There are so
many diseases that contributed to heart diseases,but we will discuss only
coronary heart diseases. At the end of this article, you will distinguish
between:
Angina pectoris vs Myocardial infarction
ANGINA PECTORIS
= is chest pain due to ischemia of
the heart muscle, generally due to obstruction or spasm of the coronary
arteries.
Classification
1. Stable angina.
2. Unstable angina.
3. Microvascular angina.
Develops
mainly in people over 40 years old,and predominantly in men and mental workers.
1. Atherosclerosis.
2. Bad habit (smoking and alcohol).
3. Bad diet (high cholesterol and
sugar).
4. Obesity.
5. Hypertension and stress.
Pathogenesis:
Most frequent cause: atherosclerosis
of the coronary arteries of the heart.
Less frequent cause: infection;
syphilitic aortitis,panarteritis,periarteritis nodosa,rheumatic
vasculitis,obliterating endarteritis.
Paroxysms of angina can develop due
to upset of nervous regulation of the coronary arteries.
Spasms of coronary arteries can also
provoke angina.
Hypoxemia(ischemia) of the
myocardium provokes the attack.
Clinical
Picture
-
Pain in restrosternal region and irradiate to
the left (last to 2-5 minutes).
-
The pain comes after forces or stress.
-
Breathlessness.
Observation
-
Paleness.
-
Sweating.
-
Slow pulse.
-
Bradyarrhythmia and
tachyarrhythmia.
Treatment and Prevention.
-
Nitroglycerin.
-
Surgical.
MYOCARDIAL INFARCTION
= A myocardial infarction (MI) is
a heart attack. A heart attack happens when the blood vessels that supply blood
to your heart (coronary arteries) are blocked. This causes areas of your heart
muscle to die.
Etiology
-
Atherosclerosis and thrombosis.
-
Hypertension.
-
Diabetes mellitus.
-
Obesity.
Pathogenesis
-
Disorder in blood coagulations system, then
becomes necrosis.
-
Insufficiency of blood supply thus, increases
oxygen demand.
Plaque: Plaque (fatty deposits)
can build up inside one or more of your coronary arteries. This can cause the
arteries to become narrow and slow or block the blood flow. Small pieces can
also break off and block blood flow
Blood clots: Blood clots may form
on each side of the plaque. This can slow or stop blood flow to your heart.
Heart spasm: A heart spasm is when
a coronary artery suddenly tightens and causes blood flow to be stopped to part
of the heart muscle.
Clinical picture
-
[Abdominal Form] Intensive long lasting pain in
epigastric region and irradiates to left and also right. Paleness, sweating and
weakness.
-
[Angina Form] 20 minutes, high temperature and
increase in ESR.
-
[Asthmatic Form] Dyspnea and heart breathing.
-
[Cerebral Form] Like hemorrhage, headache,
dizziness and increase atrial pressure.
-
[Arhythmical Form] Rhythm disorder.
-
[Non-painful Form] Not feel any pain.
Observation
-
Paleness
-
Sweating
-
Dyspnea
Treatment and Prevention.
Drugs:
Nitroglycerin
Nitroglycerin
- Angiotensin-converting enzyme inhibitors
- Aldosterone antagonists
- Beta blockers
- Calcium channel blockers
- Aspirin
- Clot busters
- Pain medicine
- Cholesterol medicine
Prevention:
-
Healthy life style.
-
Regular exercise.
-
Prevent from smoking and alcohol intake.
Summary
• Both angina and myocardial infarction are problems related
with heart.
• In both cases, blood supply to heart is blocked.
• While angina is temporary, MI is permanent.
• Angina is less severe health problem but MI can even cause
death.
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