Myocardial infractionby mohammad muztaba

Myocardial infractionby mohammad muztaba

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  Ischemic heart disease Myocardialinfraction Mohammad Muztaba Khan Assistant professor(Jr.) Department of Pharmacology Bhavdiya institute sibar Sohawal Ayodhya 3/19/2019 1MOHAMMAD MUZTABA
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  CONTENTS: 1. Definition 2. Typesof infarcts 3. Epidemiology 4. Etiology 5. Etiopathogenesis 6. Pathophysiology 7. Clinical manifestations 8. Diagnosis 9. Management: Non-pharmacological Pharmacological 3/19/2019 2MOHAMMAD MUZTABA
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  MYOCARDIAL INFARCTION 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.. Myocardial infarction, commonly known as a heart attack, is the irreversible necrosis of heart muscle secondary to prolonged ischemia.3/19/2019 3MOHAMMAD MUZTABA
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  TYPES OF INFARCTS 1.According to anatomic region of left ventricle invoved:  Anterior  Posterior  Lateral  Septal  Circumferential  Combinations- Anterolateral, Posterolateral,Anteroseptal 2. According to degree of thickness of ventricular wall involved:  Transmural (full thickness)  Laminar (subendocardial) 3. According to age of infarcts:  Newly formed (acute, recent, fresh)  Advanced infarcts (old, healed, organised) 3/19/2019 5MOHAMMAD MUZTABA
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  Tobacco smoking Hypertension Drug abuse Obesity Stress  Alcohol ETIOLOGY 3/19/2019 6MOHAMMAD MUZTABA
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  Age Gender  Diabetes  Hyperlipoproteinaemia Familyhistory of Ischaemic Heart Disease  Hyperhomocysteinemia  Chronic kidney disease 3/19/2019 7MOHAMMAD MUZTABA
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  CLINICAL MANIFESTATIONS/SYMPTOMS • Chestpain / chest discomfort • Dyspnea • Fatigue • Other symptoms include: Increased sweating Weakness Nausea Vomiting Light-headedness Palpitation •Anxiety, sleeplessness, hypertension or hypotension, arrhythmia. •Chest pain is less in women, their common symptoms are weakness, fatigue & dyspnea. 3/19/2019 8MOHAMMAD MUZTABA
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  PATHOPHYSIOLOGY Atherosclerosis Arterial spasmAtherosclerosis+Plaque split+Thrombus gradual Obstruction sudden not usually reversible occlusionsudden reversible obstruction ISCHAEMIA Hypoxia Reduced oxygen demand Angina Thrombolysis Unstable angina Permanent thrombus Necrosis MYOCARDIAL INFARCTION 3/19/2019 9MOHAMMAD MUZTABA
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  DIAGNOSIS: 1.Clinical features: Pain Indigestion Apprehension Shock Low gradefever 2.Serum cardiac markers: Creatinine phosphokinase (CK) Lactic dehydrogenase (LDH) Cardiac specific troponins (cTn) 3/19/2019 10MOHAMMAD MUZTABA
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  3.ECG changes: ST segment elevation T wave inversion appearance of wide deep Q waves. 3/19/2019 11MOHAMMAD MUZTABA
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  MAGNETIC RESONANCEIMAGING (MRI) ANGIOGRAPHY POSITRON EMISSION TOMOGRAPHY (PET scan): CHESTX- RAY 3/19/201912MOHAMMAD MUZTABA
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  MANAGEMENT: 1.NON-PHARMACOLOGICAL: Counselling and educationof patients Life style measures Smoking cessation Avoid Alcohol intake Diet and nutrition Salt restriction3/19/2019 13MOHAMMAD MUZTABA
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  2.PHARMACOLOGICAL: Thrombolytic agents Anticoagulants Antiplatelet agents Antihypertensiveagents Lipid lowering drugs Vasodialators Others i) Analgesics ii) Antiulcer drugs iii) Antidepressants 3/19/2019 14MOHAMMAD MUZTABA
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  PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA) STENT PLACEMENT 3/19/201915MOHAMMAD MUZTABA
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  ATHERECTOMY CORONARY ARTERYBYPASS GRAFT (CABG) 3/19/201916MOHAMMAD MUZTABA