Mr. Mohammed Passing hard time

Mr. Mohammed Passing hard time

1. Mohammed, 41 years old

2. Apoptosis vs. necrosis

3. Types of necrosis

   • Fat necrosis
   • Coagulative necrosis
   • Liquifactive necrosis
   • Gangerenous necrosis
   • Fibrinoid necrosis
   • Caseous necrosis

4. Angina Pectoris

   • Stable angina
     • Chest pain on exertion for less than 20 mins
     • Pain radiates to left arm and jaw with shortness of breath
   • Unstable angina
     • Chest pain at rest for more than 20 mins
   • Prinzmetal
     • Episodic chest pain
     • happens due to vessels spasms

5. Anti-anginal drugs

   • C. Nitrates and nitrites
   • b-Adrenoceptor antagonists
   • Calcium channel-blocking agents
   • Dipyridamole (Persantine)

6. Blood supply of the heart

7. Myocardial Infarction

   • ECG
     • Changes:
   • Pathogenesis
   • Morphology
   • Risk Factors
     • Age
     • High blood pressure
     • High blood cholesterol
     • Diabetes
     • Family history
     • Lack of physical activity
     • Obesity
     • Stress
   • • Initial treatment
   • Blood tests
     • Biomarkers:

8. Acute Coronary syndrome

   • Treatment
     • With ST elevation
       • Aspirin
       • Morphine
       • Oxygen
       • Restore coronary perfusion
     • Without ST elevation
       • Oral anti-platelet therapy
         • Aspirin
         • Anticoagulation
         • Glycoprotein IIb/IIIa inhibitors
       • Nitrates (PO or IV)
       • ACE-inhibitors
       • Beta-blockers
       • Lipid management
     • Thrombolytics:
       • Drugs:
         • Streptokinase
         • Urocinase
         • Alteplase
       • Clinical uses:
         • Early therapy in acute MI
         • Reduction in other MI complications (LV)
           • dysfunction
           • cardiogenic shock
           • late myocardial rupture
           • arrhythmia
         • Pulmonary embolism
       • Side effects:
         • Mostly bleeding and hemorrhage

9. Premature Ventricular Contraction (PVC)

   • caused by an ectopic cardiac pacemaker located in the ventricle.
   • Cardiac cause:
     • Acute MI or myocardial ischemia
     • Myocarditis
     • Cardiomyopathy,
     • Myocardial contusion
     • Mitral valve prolapse

10. PAIN

    • Referred pain
      • Dermatomal rule:
        • Pain is referred usually to a structure that developed from the same embryonic segment or dermatome as the structure in which the pain originates
    • Classification

11. Angiography

12. Healthy lifestyle

    • Maintaining a healthy weight
    • Quitting smoking
    • Getting regular exercise
    • Reducing stress
    • diabetes

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