Clinical Risk Factors for Ischaemic Heart Disease
Myocardial supply arises from the aorta via
coronary sinuses which are bulges in the
aorta.
There are 3 principle epicardial arteries:
o Right Coronary Artery
o Left Anterior Descending Artery
o Circumflex Artery
Coronary blood flow occurs during cardiac
diastole
Hypertension, Aortic stenosis and steroid
misuse can lead to ventricular hypertrophy.
Heart failure is when heart muscle weakens
and doesn’t pump blood around body as
efficiently.
Heart murmurs are sounds during your heartbeat cycle — such as whooshing or swishing —
made by turbulent blood in or near your heart. They indicate an underlying heart problem,
not necessarily serious.
If the pain happens during certain activities and goes away with rest, it's called stable
angina. However, if the chest pain becomes more severe or frequent, lasts longer, or occurs
while resting it's called unstable angina.
Nitroglycerin comes as a sublingual tablet to take under the tongue. The tablets is usually
taken as needed, either 5 to 10 minutes before activities that may cause attacks of angina or
at the first sign of an attack.
Left ventricular hypertrophy is enlargement and thickening (hypertrophy) of the walls
of your heart's main pumping chamber (left ventricle). Left ventricular hypertrophy
can develop in response to some factor — such as high blood pressure or a heart condition
— that causes the left ventricle to work harder.
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow
decreases or stops to a part of the heart, causing damage to the heart muscle. The most
common symptom is chest pain or discomfort which may travel into the shoulder, arm, back,
neck, or jaw.
Ischaemic Heart disease: inequality between myocardium oxygen supply and demand
, Atherosclerosis: when cholesterol gets deposited in macrophages and they can’t use it, so foam cells
form, and it also disturbs endothelial function so smooth muscle proliferates in plaque. This plaque
can possibly rupture (clot other places in body) and lead to haemostatic event causing formation of
thrombus. Stable angina occurs when the plaque causes flow limiting stenosis – reduced oxygen
supply to heart muscle leading to chest pain.
Clinical Risk Factors for IHD:
Acquired behaviour e.g. smoking
Inherited – familial hyperlipidaemia
Hypertension/Type 2 diabetes
Laboratory biomarkers
Age and sex also affect the likelihood of getting ischaemic heart disease. Risk is far greater if
certain risk factors are combined.
Systolic blood pressure increases with age (calcification of walls leading to stiffness so
reduced elasticity and compliance), but diastolic pressure declines with age.
Hypertension:
140/90 is lethal and 130/80 is high risk. It occurs as a result of increased demand of the
heart for oxygen and can lead to ventricular hypertrophy.
Treatment:
ACE inhibitor/angiotensin II receptor blocker
Calcium channel blocker
Thiazide-like diuretic – it will decrease blood volume so decrease BP.
Chronic inflammatory diseases such as rheumatoid arthritis and COPD are risk factors for
IHD – give similar signs as to the metabolic syndromes.
CANTOS – anti-inflammatory, Canakinumab is a human monoclonal antibody targeted at
interleukin-1 beta so will decrease inflammation so reduce chance of IHD.
Myocardial supply arises from the aorta via
coronary sinuses which are bulges in the
aorta.
There are 3 principle epicardial arteries:
o Right Coronary Artery
o Left Anterior Descending Artery
o Circumflex Artery
Coronary blood flow occurs during cardiac
diastole
Hypertension, Aortic stenosis and steroid
misuse can lead to ventricular hypertrophy.
Heart failure is when heart muscle weakens
and doesn’t pump blood around body as
efficiently.
Heart murmurs are sounds during your heartbeat cycle — such as whooshing or swishing —
made by turbulent blood in or near your heart. They indicate an underlying heart problem,
not necessarily serious.
If the pain happens during certain activities and goes away with rest, it's called stable
angina. However, if the chest pain becomes more severe or frequent, lasts longer, or occurs
while resting it's called unstable angina.
Nitroglycerin comes as a sublingual tablet to take under the tongue. The tablets is usually
taken as needed, either 5 to 10 minutes before activities that may cause attacks of angina or
at the first sign of an attack.
Left ventricular hypertrophy is enlargement and thickening (hypertrophy) of the walls
of your heart's main pumping chamber (left ventricle). Left ventricular hypertrophy
can develop in response to some factor — such as high blood pressure or a heart condition
— that causes the left ventricle to work harder.
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow
decreases or stops to a part of the heart, causing damage to the heart muscle. The most
common symptom is chest pain or discomfort which may travel into the shoulder, arm, back,
neck, or jaw.
Ischaemic Heart disease: inequality between myocardium oxygen supply and demand
, Atherosclerosis: when cholesterol gets deposited in macrophages and they can’t use it, so foam cells
form, and it also disturbs endothelial function so smooth muscle proliferates in plaque. This plaque
can possibly rupture (clot other places in body) and lead to haemostatic event causing formation of
thrombus. Stable angina occurs when the plaque causes flow limiting stenosis – reduced oxygen
supply to heart muscle leading to chest pain.
Clinical Risk Factors for IHD:
Acquired behaviour e.g. smoking
Inherited – familial hyperlipidaemia
Hypertension/Type 2 diabetes
Laboratory biomarkers
Age and sex also affect the likelihood of getting ischaemic heart disease. Risk is far greater if
certain risk factors are combined.
Systolic blood pressure increases with age (calcification of walls leading to stiffness so
reduced elasticity and compliance), but diastolic pressure declines with age.
Hypertension:
140/90 is lethal and 130/80 is high risk. It occurs as a result of increased demand of the
heart for oxygen and can lead to ventricular hypertrophy.
Treatment:
ACE inhibitor/angiotensin II receptor blocker
Calcium channel blocker
Thiazide-like diuretic – it will decrease blood volume so decrease BP.
Chronic inflammatory diseases such as rheumatoid arthritis and COPD are risk factors for
IHD – give similar signs as to the metabolic syndromes.
CANTOS – anti-inflammatory, Canakinumab is a human monoclonal antibody targeted at
interleukin-1 beta so will decrease inflammation so reduce chance of IHD.
