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... ... middle of paper ... ... of the need of duplicate revascularization over balloon angioplasty [75]. Both pre- and post -conditioning appears to protect cardiomyocytes at the time of reperfusion therapy. Ischemic post-conditioning is a chain of repetitive intermissions of coronary blood flow administered after a period of ischemia. Inhibition of ONOO−-induced nitro-oxidative stress might pay a critical role in postcon-mediated cardioprotection [76]. Iliodromitis et al also reported that postcon-mediated cardioprotection was in cohorts with reduced nitro-oxidative stress in vivo. The acknowledgment that iNOS activation in cardiac myocytes could be advantageous and that nitriate/NO could have both beneficial and detrimental effects, lead to the dose of 1400W iNOS inhibitor being chosen to significantly inhibit, but not restrict, increase in the level of myocardial iNOS activity after MI [77]
A Transient Ischemic Attack, generally referred to as a TIA, is a type of stroke that only last a few min...
The answers are A&D. Decreasing myocardial oxygen demand (heart rate control, preload/after load reduction) and Increasing myocardial oxygen supply (perfusion) are essential in the treatment of MI.
...ve stress [8] and can help combat many cardiovascular disorders, thus confirming the protective capabilities of nitric oxide. Another one of nitric oxide’s protective capabilities stems from its role as a potent vasodilator, and these vasodilation properties are primarily achieved through the activity of eNOS. eNOS is a membrane bound protein that is classified as a calcium-calmodulin dependent enzyme [13]. At resting concentrations of calcium, eNOS generates low amounts of nitric oxide, however, as intracellular calcium concentration increases, there is a potent enhancement of nitric oxide production by eNOS [13], which then goes on to cause vasodilation to prevent blockage of blood flow. Due to its generally low output, eNOS is largely associated with basal cardiac function, while iNOS is a much higher output enzyme, generating much more nitric oxide than eNOS [5].
Cardiogenic shock can acute or chronic disorders that effect the function of the heart in supplying adequate tissue/organ perfusion.
The human body is an amazing machine, we have cells, tissues, organs and organ system that come together to create the human race. Each system plays a key role in our bodies mechanism. Without each systems our bodies would not function properly, but what happens when one of these system fails? The Cardiovascular system components are blood, blood vessels and the heart. The hearts function is to pump blood to all the major organs and tissues (Circulatory). It’s also important to be aware of the derivation that our bodies may encounter, for example a stroke. In this passage I discuss different types of strokes, what are the signs and symptoms and after care for this disorder of the cardiovascular system.
What is a Myocardial Infarction? Myocardial Infarction, also known as a heart attack, occurs when there is a blockage in one of the coronary arteries. The heart is a muscle that needs oxygenated blood and nutrients to survive. When a blockage occurs in the arteries, oxygen and nutrients are cut off from the heart for an extensive time. The blocked portion of tissue in heart dies. Blockages can occur due to several factors. Coronary artery disease is the most prevalent cause. Coronary artery disease or atherosclerosis is due to plaque buildup and narrowing in the artery walls. These plaques are made from cholesterol and waste products. This buildup on artery walls can restrict blood flow; a process that can take
A heart attack (myocardial infarction) is the death of heart muscle due to the loss of blood supply. Usually, the loss of blood supply is caused by a complete blockage of a coronary artery by a blood clot. A coronary artery is an artery that supplies blood to the heart muscle. Death of the heart muscle causes chest pain and electrical instability of the heart muscle tissue. Electrical instability of the heart causes ventricular fibrillation (chaotic electrical disturbance). Orderly transmission of electrical signals in the heart is important for the regular beating (pumping) of the heart. A heart undergoing ventricular fibrillation quivers, and can not pump or deliver oxygenated blood to the brain. Permanent brain damage and death can occur unless oxygenated blood flow is restored within five minutes.
Myocardial infarctions are caused by vascular endothelial disruption most often associated with plaque build-up or atherosclerosis that develops over several years and causes thrombus formation which in turn
Heart Disease You need your heart for all your body needs. It pumps about 2000 gallons of blood a day. It takes about 20 seconds for blood to reach every cell in the body. An artery that carries blood out of the heart.
Coronary Heart Disease Coronary heart disease is the most common form of heart disease. It is a general term for both heart attack and angina. Many people suffer from it and 500,000 Americans die from it each year. It is much more common in older people and in males. However, women tend to be older and sicker when they are first treated for a heart attack.
...., & Jr, L. H. (1992). Release of vasoactive substances during cardiopulmonary bypass. Annals of Thoracic Surgery. doi:10.1016/0003-4975(92)90113-I-6
Cardiovascular disease (CVD) refers to the dysfunctional conditions of the heart, arteries, and veins that supply oxygen to vital life- sustaining areas of the body like the brain, the heart itself and other vital organs. Since the term cardiovascular disease refers to any dysfunction of the cardiovascular system there are many different diseases in the cardiovascular category, and many of these diseases are strongly intertwined. Ischemic Heart Disease is the medical idiom for the obstruction of blood flow to the heart. It is usually due largely in part to excess fat or plaque deposits that narrow the veins that provide oxygenated blood to the heart. This excess fat buildup and plaque are respectively known as arteriosclerosis and atherosclerosis. Hypertension is frequently a result of both arteriosclerosis and atherosclerosis, and can lead to more serious CVDs, such as angina attack (an acute and squeezing chest pain due to inefficient blood flow to the heart), and myocardial infarction( the sudden death of part of the heart muscle). A stroke is a CVD that occurs when there is in inadequate oxygen flow to the brain. An abnormally high or abnormally low heart rate because of the disruption of the natural electric impulses of the heart is called cardiac arrhythmia. Carditis and endocarditis, the infection and inflammation of the heart, can occur as a result of a weak immune system, liver problems, heart surgery, or an autoimmune disorder.
Oxygen is widely used in both chronic and acute cases, in emergency medicine, at hospital or by emergency medical services (Nicholson, 2004 ). Just like any other form of medication oxygen is a drug that if used incorrectly could cause potential harm, even death (Luettel, 2010 ). Oxygen is admitted to the patient with chest pain for two main rationales. The first is by increasing arterial oxygen tension, which in opposing causes a decrease to the acute ischemic injury, and thus over time the entire infarct area (Moradk...
Myocardial infarction and acute coronary syndrome require the same medications such as: “aspirin, nitroglycerin, morphine, beta blockers, and thrombolytics” (Smeltzer, pp. 744, 2010) Oxygen administration and a 12-lead electrocardiogram is also required upon arrival to the hospital. A PCIS is a procedure for “opening the occluded artery and providing perfusion to the area of the heart that has been deprived of oxygen” and should be done in less than one hour of patient arrival (Smeltzer, pp. 745, 2010). When a PCI is contraindicated or unavailable at a certain facility, thrombolytics are admistered to “dissolve the thrombus in a coronary artery” in order for reperfusion to the deoxygenated area of the heart to occur (Smeltzer, pp. 745, 2010). After the initial medical treatment for acute coronary syndrome and a myocardial infarction, “continuous cardiac monitoring” is required to ensure that another episode is not going to occur (Smeltzer, 745, 2010). Monitoring is preferably done on an intensive care unit because of the severity of the complications that could occur. Medications such as “aspirin, beta-blockers, and an ACE inhibitor” is included in the ongoing treatment (Smeltzer, pp. 745, 2010). Cardiac rehabilitation is initiated after the patient with acute coronary
These causes will change the heart significantly. The pathophysiology of heart failure is described differently as: (1) an oedematous disorder, by means of which the deviations in renal hemodynamics and excretory ability lead to salt and water holding; (2) a hemodynamic disorder, considered by peripheral vasoconstriction and decreased cardiac output; (3) a neurohormonal disorder, mainly by stimulation of the renin-angiotensin-aldosterone system and adrenergic nervous system; (4) an inflammatory syndrome, related with amplified local and circulation pro-inflammatory cytokines; (5) a myocardial disease, started with an damage to the heart trailed by pathological ventricular transformation. In heart failure, the heart sustains either a sudden or longstanding structural injury. When damage occurs, sequences of firstly compensatory but consequently maladaptive mechanisms follow (Henry & Abraham, ).