In order for the heart to function properly the coronary arteries should be constantly supplying oxygen, if any of these arteries becomes blocked we experience angina, injury to the heart muscle, heart attack and in worst cases heart failure and death. Disease of the coronary arteries is the number one of all the heart diseases and the leading cause of death.
Coronary artery disease (CAD) is caused by the occlusion of the coronary arteries. When the artery gets occluded, it diminishes the blood flow to the heart. The heart muscle, the myocardium, doesn’t get enough oxygen to support its function. Myocardium cells become ischemic from the lack of oxygen, and without timely intervention, can become necrotic, dead, which is Myocardial Infarction (MI).
Main cause of the CAD is Atherosclerosis. Atherosclerosis is the narrowing of the lumen due to the build up of plaque on the inner lining (Intima) of the arteries.
Plaque can form over time, starting at young age from the deposits of cholesterol cells on the intima. Building up slowly, it can develop into an inflammatory disease, that can completely close off the artery. Plaque can be soft, mostly consist of lipids and have a thin fibrous cap, or it can be fibrous, have very few lipids, consist of smooth muscle cells and have a thick fibrous cap, that can withstand the pressure. Fibro...
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...ickening in systole and is not really squeezing), Diskinetic (the wall is thin and moves outward in systole) and the last step is an Anurismal wall (thin wall, that is bulging out both systole and diastole). The wall that’s opposite to affected wall becomes hyperkinetic. We evaluate the global LV or RV function, and calculate the LV ejection fraction. Its important to note that the wall, salvaged by reperfusion (PTCA or CABG) can appear akinetic, but is just displaying a post-ischemic dysfunction, this is called Stunned Myocardium. The wall that has lost some mobility, due to ischemia, but has the cells that are viable is called Hibernating Myocardium. In the area of diminished wall motion we can detect spontaneous echo contrast that appears there do to slow blood velocity.
In M-Mode allows us to check the wall motion, chamber size, wall thickening in systole,
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