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Ischaemic heart disease revision notes
Ischaemic heart disease revision notes
Ischaemic heart disease Pathophysiology
Fatty streak-> lipid deposition-> monocytes become -> macrophages become foam cells-> smooth muscle proliferation + collagen deposition->
Intimal hypertrophy
narrowed artery: o2 supply demand mismatch-> angina
Fibrous plaque formation-> crack in fribrous plaque-> platelet aggregation-> vessel occlusion-> myocardial infarction
Ischaemic heart disease Investigations
ECG: ST elevation / depression in MI
Stress test:
Exercise Tolerance Test: treadmill
Stress echocardiography
Radionucleotide
MRI
Angiography
Ischaemic heart disease clinical features
Chest pain: dull ache, radiates neck + arms + back
Associated nausea + vomit + short of breath
Exertional, relieved by rest + GTN
MI: pain at rest,
arrhthmias
,
heart failure
Ischaemic heart disease management
Angina
Angina symptom relief: beta-blockers, calcium channel blockers, nitrates, nicorandil, ranolazine
Primary prevention: aspirin, statin
MI:
dual anti-platelet, glycoprotein IIB/IIIA inhibitor, IV GTN, morpine, O2
Angiography- PCI (balloon angioplasty + stent)
Secondary prevention: statin, ACEi/ARB, BB, eplerenone
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Home
Medicine Notes
Surgery
Cardiology
Neurology
Obstetrics and gynaecology
gastroenterology
Haematology
Respiratory
Endocrinology
Nephrology
Psychiatry
Paediatrics
Rheumatology
Clinical Examination
Contact
eBook