Mr. Mohamed passing hard time

Mr. Mohamed passing hard time

1. Causes of Retrosternal pain

2. Types of shock

3. Types of Necrosis

   • 1- Coagulative:
   • 2- Liquefactive
   • 3- Caseous
   • 4- Fat necrosis
   • 5- Fibrinoid necrosis
   • 6- Gangrenous necrosis

4. athroma

   • s an accumulation of degenerative material in the inner layer of an artery wall. The material consists of mostly macrophage cells,[1][2] or debris, containing lipids, calcium and a variable amount of fibrous connective tissue. The accumulated material forms a swelling in the artery wall, which may intrude into the channel of the artery, narrowing it and restricting blood flow. Atheroma occurs in atherosclerosis
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5. Myocardial Infarction

   • Definition
     • Myocardial infarction is the death of the cells of an area of the heart muscle (myocardium) as a result of oxygen deprivation, which in turn is caused by obstruction of the blood supply.
       • The myocardium receives its blood supply from the two large coronary arteries and their branches. Occlusion of one or more of these blood vessels is one of the major causes of myocardial infarction.
   • Pathogenesis
   • Signs and Symptoms
     • Pressure or tightness in the chest
       • Pain in the chest, back, jaw, and other areas of the upper body that lasts more than a few minutes or that goes away and comes back
         • Dyspnea (shortness of breath)
           • Diaphoresis (sweating)
             • Nausea
               • Vomiting
                 • Anxiety
                   • Dizziness
                     • Tachycardia
     • Note that not all patients experience the same number and severity of symptoms.
   • How is angina different from mi?
   • investigations
     • NSTEMI ECG changes
       • ECG changes in infarcts
         • ST depression
           • ST elevation
             • T-waves (peaked, flattened, inverted)
               • Appearance of pathologic Q-waves
                 • Different types and stages of infarcts have different ECG changes
         • ECG and MI
       • STEMI ECG changes depending on different stages
     • Blood test (Biomarkers)
       • Cardiac enzymes (isoenzymes):
         • Lactate dehydrogenase (LDH)
           • Creatine Kinase (CK)
       • 2- Cardiac Proteins:
         • Myoglobin
           • Troponins
   • management

6. angina

   • Paroxysmal attacks of substernal chest discomfort radiating to left shoulder (15 sec-15 min)
   • Types:
   • Complications
     • ISCHEMIC (including failure of reperfusion): angina, re-infarction, infarct extension.
     • MECHANICAL: heart failure, cardiogenic shock, mitral valve dysfunction, aneurysms, cardiac rupture
     • ARRHYTHMIC: atrial or ventricular arrhythmias, sinus or atrioventricular (AV) node dysfunction
     • THROMBOTIC AND EMBOLIC: central nervous system or peripheral embolization.
     • INFLAMMATORY: pericarditis
     • PSYCHOSOCIAL: depression.

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