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ISCHEMIC HEART DISEASE

is a disease characterized by ischemia (reduced blood supply) of the heart muscle, usually due to coronary artery disease (atherosclerosis of the coronary arteries). condition caused by a reduced amount of blood supplying the heart muscle. It can be caused by cholesterol and other lipids building up on the inner walls of arteries that supply the heart, forming a thick plaque that can reduce the amount of blood carrying nutrients and oxygen to heart tissue.

most common in older individuals. Males are affected more often than females however the rates equalize between men and women following menopause.

Pathophysiology
The arteries become "furred up" by fat-rich deposits in the vessel wall called plaques. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called Atherosclerosis. Stable angina is due to inability to supply the myocardium (heart muscle) with sufficient blood in situations of increased demand for oxygen, such as exertion.

Unstable angina, STEMI ("ST segment elevation myocardial infarction,") and NSTEMI (NON ST segment elevation myocardial infarction,") are attributed to "plaque rupture", where one of the plaques gets weakened, develops a tear, and forms an adherent blood clot that either obstructs blood flow or floats further down the blood vessel, causing obstruction there.

Risk Factors:
Family history of coronary artery disease Diabetes high blood pressure or atherosclerosis Smoking Poor nutrition Overweight Hypertension birth control pills physical inactivity stress

Signs and Symptoms


severe chest pain of Myocardial Infarction, which may be fatal. the warning symptoms occur in a large number of patients in the form of Angina Pectoris. The main symptom of Angina is pain over the central chest that sometimes radiate down the left arm, to the jaw or to the back. sense of compression or tightness in the middle of the chest, and may last for 5-20 minutes. The pain may be accompanied by sweating. The presence of anginal episodes is virtually diagnostic of Ischaemic Heart Disease

Lab. Findings:
The laboratory tests of value in confirming the diagnosis may be divided into four groups: (1) ECG (2) serum cardiac biomarkers (3) cardiac imaging (4) nonspecific indices of tissue necrosis and inflammation.

During the initial stage, total occlusion of an epicardial coronary artery produces ST-segment elevation. Most patients initially presenting with STsegment elevation ultimately evolve Q waves on the ECG. However, Q waves in the leads overlying the infarct zone may vary in magnitude and even appear only transiently, depending on the reperfusion status of the ischemic myocardium and restoration of transmembrane potentials over time.

Management
Medications used to treat ischemic heart disease
Drug therapy is commonly used for treatment of ischemic heart disease and includes:

Angiotensin Anti-ischemic agents Antiplatelet drugs Beta-blockersmuscle NitratesStatins

Surgical procedures used to treat ischemic heart disease


Severe symptoms that are not relieved by medication alone are treated with surgical procedures including: Angioplasty (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)

What you can do to improve your ischemic heart disease?


In addition to following your treatment plan, you may be able to improve your ischemic heart disease by: Getting regular physical activity Keeping your cholesterol at a healthy level Maintaining normal blood pressure Quitting tobacco use Reducing cholesterol and fat in your diet

QUIZ!
1. Ischemic Heart Disease is common in what individuals? 2. It is made up of fat, cholesterol, calcium, and other substances found in the blood. 3. What do you call the condition when plaque builds up in the arteries? 4. What is the main symptom of Angina pectoris? 5. STEMI stands for?

6-8. Give atleast 3 medications used to treat Ischemic Heart Disease


9. Unstable angina, STEMI and NSTEMI are attributed to what? 10-14. Give atleast 5 Risk factors of Ischemic Heart Disease

15. procedure to remove plaque and restore blood flow in clogged arteries
16. procedure that helps restore blood flow to the heart by routing the flow through transplanted arteries

17-20. Give 4 ways to improve IHD