PHTY208 Lecture Notes - Lecture 7: Acne Vulgaris, Heart Rate, Heart Sounds
Disorders of cardiac function:
Lecture overview:
-Coronary artery disease
-Cardiomyopathies
-Pericardium
Introduction:
-Cardiovascular disease is the leading cause of death in men and women in the US
-Predicted to become the leading cause of death worldwide by 2020
-Significant cost to both individual and to the country
Concept1: Ischemic heart disease:
Ischemic heart disease:
-Refers to an imbalance between myocardial oxygen demand and supply
-Results in myocardial and hypoxia and accumulation of waste metabolites
-Classifications
-Angina pectoris
-Stable angina
-Unstable angina
-Myocardial infarction
-Silent ischemia
-Variant angina
Coronary circulation:
-Ischemic heart disease is often a result of occlusion of the coronary circulation
-Also known as coronary heart disease
-Supplies the myocardium with oxygen and nutrients
Ischemic heart disease:
Commonly divided into two disorders:
-Chronic ischemic heart disease
-Recurrent and transient episodes of myocardial schema
-Stable angina
-Acute coronary syndromes
-Represent the spectrum of ischemic coronary disease, ranging from unstable angina trough
myocardial infarction
-Results from disruption of plaque
Angina pectoris:
-Commonly known as angina
-Chest pain due to schema of the heart muscle
-Generally due to obstruction or spasm of the coronary arteries
-Manifestations:
-Constricting or squeezing pain in the pericardial or substernal area of the chest, possibly
radiating to the arms, jaw or thorax
-Pain is typically relieved by rest
Cause of angina pectoris:
-Most common cause of angina is atherosclerosis
-Two Amin types of lesions
-stable:
-Associated with a mixed coronary obstruction
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-More common in stable angina
-Unstable:
-Can rupture and cause platelet adhesion and thrombus formation
-More common in unstable angina and myocardial infarction
Stable angina:
-predictable, transient chest discomfort during exertion or emotional stress
-Pattern of symptoms related to degree of occlusion
-When vessel is occluded by approx. 70%
-Enough oxygen at rest
-Insufficient to compensate with increased oxygen
Manifestations of stable angina:
-often described as pressure, discomfort, tightness, burning or heaviness in the chest
-Rarely described as pain
-Sensation is neither sharp nor stabbing
-Does not vary significantly with inspiration
-Rarely lasts more than 5-10mins
-Accompanying symptoms:
-Tachycardia
-Diaphoresis
-Nausea
-Dyspnoea
-Fatigue and weakness
Acute coronary syndromes:
-Life threatening conditions
-Commonly from a ruptured plaque resulting in coronary thrombosis
-Range of syndromes that include
-Unstable angina
-Acute myocardial infarction
-Acute MI can be further divided into
-Non-ST elevation myocardial infarction
-ST elevation myocardial infarction
Determinants of acute coronary syndrome:
-Persons with an ACS are routinely classified as low risk or high risk for infarction based on:
-Presenting characteristics
-ECG variable
-Serum cardiac markers
-Timing of presentation
Unstable angina:
-Considered to be a clinical syndrome of myocardial schema
-Causes can be divided into 3 phases:
-Atherosclerotic plaque disruption
-Platelet aggregation
-Secondary haemostats
-Inflammation also plays a role in plaque instability
-Symptoms of unstable angina:
-Worsening angina attacks
-Sudden-onset angina at rest
-Angina lasting more than 20 minutes
-Occurs at rest or minimal exertion
-Severe and described as frank pain
-Occurs with a crescendo pattern (more severe, prolonged, or increased frequency)
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Document Summary
Cardiovascular disease is the leading cause of death in men and women in the us. Predicted to become the leading cause of death worldwide by 2020. Signi cant cost to both individual and to the country. Refers to an imbalance between myocardial oxygen demand and supply. Results in myocardial and hypoxia and accumulation of waste metabolites. Ischemic heart disease is often a result of occlusion of the coronary circulation. Supplies the myocardium with oxygen and nutrients. Recurrent and transient episodes of myocardial schema. Represent the spectrum of ischemic coronary disease, ranging from unstable angina trough myocardial infarction. Chest pain due to schema of the heart muscle. Generally due to obstruction or spasm of the coronary arteries. Constricting or squeezing pain in the pericardial or substernal area of the chest, possibly radiating to the arms, jaw or thorax. Most common cause of angina is atherosclerosis. Can rupture and cause platelet adhesion and thrombus formation.
