Ischemic heart Disease anaesthetic management Presentation

IHD

1. Ischemic heart Disease and Anesthetic Management Presenter: Dr Mayur Patel

2. Ischemic Heart Disease A disease inadequate supply of blood and oxygen to a portion of myocardium of coronary arteries Also known as - Coronary artery disease Most common –atherosclerotic disease of epicardial coronary arteries Regional reduction in myocardial blood flow and inadequate supplied by involved coronary artery Presentation of patients with ischemic heart disease can include chronic stable angina or an acute coronary syndrome (ACS) . ACS can manifest as ST-elevation MI (STEMI) or unstable angina /non–ST-elevation MI (UA/NSTEMI).

3. Risk Factors for Development of Ischemic Heart Disease Male gender Increasing age Hypercholesterolemia Hypertension Cigarette smoking Diabetes mellitus Obesity Sedentary lifestyle Genetic factors family history

4. ANGINA PECTORIS Angina pectoris occurs when there is a mismatch of oxygen delivered to the myocardium (supply) and myocardial oxygen consumption (demand). Stable angina typically develops in the setting of partial occlusion or significant (>70%) chronic narrowing of a segment of coronary artery. When the imbalance between myocardial oxygen supply and demand becomes critical, congestive heart failure (CHF), electrical instability with dysrhythmias, and MI can result. Pain of angina pectoris is generally described as retrosternal chest discomfort, pain, pressure, or heaviness that often radiates to the neck, left shoulder, left arm, or jaw and occasionally to the back or down both arms.