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CAD+And+ACS
- 1. CAD & ACS
- 6. ATHEROSCLEROSIS: HARMFUL CONSEQUENCES Atherosclerosis causes decrease in lumen of arteries and thus decreases blood supply Artery involved Organ Condition Symptoms Events Coronary Heart CAD Angina MI Cerebral carotid Brain CVD TIA Stroke Peripheral Peripheral tissue (sk muscle) PVD/PAD Intermittent claudication Gangrene
- 10. MYOCARDIAL INFARCTION Myocardium : heart muscle Infarction : death of the tissue (necrosis) MI is death of the myocardial tissue due to complete blockade of coronary artery
- 11. ISCHEMIA & MYOCARDIAL INFARCTION Ischemia Myocardial infarction Partial block of artery Complete block of artery Temporary decrease in O 2 supply Permanent damage (necrosis) ST Segment depression Usually ST Segment elevation
- 15. Investigations in ACS & CAD
- 17. ECG ABNORMALITIES IN ISCHEMIA & MI ECG (Electrocardiogram)
- 24. CCBs Block Calcium channels Prevent entry of Ca++ ions Myocardial Cell Vascular smooth muscle Decreased force of Coronary Artery Peripheral contraction arteriole Coronary blood flow PVR
- 25. NICORANDIL Nitrate-like action K + channel opener ATP Dilates epicardial Coronary arteries Venodilatation Dilates peripheral arterioles Dilates coronary Resistance vessels Decreased Preload Decreased afterload ↑ coronary blood flow ↓ Myocardial O 2 requirement ↓ Myocardial O 2 requirement ↑ coronary blood flow Nicorandil dual action
- 27. PTCA WITH STENTING Opening of the artery after stenting The arrow on the angiogram shows block in the artery.
- 28. CABG (Coronary Artery Bypass Graft Surgery) (Done by CVTS in Cardiac OT)
- 29. Thank You
Editor's Notes
- Events = acute one time event which can be life threatening
- Ecg = electrical current measured through skin by using 12 electrodes
- Angiography Angiography allows your doctor to measure the flow and pressure of the blood in the chambers of your heart and to see if the arteries that supply blood and oxygen to the heart muscle are blocked. During angiography, a dye is injected into your heart's chambers. Images are then captured using X-rays. Cardiac catheterization is done first so that the dye can be injected through the catheter and into the heart. The movement of the dye through your heart and coronary arteries is recorded as an angiogram and viewed on a television monitor. Your doctors can put the catheter in different places, depending on which arteries or chambers of the heart they want to see. During dye injections, X-ray pictures are taken which can later be reviewed. You may notice a warm sensation throughout your body when the dye is injected. You may also be asked to cough vigorously. Let the doctor or nurse know if you have any chest discomfort. During the procedure, you will see monitors nearby and may be able to see your electrocardiogram electrocardiogram and the pictures of the heart and arteries. The total procedure may take one to two hours. However, getting ready and recovery will take an additional two to four hours. Angiography is a safe test. The dye used is harmless. By drinking lots of liquids after the test, you can help rid your body of the dye. In rare cases, some people may have an allergic reaction to the dye. Tell your doctor before the test if you are allergic to iodine, shellfish or strawberries.
- Angiography Angiography allows your doctor to measure the flow and pressure of the blood in the chambers of your heart and to see if the arteries that supply blood and oxygen to the heart muscle are blocked. During angiography, a dye is injected into your heart's chambers. Images are then captured using X-rays. Cardiac catheterization is done first so that the dye can be injected through the catheter and into the heart. The movement of the dye through your heart and coronary arteries is recorded as an angiogram and viewed on a television monitor. Your doctors can put the catheter in different places, depending on which arteries or chambers of the heart they want to see. During dye injections, X-ray pictures are taken which can later be reviewed. You may notice a warm sensation throughout your body when the dye is injected. You may also be asked to cough vigorously. Let the doctor or nurse know if you have any chest discomfort. During the procedure, you will see monitors nearby and may be able to see your electrocardiogram electrocardiogram and the pictures of the heart and arteries. The total procedure may take one to two hours. However, getting ready and recovery will take an additional two to four hours. Angiography is a safe test. The dye used is harmless. By drinking lots of liquids after the test, you can help rid your body of the dye. In rare cases, some people may have an allergic reaction to the dye. Tell your doctor before the test if you are allergic to iodine, shellfish or strawberries.
- CVTS = Cardiovascular & Thoracic Surgeon Cardiac OT = Cardiac Operation Theatre