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Ischaemic heart disease revision notes

Ischaemic heart disease mind map, Pathophysiology, Clinical features, management.

Ischaemic heart disease revision notes

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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
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Ischaemic heart disease Investigations

ECG: ST elevation / depression in MI
Stress test:
  • Exercise Tolerance Test: treadmill
  • Stress echocardiography
  • Radionucleotide 
  • MRI
Angiography

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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
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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
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