. The document covers the epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis and treatment of these conditions. It emphasizes that risk factor identification and modification are important for managing patients with known or suspected IHD.
- Myocardial infarction is caused by the sudden blockage of arteries that supply the heart muscle, usually due to atherosclerosis where plaque builds up in the artery walls over time.
- Inflammation plays a key role in weakening the fibrous cap of plaque and increasing the risk of cap rupture, which can lead to complete blockage and a heart attack.
- Lifestyle factors like smoking, obesity, and diabetes can increase inflammation and thus heart attack risk, so reducing or eliminating these risk factors may help lower inflammation.
Ischemic heart disease (IHD) is caused by an inadequate blood supply to the heart muscle due to narrowed coronary arteries. The most common cause is atherosclerosis which develops over many years and is worsened by risk factors like smoking, high cholesterol, and hypertension. Symptoms include chest pain and shortness of breath during physical exertion. Diagnosis involves tests like electrocardiograms, stress tests, and cardiac catheterization. Treatment aims to improve symptoms, prevent heart attacks, and includes risk factor modification, medications like nitrates, beta blockers, and calcium channel blockers, and revascularization procedures like angioplasty and bypass surgery.
This document provides information about myocardial infarction (MI) or heart attack. It defines MI as death of heart muscle cells due to lack of oxygen, usually caused by a blockage in the coronary arteries. It lists risk factors for MI such as smoking, diabetes, hypertension, and family history. It describes the signs and symptoms of MI, diagnostic tests including ECG and cardiac enzymes, types of MI, and treatments including thrombolytics, angioplasty, medications, and lifestyle changes to prevent future heart attacks. The nursing management of MI focuses on reducing pain, improving perfusion, preventing complications, health education, and calling for help if symptoms worsen.
1. Myocardial infarction, also known as a heart attack, occurs when blood flow to part of the heart is blocked, damaging heart muscle.
2. It is usually caused by a buildup of fatty plaques in the coronary arteries that supply blood to the heart. When a plaque ruptures, a blood clot forms that blocks one of the arteries.
3. Symptoms of a heart attack include chest pain or discomfort that may travel to the arm, shoulder, or jaw. Early treatment is critical to reduce damage to the heart.
Coronary artery disease (CAD) refers to a group of diseases caused by narrowing of the coronary arteries due to atherosclerosis. It includes conditions like stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A survey found that residents of public housing in Charlotte had several risk factors for CAD such as high blood pressure, high cholesterol, diabetes, and smoking. Diagnosis involves tests like ECG, cardiac markers, stress echocardiography, and coronary angiography. Treatment includes lifestyle changes, medications, angioplasty, stents, and coronary artery bypass grafting. Nursing management focuses on pre-procedure teaching, post-procedure monitoring for bleeding or other complications, and managing post-surgical
The term ischemic heart disease (IHD) describes a group of clinical syndromes characterized by myocardial ischemia, an imbalance between myocardial blood supply and demand.
Because the fundamental pathophysiologic defect in the ischemic myocardium is inadequate perfusion, ischemia is associated not only with insufficient oxygen supply, but also with reduced availability of nutrients and inadequate removal of metabolic end products.
Ischemic heart disease (IHD) caused by atherosclerosis of the epicardial vessels leading to coronary heart disease (CHD) is the main etiology of IHD.
Leading cause of death
Resulting from myocardial ischemia—an imbalance between the supply (perfusion) and demand of the heart for oxygenated blood.
90% of cases, the cause of myocardial ischemia is reduced blood flow due to obstructive atherosclerotic lesions in the coronary arteries.
IHD is often termed coronary artery disease (CAD) or coronary heart disease.
There is a long period (up to decades) of silent, slow progression of coronary lesions before symptoms appear.
IHD are only the late manifestations of coronary atherosclerosis that may have started during childhood or adolescence
Myocardial infarction, the most important form of IHD, in which ischemia causes the death of heart muscle.
Angina pectoris, in which the ischemia is of insufficient severity to cause infarction, but may be a harbinger of MI.
Chronic IHD with heart failure.
Sudden cardiac death.
The dominant cause of the IHD syndromes is insufficient coronary perfusion relative to myocardial demand, due to • Chronic, progressive atherosclerotic narrowing of the epicardial coronary arteries, and • Variable degrees of superimposed acute plaque change, thrombosis, and vasospasm
Clinical manifestations of coronary atherosclerosis are generally due to • Progressive narrowing of the lumen leading to stenosis (“fixed” obstructions) or • Acute plaque disruption with thrombosis, both of which compromise blood flow.
A fixed lesion obstructing 75% or greater of the lumen is generally required to cause symptomatic ischemia precipitated by exercise (most often manifested as chest pain, known as angina)
Obstruction of 90% of the lumen can lead to inadequate coronary blood flow even at rest.
Cardiovascular diseases (CVDs) accounted for 17.9 million deaths worldwide in 2019, or 32% of all deaths. Heart attack and stroke caused 85% of CVD deaths. In low- and middle-income countries, over three quarters of deaths are due to CVDs. Addressing behavioral risk factors like smoking, diet, obesity, and alcohol can prevent the majority of CVDs. Early detection through screening and treatment management are also important for reducing CVD burdens.
Nursing care of client with Coronary Artery Disease Part 1 of 2 Carmela Domocmat
This document discusses nursing care for clients with acute coronary syndrome. It begins by defining coronary artery disease and its causes, including atherosclerosis. Major risk factors for coronary artery disease are then outlined, including nonmodifiable factors like age, gender and heredity, as well as modifiable factors such as smoking, hypertension, high cholesterol, diabetes, obesity, physical inactivity, and stress. The document emphasizes lifestyle modifications, medication adherence, and management of risk factors to prevent acute coronary events.
A blockage of blood flow to the heart muscle.
A heart attack is a medical emergency. A heart attack usually occurs when a blood clot blocks blood flow to the heart. Without blood, tissue loses oxygen and dies.
Symptoms include tightness or pain in the chest, neck, back or arms, as well as fatigue, lightheadedness, abnormal heartbeat and anxiety. Women are more likely to have atypical symptoms than men.
Treatment ranges from lifestyle changes and cardiac rehabilitation to medication, stents and bypass surgery.
1) Ischemic heart disease results from an imbalance between the heart's demand for oxygenated blood and the supply delivered by the coronary arteries, usually due to atherosclerotic plaque buildup.
2) It manifests as stable angina, unstable angina, myocardial infarction, or sudden cardiac death.
3) Myocardial infarction occurs when a blockage in a coronary artery results in prolonged ischemia and cell death in the heart muscle.
This document provides objectives and content about acute myocardial infarction (AMI) or heart attack. It begins with objectives of explaining AMI and its various aspects. It then defines AMI as reduced blood flow in a coronary artery due to atherosclerosis or thrombus. It discusses the incidence, classifications, risk factors like hypertension and smoking, etiological factors, pathophysiology of plaque buildup and thrombus formation blocking blood flow. It covers clinical features like chest pain, diagnostic evaluation including ECG, cardiac enzymes and angiography. It outlines management including pharmacological treatments, angioplasty, and other surgical procedures to reopen blocked arteries and restore blood flow to the heart.
The document discusses cardiovascular disease and cancer. It covers major risk factors for cardiovascular disease like smoking, high blood pressure, high cholesterol, and physical inactivity. It also discusses forms of cardiovascular disease like atherosclerosis, heart attack, and stroke. For cancer, it covers causes like genetic mutations, types of cancer, common cancer sites, risk factors, detection methods, and prevention strategies.
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The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
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2. Definition
Acute myocardial infarction (AMI), commonly
known as a heart attack, is the irreversible necrosis
of heart muscle secondary to prolonged ischemia.
Results from an imbalance in oxygen supply and
demand, caused by plaque rupture with thrombus
formation in a coronary vessel, resulting in an
acute reduction of blood supply to a portion of
the myocardium.
2
3. Epidemiology
Every year about 735,000 Americans have a
heart attack. Of these, 525,000 are a first
heart attack and 210,000 happen in people
who have already had a heart attack.
In 2010, approximately 1 in 6 people in the
United States died of Acute Myocardial
Infarction.
Approximately every 34 seconds, 1 American
has a coronary event, and approximately
every 1 minute 23 seconds, an American will
die of one.
3
The incidence of MI in India is 64.37/1000
people in men aged 29-69 years
8. Risk Factor 8
• Increasing age and male sex. Individuals aged
older than 45 years have an eight times greater
risk for AMI.
Even after menopause, when women's death
rate from heart disease increases, it's not as
great as men's
• Hypertension, dyslipidemia,and
diabetes
“A case-control study of AMI in 52 countries,
comprising 15,152 cases and 14,820 controls,
was conducted. Among the important risk factors
for AMI in both men and women were were
raised ApoB/ApoA1 ratio (OR = 3.25), history of
hypertension (OR = 1.91), and diabetes (OR =
2.37)”
9. Risk Factor 9
• Smoking increases a person's risk for heart
disease to about 4 times greater than non-
smokers.
• Obesity and physical inactivity People who
have excess body fat — especially at the waist
— are more likely to develop heart disease
even if they have no other risk factors.
• Lack of exercise has been linked to 7–12% of
cases
• Acute and prolonged intake of high quantities
of alcoholic drinks (3-4 or more) increase the risk
of a heart attack
10. Pathophysiology
Coronary Arterial Occlusion.
Rupture of high-risk atheromatous plaque in the coronary
arteries is a primary causative factor in the development of
AMI.
When exposed to subendothelial collagen and necrotic
plaque contents, platelets adhere, become activated,
release their granule contents, and aggregate to form
microthrombi.
10
11. Pathophysiology
Vasospasm is stimulated by mediators released from
platelets.
Tissue factor activates the coagulation pathway, adding
to the bulk of the thrombus.
Within minutes, the thrombus expands to completely
occlude the vessel lumen.
11
12. Pathophysiology
In approximately 10% of cases, AMI occurs in the absence of
the typical coronary atherothrombosis.
12
Vasospasm Emboli Others
• Intravascular
Platelet
aggregation
• drug ingestion
(e.g., cocaine
or ephedrine)
• Vegetations of
infective
endocarditis,
• Intracardiac
prosthetic
material
• Vasculitis,
• Hematologic
abnormalities
(e.g., sickle cell
disease),
• Amyloid
deposition,
• Vascular
dissection,
• Aortic stenosis,
• Lowered
systemic blood
pressure (e.g.,
shock)
13. Pathophysiology
Myocardial Response.
Coronary arterial obstruction diminishes blood flow to a
region of myocardium causing ischemia, rapid myocardial
dysfunction, and eventually—with prolonged vascular
compromise — myocyte death.
The anatomic region supplied by that artery is referred to
as the area at risk.
13
15. Pathophysiology
Experimental and clinical evidence shows that only severe
ischemia lasting 20 to 30 minutes or longer leads to irreversible
damage (necrosis) of cardiac myocytes.
This delay in the onset of permanent myocardial injury provides
the rationale for rapid diagnosis in acute MI—to permit early
coronary intervention to establish reperfusion and salvage as
much “at risk” myocardium as possible.
15
17. Pathophysiology
The earliest detectable feature of myocyte necrosis is the
disruption of the integrity of the sarcolemmal membrane, allowing
intracellular macromolecules to leak out of necrotic cells into the
cardiac interstitium and ultimately into the microvasculature and
lymphatics.
Intracellular myocardial proteins into the circulation forms the basis
for blood tests that can sensitively detect irreversible myocyte
damage, and are important for managing AMI.
17
18. Pathophysiology 18
• Time to elevation of CKMB, cTnT and cTnI is 3 to 12 hrs
• CK-MB and cTnI peak at 24 hours
• CK-MB returns to normal in 48-72 hrs, cTnI in 5-10 days, and cTnT in 5 to 14 days
19. Classification
The two main types of acute myocardial infarction, based
on pathology, are:
Transmural infarction- Transmural infarcts extend through
the whole thickness of the heart muscle and are usually
a result of complete occlusion of the area's blood
supply.
Subendocardial (nontransmural) infarction - involves a
small area in the subendocardial wall of the left
ventricle, ventricular septum, or papillary muscles.
A transmural infarct is sometimes referred to as an “ST
elevation myocardial infarct” (STEMI) and a subendocardial
infarct as a “non–ST elevation infarct” (NSTEMI).
19
21. 21
A transmural acute myocardial infarct, predominantly of the posterolateral left
ventricle (arrow). Note the myocardial hemorrhage at one edge of the infarct
that was associated with cardiac rupture, and the anterior scar (arrowhead),
indicative of old infarct.
22. Sign and symptoms
Chest pain
most common symptom
described as a sensation of tightness,
pressure, or squeezing.
not relieved by rest, position change or
nitrate administration.
Pain radiates most often to the left arm, but
may also radiate to the lower jaw, neck, right
arm, back, and upper abdomen, where it
may mimic heartburn.
Levine's sign, in which a person localizes the
chest pain by clenching their fists over
their sternum.
22
SILENT AMI - 20-30% subjects don’t have chest pain, common in patients with
diabetes mellitus, hypertension, & in elderly patients.
23. Sign and symptoms
Nausea and Vomiting
Vomiting results as a reflex from severe pain.
Vasovagal reflexes initiated from area of ischemia.
Shortness of breath (dyspnea)
the damage to the heart limits the output of the left
ventricle, causing left ventricular failure and
consequent pulmonary edema.
Diaphoresis (an excessive form of sweating),
Light-headedness, and
Palpitations
Loss of consciousness
inadequate blood flow to the brain
and cardiogenic shock.
Sudden death
due to the development of ventricular fibrillation
23
massive surge
of catecholamines from
the sympathetic
nervous system
25. Diagnosis
ECG changes
ST segment elevation, followed by T wave inversion and Q
waves, are associated with transmural infarction.
ST segment depression and T wave inversion are associated
with subendocardial infarction.
25
26. Diagnosis
Serum Cardiac Biomarkers
26
The combination of
CPK MB and troponin
testing have higher
sensitivity and is used
for the purpose of
"ruling out" myocardial
infarction.
27. Management overview
MONA- B
Morphine
Oxygen
Nitroglycerin
Aspirin / Clopidogrel
Beta-Blockers
Other Early Hospital Therapies
ACE Inhibitors
Non- Dihydropyridine Calcium Channel Blockers.
Fibrinolytics
~Targeted temperature management
27
29. Preventive Measures
Lifestyle modifications:
Smoking cessation: Two years after cessation,
the risk of AMI drops by 50%
Alcohol moderation and prevention of illicit
drug use.
Physical activity and exercise:
Exercise 30 minutes per day 7 days a week.
Physical activity can help control blood
cholesterol, diabetes and obesity, as well as
help lower blood pressure.
losing even 10% from current weight, can lower
your heart disease risk.
29
30. Preventive Measures
Diet modification
Diets rich in soluble fiber, vegetables, fruits,
and whole grains, and low in saturated
fat/trans fat and cholesterol should be
encouraged.
Lipid management:
Saturated fat (<7% of total calories),
cholesterol and trans fatty acids (<200
mg/day),
plant stanols/sterols (2 g/day),
viscous fiber (10 g/day),
Olive oil, rapeseed oil and related products
are to be used instead of saturated fat
use of omega-3 fatty acids (fish)
30
31. Preventive Measures
Management and control of comorbid diseases
Hypertension should be managed.
Patients with CAD should have their blood pressure maintained at
less than 130/80 mm Hg.
This may be achieved using a multimodal approach, which
includes diet modification, lifestyle changes, exercise, and
medications.
Diabetes control should be appropriate
According to the 2007 AHA guideline for management of patients
with STEMI, the goal for HbA1c in diabetic patients should be less
than 7%
Patient education:
Patients, their family members, and the community should be
educated properly, especially on how to detect and respond to
an episode of AMI
31