Ischemic Heart Disease

Nota:

• Sedentary lifestyle, obesity, oral contraceptives, type A personality /perfectionist/, stress

Nota:

• 20 to 30 minutes after vessel occlusion

1. 0-12 hrs no change
2. 18-24 hrs slight pallor
3. 24-72 hrs pallor
4. 4-7 days hyperemic rim
5. 10 days yellow, soft, shrunken
6. 7 weeks firm pale scar

1. 4-12 hrs early coagulative necrosis
2. 18-24 hrs neutrophil infiltrate
3. 24-72 hrs complete coagulative necrosis and heavy neutrophile infiltrate
4. 4-7 days macrophages and early granulation tissue
5. 10 days prominent granulation tissue
6. 7 weeks fibrosis

1. Q waves
2. ST segment abnormalities
3. T wave inversion

1. CK-MB 2 to 4 hrs, peak 18 hrs
2. Lactate Dehydrogenase 24 hrs, peak 72 hrs
3. Troponins (T and I)

Nota:

• weeks-few months later pericarditis

1. Episodic chest pain
2. Associated with exertion
3. Relieved by rest

1. Fixed atherosclerotic narrowing
2. Inadequate myocardial oxygen supply

1. Reduce demand - rest
2. Vasodilator

1. Increased attack frequency
2. Increased attack intensity
3. Precipitated by less exertion

1. Acute plaque change

1. Pain at rest

1. Coronary artery spasm