ISCHAEMIC HEART DISEASE

🔸Etiology

1) Coronary atherosclerosis

2) Complications in atherosclerotic plaque

3) Non-atherosclerotic causes

🔸Etiology

⭕Coronary atherosclerosis

a) Distribution

b) Location

⭕Complications in atherosclerotic plaque

a) Ulceration

b) Thrombosis

c) Haemorrhage and plaque dyslocation

⭕Non-atherosclerotic causes

a) Vasospasm

b) Stenosis of coronary ostia

c) Arteritis

d) Embolism

e) Thrombotic

f) Trauma

g) Aneurysm

🔸Effects of myocardial ischaemia

a) Asymptomatic state

b) Angina pectoris

c) Acute myocardial infarction

d) Chronic ischaemic heart disease/Ischaemic cardiomyopathy/Myocardial fibrosis. 

🔸Acute myocardial infarction (AMI)

- 10 to 25% of all deaths

- common in males

- usually seen in elderly

- less common below 40 yrs age

- risk factors for atherosclerosis like hypertension

- diabetes mellitus, cigarette smoking, familial hyperlipidemia etc increase chances of AMI.

🔸Etiopathogenesis –

Various factors individually or more commonly in combination bring about myocardial ischaemia. 

i) Diminished coronary blood flow (coronary artery disease, shock)  

ii) Increased myocardial demand (in exercise, emotional stress) 

iii) Hypertrophy of heart (in hypertension, valvular heart disease)