Ischemic heart disease and angina pectoris

Topics included :- ISCHEMIC HEART DISEASE - Introduction, symptoms, risk factors, medication, surgical procedures and diagnosis.
ANGINA PECTORIS - Introduction, symptoms and diagnosis.

1. ISCHEMIC HEART DISEASE AND ANGINA PECTORIS SUBJECT : CLINICAL BIOCHEMISTRY BY : S. DASH

2. INTRODUCTION ISCHEMIC HEART DISEASE It is a condition of recurring chest pain or discomfort that occurs when a part of the heart does not receive enough blood. This condition occurs most often during exertion or excitement, when the heart requires greater blood flow. Ischemic heart disease, also called Coronary Heart Disease (CHD). It develops when cholesterol particles in the blood begin to accumulate on the walls of the arteries that supply blood of the heart. Eventually, deposits narrow the arteries and eventually block the flow of blood. This decrease in the blood flow reduces the amount of oxygen supplied to the heart muscle. The signs and symptoms of ischemic heart disease may develop slowly as arteries gradually become blocked, or they may occur quickly if an artery suddenly becomes blocked.

3. SYMPTOMS The common symptoms include chest pain, chest pressure or shortness of breath that :- May feel as if the pain starts in the chest spreads to the arms, back or other areas. May feel like gas or indigestion (more common in women). Occurs repeatedly; episodes tend to be alike. Occurs when the heart must work harder, usually during physical exertion Usually lasts a short time (five minutes or less). It is relieved by rest or medicine.

4. RISK FACTORS Risk factors for ischemic heart disease include :- Diabetes. Family history of heart disease. High blood cholesterol. High blood pressure. High blood triglycerides. Obesity. Physical inactivity. Smoking and other tobacco use.

5. MEDICATIONS USEDTO TREAT ISCHEMIC HEART DISEASE Drug therapy is commonly used for treatment of ischemic heart disease and includes :- Angiotensin converting enzyme (ACE) inhibitors, which relax the blood vessels and lower blood pressure. Angiotensin receptor blockers (ARB’s),which lower blood pressure. Anti-ischemic agents such as Ranexa (Ranolazine). Anti-platelet drugs, which prevent the formation of blood clots. Beta-blockers, which lower the heart rate. Calcium channel blockers, which reduce workload on the heart muscle. Nitrates, which dilate the blood vessels. Statins, which lower cholesterol.

6. SURGICAL PROCEDURES USED TO TREAT ISCHEMIC HEART DISEASE. Severe symptoms that are not relieved by medication alone are treated with surgical procedures including :- Angioplasty and stent placement (procedure to remove plaque and restore blood flow in clogged arteries) Coronary Artery Bypass graft (Procedure that helps restore blood flow to the heart by routing the flow through transplanted arteries)

7. DIAGNOSIS :- CARDIAC CATHETERIZTION AND ANGIOGRAM ECHOCARDIOGRAM ELECTROCARDIOGRAM ELECTRON BEAM (ULTRAFAST) CT SCAN EXERCISE STRESS TESTS

8. ANGINA PECTORIS Angina Pectoris or angina is temporary chest pain or discomfort as a result of decreased blood flow to the heart muscle. Angina is not a heart attack, but it is a sign of increased risk for heart attack. Angina may be stable (develops during physical activity, lasts five minutes or less and is relieved with rest) or unstable (occurs during periods of rest, lasts longer, and symptoms may be more severe).

9. SYMPTOMS : Chest pain or discomfort, such as tightening of the chest. Discomfort in the jaw, neck, arms, upper abdomen, shoulder or back. Fatigue. Sweating. Nausea. Dizziness

10. DIAGNOSIS : ELECTROCRDIOGRAM STRESS TEST WITHOUT IMAGING BLOOD TESTS Additionally….. CHEST X-RAY CT OF THE CHEST CORONARY COMPUTED TOMOGRAPHY (CT) ANGIOGRAPHY MAGNETIC RESONANCE (MR) IMAGING CATHETER ANGIOGRAPHY ECHOCARDIOGRAM MYOCARDIAL SINGLE PHOTO EMISSION COMPUTED TOMOGRAPHY (SPECT)

11. REFERENCES : www.radiologyinfo.org www.healthgrades.com www.heart.org www.webmd.com

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