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ISCHAEMIC HEART DISEASE (Myocardial infarction (Caused when (Vasculitis…

- - - - Reduced venous drainage
      - Decreased arterial supply
- - - - Stable pattern of pain which dissapears after a few minutes
      - Numbness that can be felt along the arm, neck and jaw
    - - Extreme emotional stress
      - overexertion
      - Alcohol consumption
      - Smoking
      - Extreme hot/cold temperature
      - After large meal
      - During or after extreme exercise
      - Anaemia
      - Increased cardiac mass
        
        Hypertrophy therefore may reflect important non-cardiac disease
      - Atherosclerosis of coronary arteries
        
        decreasesing blood flow so can't accomadate metabolic demand of the myocardium during exertion
    - - Shortness of breath
      - Diaphoresis (increased amount of sweating)
    - - ST segment depression on EKG due to subendocardial ischemia
      - Angiography
    - - Nitroglycerine
    - - Rest
  - - - High risk of progression to Myocardial Infarction
    - - Distribution of an atherosclerotic plaque
      - Secondary thrombus
    - - Rupture of an atherosclerotic plaque with thrombosis and incomplete occlusion of a coronary artery.
    - - ST segment depression on EKG due to sub endocardial ischemia
    - - Nitroglycerin
  - - - Vasospam of Coronary Artery
    - - ST segment Elevation on EKG due to trans mural ischemia
    - - Nitroglycerin
      - Calcium Channel Blockers
      - Vasodilation
- - - - Kawasaki disease (presents in pediatrics)
    - - Infarction of the LAD leads to infarction of the anterior wall and anterior septum of the LV
  - - - Troponin 1
        
        Levels rise 2-4 hours after infarction
        
        Peak at 24 hours
        
        Return to normal by 7-10 hours
      - Troponin Troponin
        
        Stay elevated for 7-10 hours
        
        Indicates
        
        Extent of infarction
        
        Location of obstruction
        
        Significance of vessel
        
        Degree of Myocardial Hypertrophy
        
        Collateral coronary circulation
      - Can be caused by
        
        Cardiac surgery
        
        Cardiac contusion (trauma)
        
        Myocarditis
        
        Hypertrophic obstructive Myopathy
        
        Cardiomyopathy
        
        Chemotherapy
- - - - Ventricular fibrillation