Ischemic heart disease (IHD) refers to dysfunction of the left ventricle as a result of insufficient delivery of oxygen to the myocardium, which can occur due to coronary artery disease (CAD) (Cassar et al., 2009). If it is severe and sustained will lead to irreversible myocardial cell damage and infarction of the myocardium (Cassar et al., 2009). CAD is the most frequent cause of IHD in which deposition of atherosclerotic plaque overtime results in stenosis inside the artery and reduced blood flow to the heart or a rupture of an atherosclerotic plaque in a coronary artery can occur leading to thrombus formation in that artery (Koulaouzidis, 2013). The subendocardium is most vulnerable to ischemia and the infarct may expand to the subepicardium …show more content…
The ability of CMR to acquire images in different orientations and availability of wide range of sequences to assess cardiac morphology, function, flow, perfusion, tissue injury, and fibrosis in a single imaging helped in emerging this powerful technique to evaluate myocardial ischaemia and viability (Kramer, 2011). Therefore CMR became an increasingly used technique to monitor and guide treatment in the different clinical presentations of IHD (Schwitter & Arai, 2011). CMR can assess global and regional function of myocardium (Khan et al., 2011). It is used to detect acute and chronic infarcts as well as ischemia(Kramer, 2011). Different literatures acknowledge CMR strength in distinguishing hibernating, which refers for tissue will recover after vascularization, and stunned myocardium, which refers for tissue with spontaneous recovery of function, from scar, likely no recovery, and determining myocardial viability (Von & Schulz, 2012 and West& Kramer, 2010). CMR has a role in identification of risk stratification for treatment decisions, such as revascularization or medical therapy, especially in the chronic phases of CAD (Schwitter & Arai, 2011). In the acute phases of CAD viability assessment is most important and CMR is expected to play an
Patients that come in in cardiogenic shock during there echocardiogram need to be evaluated in a whole looking for any abnormalities. Diastole dysfunction, systolic dysfunction, any possible shunting issues, aortic stenosis, coarctation of the aorta or
The preliminary step in myocardial infarction is atherosclerosis. Atherosclerosis does not occur abruptly, it is a gradual and dynamic inflammatory disease which causes the narrowing of lumen due to the deposition of lipid and foam cells. The formation of fatty streak; which will eventually become a plaque causes the vessel lumen to diminish. The plaque will become unstable, rupture and eventually lead to the event of plaque disruption.
Patients with dilated cardiomyopathy will often have normal thickness of the ventricles with an enlarged right, left, or both ventricular cavities. In the early stages of this disease, there is an initial increase in the stroke volume from the increased force of contraction due to the stretching of the myocardium, which is described by the Frank-Starling mechanism. However, as the disease progresses, the heart loses that compensatory mechanism leading to a decrease in the strength of the contraction of the heart, hence, a decrease in left ventricular ejection fraction. There are two types of DCM, primary and secondary. Primary dilated cardiomyopathy are usually idiopathic in nature, however, “approximately 30% of cases” have a “familial transmission pattern.”3(138) Secondary dilated cardiomyopathy, on the other hand, are associated with “alcohol abuse, cocaine abuse, the peripartum state, pheochromocytoma, infectious diseases (human immunodeficiency virus infection), uncontrolled tachycardia, Duchenne’s muscul...
Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
Cost effectiveness and noninvasiveness seem to be a theme in developing preventative treatments of coronary artery disease. A study presented by the Journal of Magnetic Resonance Imaging proposes that the use of coronary wall MRI would encompass both of these factors. These MRI images compared coronary artery thickness of symptomatic and asymptomatic patients. It was found that these images could successfully detect artery wall thickness in asymptomatic patients who would have otherwise not been screened for risk factors.
The term, ischemia, denotes inadequate blood supply to tissues due to blockage of the arterial inflow, while, reperfusion injury is defined as the injury caused by the restitution of blood flow after an ischemic peroid, leading to death of cells that were only reversibly injured at the time of blood flow restitution. [63]. The final infarct size after an MI event is therefore the result of the ischemic and reperfusion damage. For this reason, the term that best describes this process of myocyte death in reperfused MI is myocardial ischemia/reperfusion (I/R) injury [64]. In the early hours post myocardial ischemia, injured cardiac cells can release several molecules, including adenosine, opioids, and bradykinin, which activate the G protein signaling pathways therefore promoting myocardial survival. While in the late phase, myocardial ischemia induces upregulation of growth factors and cytokines, including VEGF, ILGF and SDF-1, in the injured myocardium, hence promoting a cardio-protective state. The liver also participates in cardioprotection through the up regulation and release of secretory proteins, including FGF21 and TFF3, which also promote cardiomyocyte survival. [65]. Foundational studies performed about three decades ago with animal models demonstrated that an early reperfusion was able to limit infarct size [66]. Then fibrinolysis was indisputably associated with a decrease in mortality in patients with STEMI [67].A decade later; primary angioplasty was shown to be more superior than fibrinolysis [68]. Currently primary coronary angioplasty (PCI) has been established as the backbone treatment for STEMI patients. The period from the onset of symptoms of MI (representative of the time of coronary occlusion) and reperfusio...
Cardiovascular Disease is defined by the American Heart Association as “Heart and blood vessel disease”. Atherosclerosis of the arteries, can lead to hypertension, heart failure, arrhythmias, heart valve problems, myocardial infarctions or a stroke (AHA, 2016). In this paper, all of heart and vessel diseases aforementioned, will be considered cardiovascular disease (CVD). According to
[12] Ho, Carolyn Y, MD; López, Begoña, PhD; Coelho-Filho, Otavio R, MD; Lakdawala, Neal K, MD; Cirino, Allison L, MS, CGC; Jarolim, Petr, MD, PhD; Kwong, Raymond, MD; González, Arantxa, PhD; Colan, Steven D, MD; Seidman, JG, PhD; Díez, Javier, MD, PhD; Seidman, Christine E, MD. (2010) Myocardial Fibrosis as an Early Manifestation of Hypertrophic Cardiomyopathy, Boston, MA: Massachusetts Medical Society
The primary concern for Mr. Miller would be preventing further ischemia and necrosis of the myocardial tissues, preventing serious complications such as cardiac dysrhythmias and heart failure, as well as relieving his chest pain that radiates to his left arm. Preventing further ischemia and necrosis of the myocardial tissue will help prevent the development of heart failure due to myocardial infarction, whereas relieving his pain will help reduce his episodes of shortness of breath, and will also help to reduce any anxiety and restlessness he may be having from being in pain and short of breath.
left ventricular function and heart failure.” Clinical Investigative Medicine. 31.2 (2008): E90-E97. Web. 15 Feb. 2014.
Coronary heart disease or coronary artery disease affects 16.8 million people in the United States and causes more than 607,000 deaths annually (Lemone, chap.30). It is caused by atherosclerosis which is the accumulation of fatty deposits in the arteries causing impaired blood flow to the myocardium. CAD or coronary artery syndrome is usually without symptoms but may induce heart attack, angina and acute coronary syndrome if not properly treated. There are many risk factors associated with CAD like obesity, high cholesterol diet, hereditary, physical inactivity, just to name a few. Patients with CAD may be unable to identify and manage their risks factors. It is imperative for nurses to educate the patient about CAD and measures to enhance their health.
Just as breast cancer is killing our African American women, heart disease is also one of the major diseases killing our women. Heart disease is one of the nation’s leading causes of death in both woman and men. About 600,000 people die of heart disease in the United States (Americas heart disease burden, 2013). Some facts about heart disease are every year about 935,000 Americans have a heart attack. Of these, 610,000 are a first heart attack victim. 325,000 happen in people who have already had a heart attack. Also coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and loss of productivity. Deaths of heart disease in the United States back in 2008 killed about 24.5% of African Americans.
...ital if you have symptoms such as dizziness, fatigue, chest pain, or heartburn it is essential that you get to a hospital immediately, just to make sure that you can get the treatment that you need so you and your family do not have to experience a myocardial infraction. Even though coronary artery disease usually affects persons over age 60, the disease can still be seen in people who are much younger for various reasons. The diagnosis of coronary artery disease remains the number one cause of hospitalization and death in the adult population in the United States today, but with the proper treatments, knowing the risk factors of coronary artery disease and medical technology such as stents, coronary endocartomy, and coronary bypass grafting that we have available to us today the prognosis can be positive for many patients and will save more lives than not knowing.
What is coronary heart disease (CHD)? It is a disease when plaque gets built up in the coronary arteries; and the job of the arteries are to provide rich-oxygenated blood to the heart muscle. Built plaque in the arteries leads to atherosclerosis and the plaque that is built can result from over the years. Throughout the years, the plaque tends to get hard or can rupture. If hardened, the arteries are now narrow and have weakened the flow of blood that travels to the heart. Blood clots can form from the plaque rupturing which can cause a great chance for the blood flow to be mostly blocked or blocked altogether. There are other names for coronary heart disease such as coronary artery disease, atherosclerosis, ischemic heart disease, etc.
Etiology Myocardial infarction occurs when the coronary arteries are blocked by a blood clot. It is commonly known as a “heart attack”. The heart needs its own constant supply of oxygen and nutrients to work properly. Two coronary arteries deliver oxygenated blood to the heart, and if one of these two arteries fails or becomes blocked, then a portion of the heart will not acquire the necessary oxygen. This clot could be because of CAD (coronary artery disease), which happens when the inner walls of the coronary arteries thicken because of buildup of cholesterol, fatty deposits, calcium among other elements that are carried in the blood (Boston Scientific, 2009).