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CR - ischaemic heart disease (iii) (Chronic ischaemic heart disease…
CR - ischaemic heart disease (iii)
pul oedema
LHF -> pul venous hypertension -> increased hydrostatic pressure -> transudate in alveoli
dyspnoea
pump problems associated with ant MI
conduction problems associated with post MI
Combination of both pump + conduction problems suggests extensive damage (poor prognosis)
post MI muscle rupture
if through free wall (usually after 4 days): haemopericardium
if through septum: septal defect
if papillary muscles rupture: acute valve dysfunction -> intractable heart failure
Chronic ischaemic heart disease
symptoms may be due to chronic angina from past MI
progressive heart failure
cardiomegaly, hypertrophy, dilatation, narrowed coronaries, myocardial fibrosis
primary prevention viral
non-invasive coronary imaging
statins
angioplasty
min invasive
PCI (percut coronary intervention)
balloon widens narrowed/obstructed vessels
transplant
signs of heart failure
right
raised JVP
bilat LL oedema
if severe hepatomegaly + ascites
due to obstructed venous return to right heart
other causes of this...
pericardial effusion (increased intracranial pressure -> decreased pump function)
mass compressing IVC/SVC (e.g. lymphoma)
left
low BP
weak thready pulse
bibasal creps/rales
cold peripheries
murmurs
sign of VSD + mitral regurgitate