Ischemic Heart Disease (IHD)

ischemic heart disease (IHO) is a disease of the heart due to a deficiency of supply of blood, oxy­gen and nutrients to the heart. Ischemic heart disease occurs when there is imbal­ance between supply (of blood, oxygen, nutrients) and demand (increased demand, less supply).

Ischemic Heart Disease (IHD) Causes

  • Atherosclerosis -is the commonest cause Coronary spasm
  • Arterial thrombi
  • Coronary emboli.
Ischemic Heart Disease (IHD) 1

Ischemic Heart Disease (IHD) Causes and Risk factors for Ischemic Heart Disease

Causes other than coronary atherosclerotic heart disease:

   

  • Luteic aortitis (Syphilitic)
  • Anomalous origin of left anterior descending
  • coronary artery from pulmonary artery
  • Aortic stenosis with LVH
  • Anaemia
  • Kawasaki disease in children coronary artery affected)
  • Aortic regurgitation (AR)
  • Hypertrophic obstructive cardiomyopathy (HOCM).
Ischemic Heart Disease (IHD) 2

Ischemic Heart Disease (IHD) Causes and Risk factors for Ischemic Heart Disease

Risk factors for Ischemic Heart Disease (IHD)

  • Variable degrees of association and, in some studies, no associations have been found for diabetes and insulin resistance, dyslipidemia,hypertension,  and heart disease with VaD in population-based cohorts
  • Age is nearly uniformly found to increase the risk of dementia after stroke
  • High LDL (low density lipoprotein)
  • Low HDL (high density lipoprotein)
  • High TG and TC (triglycerides and total cholesterol)
  • Stenoses within the coronary circulation most commonly occur in people who smoke
  • Cigarette smoking
  • Hypertension
  • Diabetes mellitus
  • Obesity.

 

Risk factors Role of Vascular Endothelium

   

  • It maintains vascular tone
  • It has anticoagulant surface
  • It prevents inflammation
  • Prevents atheroma formation .
  • Prevents coronary artery disease
  • The vascular endothelium is damaged by risk factors and atherosclerosis.
  • plague fissuring, rupture of plaque, or haemorrhage into a plaque
  • Collaterals do not develop in sudden occlusion of the coronary artery.
  • Coronary blood supply is obstructed by atheroma, thrombus, thromboemboli, .
  • When there is gradually progressive occlusion of the coronary arteries then collaterals develop which main­tain the perfusion of the heart.
  • If the cross-sectional area of coronary artery is re­duced to 750/0, then at the time of increased demand, the blood flow cannot increase appropriately It means there is significant coronary artey obstruction, and such patients are usually symptomatic.
  • At 800/0 reduction of the cross sectional areal the
  • blood flow at rest is also compromised. Such
  • patients are greatly handicapped, and are unable to carry out even routine activities without discomfort ..

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