PRESENTATIONS OF ischemic heart disease(IHD)

PRESENTATIONS OF ischemic heart disease (IHD)

Angina pectoris, acute MI or death may be the First presentation of IHD. Stable Angina Pectoris

  • stable angina pectoris is chest pain due to coronary :; ischemia which is of very short duration and easily -relieved (within 5-10 minutes) by simple measures like rest.
  • Exercise testing or ambulatory monitoring shows transient ST segmen

PRESENTATIONS OF IHD 1

PRESENTATIONS OF ischemic heart disease (IHD)

 

ischemic heart disease EPIDEMIOLOGY —

 

  • The epidemiology of silent ischemia may be viewed from the standpoint of two groups of patients:
  • patients with a history of myocardial infarction or angina pectoris,

 

IHD Common in:

   

  • Men – 50 to 60 yrs
  • Women – 60 to 70 years

 

Symptomatic patients —

  • The largest number of patients at risk of silent ischemia are those with stable angina.
  • A number of studies have evaluated the prevalence of silent ischemia in patients with prior MI and in those with angina pectoris

PRESENTATIONS OF IHD 2

PRESENTATIONS OF ischemic heart disease (IHD)

 

Character of ischemic heart disease IHD  pain:

     

Presents with chest discomfort –

 

  • heaviness, chok­ing, smothering, pressure.
  • Frank pain may be present or only substernal discomfort.
  • Patient can localize pain only with fist – diffuse pain.
  • Pain which can be pointed with a finger is not cardiac pain.
  • Squeezing, tightening or band-like constricting pain is typical of coronary ischemia.
  • sient, fleeting, stabbing pain, pricking pain, and localized pain is rarely angina.
  • Angina may be seasonal more in winters.

 

ischemic heart disease Durationion:

   

  • 1 to 5 minutes
  • ‘Radiation to left shoulder, both arms, ulnar surface of arms and ulnar syrfaces  and hands back-of neck, jaw, teeth, epithilium occurs.
  • pitated by:
  • Angina typically occurs due to stress, z.ise, activity, emotions, fear, flight, frustration, –;e, hurry and worry.

 

  • Angina may be precipitated by unusual exertion, heavy meal or exposure to cold.
  • Angina at rest may occur:
  • called rest angina
  • Angina in recumbent position is called decubitus an

   

Nocturnal angina :

 

  • Angina occurring at night, like an attack of PNO Paroxysmal nocturnal , nocturnal angina.
  • hreshold for an ina the level of exertion whictLQrings on pain) varies from elsn to erson, day to day.

 

Diurnal variation:

  • Angina is more common early in the morning than late in the day.

 

Angina equivalents:

  • are symptoms of myocardial is­chemia other than pain like dyspnoea, fatigue, faint­ness. Angina equivalents are more common in the elderly.