Ischemic heart disease, IHD, ihd, ischemic heart disease ischaemic attack myocardial infarction mi angina ecg electrocardiogram
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IHD Clinical Features & Investigations. BY : MUKESH SHANKER, KMC Manipal. INDIA.
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Ischemic heart disease, IHD, ihd, ischemic heart disease ischaemic attack myocardial infarction mi angina ecg electrocardiogram
- 2. Mukesh Shanker S.no. 22 KMC Manipal INDIA.
- 3. Atherosclerosis Vaso Spasm Aortitis Severe LV Hypertrophy Aortic Stenosis Severe Anemia Micro vascular Angina THE CAUSES :
- 4. Supply Demand INCREASED DEMAND Heart Rate, BP, Myocardial Contractility, LV Hypertrophy, AS etc. DECREASED SUPPLY Duration of Systole, CAPP, Tone, HB, O₂ etc. THE PATHOPHYSIOLOGY :
- 5. THE RISK 1 + 1 ≠ 2
- 7. Stable Angina Unstable Angina / Subendocardial MI Transmural MI / Sudden Death Pathologic Basis Of Disease.
- 10. TREADMILL TEST : Monitor Symptoms, ECG, BP. Stop : chest pain, breathless; ST depression >2mV ; SBP >10mmHg ; Ventricular Tachyarrthmias. Flat /Down sloping is significant.
- 11. TREADMILL TEST : Monitor Symptoms, ECG, BP. Stop : chest pain, breathless; ST depression >2mV ; SBP >10mmHg ; Ventricular Tachyarrthmias. Flat /Down sloping is significant. MYOCARDIAL PERFUSION SCANNING : Stress Myocardial Radio nucleotide perfusion imaging. Using technetium 99m or thallium. Exercise or pharmacological. 2D ECHO Or CARDIAC MR Or CT .
- 12. TREADMILL TEST : Monitor Symptoms, ECG, BP. Stop : chest pain, breathless; ST depression >2mV ; SBP >10mmHg ; Ventricular Tachyarrthmias. Flat /Down sloping is significant. MYOCARDIAL PERFUSION SCANNING : Stress Myocardial Radio nucleotide perfusion imaging. Using technetium 99m or thallium. Exercise or pharmacological. 2D ECHO Or CARDIAC MR Or CT . CORONARY ARTERIOGRAPHY : Outlines the lumina. If patient symptomatic despite therapy. Before PCI / CABG.
- 18. Lateral Wall Inferior Wall Anterior Wall ELECTROCARDIOGRAPHY:
- 24. Assess Likelihood Of CHD : History & Examination High/Intermediate likelihood. Low likelihood Stable Angina Atypical/ other cause. Investigation : ECG Cardiac Biomarkers Imaging. Treadmill Test Imaging ECG to rule out X Ray Others Assessment : Repeat Assess Risk Find a Cause Classify : UA NSTEMI STEMI Critical Not Critical Manage : Discharge Follow Up Treat Admit in CU & Treat +ve +ve +ve +ve THE CRITICAL PATHWAY FOR ED EVALUATION OF CHEST PAIN.