Myocardial ischemia

Myocardial ischemia's disease overview

myocardial ischemia or ischemic myocardial ischemic , ischemic heart disease are the terms that bring the same meaning about artery disease rim. Coronary artery is a blood artery that nourishes the heart, including the anterior ventricular artery, the hat artery comes from the body of the left coronary artery and the right coronary artery. Coronary artery disease is a disease of the present era with the incidence and the number one mortality rate worldwide (ranked on cancer, brain stroke, etc.). Currently, with many advances in cardiovascular intervention as well as medications, it has greatly improved in the mortality rate of coronary disease.

Coronary artery disease is divided into two main groups: acute rim syndoms (myocardial infarction with st differentiation, non -stable myocardial infarction, unstable chest pain) and stable angina (vascular disease stable rim). This article will refer to chronic myocardial disease anemia (stable chest pain, stable coronary artery disease).

Causes of Myocardial ischemia's disease

The cause of myocardial ischemia is due to:

  • Coronary artery blockage caused by atherosclerotic plaques: The atherosclerotic plaques that cause coronary artery narrowing to a certain extent will cause myocardial ischemia, symptoms of chest pain on forestry Sound. If atherosclerosis suddenly cracks, the blood clotting process starts, creating thrombosis that covers the coronary heart, then the heart attack will occur.
  • Local spasms or coronary arteries
  • Coronary dysfunction

    • Symptoms of Myocardial ischemia's disease

    symptoms of myocardial ischemia :

  • Chest pain: myocardial ischemia manifests itself mainly with clinical angina. Coronary angina is described with 3 characteristics:
  • Feeling of pain like strangling, pain like angina or heavy, behind the breastbone, spreading to the chin, on the left shoulder and spreading to the left arm
  • Appears of a rule, increasing after exertion, strong emotions, cold, ... lasting 3-15 minutes
  • Chest pain when resting or using nitroglycerin

    • If there are all 3 characteristics, called typical angina, if only 2/3 of the standard is called a typical pain, if only 1 or 1 or There is no criteria, then find another cause not coronary artery

  • For high -age patients or especially diabetes, chest pain may not be typical or unclear, faint. Patients can go to the hospital with heart failure without knowing the previous chest pain, surveying the coronary artery is narrowed in a significant way. Such cases are called silent myocardial ischemia

    • In addition to chest pain, patients with local myocardial ischemia often have no special symptoms.

    People at risk for Myocardial ischemia's disease

  • Men

    • Old age

  • Smoking

    • obesity

    Diabetes

    Blood lipid disorders

    Hypertension

  • Static, sedentary lifestyle

    • Prevention of Myocardial ischemia's disease

  • Quit smoking

    • Weight loss if overweight

    Exercise regularly: at least 30 minutes a day, 5 days per week

  • Healthy diet: Many green vegetables, fruits, limit animal fat instead of vegetable oil, limit animal organs, reduce salt in food, do not eat other Salt foods like pickles, salted tomatoes ...
  • Control blood pressure by changing the diet with oral medication regularly
  • Control blood sugar, blood lipid

    • Diagnostic measures for Myocardial ischemia's disease

  • Electrolyte: is the first means to perform first to diagnose coronary disease. On the ECG can see the difference of ST horizontal, t soundwaves, necrotic Q waves of old myocardial infarction. In addition, if those electrocardiograms appear in the pain, the more anemia is confirmed.
  • Electrolyte effort (with rugs, bicycles ..): Record the continuous electrocyte when the patient is active, seeking an electrocardiogram while trying to be exertion Performed when suspected patients with coronary artery disease and electrocardiogram during normal leave, no signs of suggestions

    • Echocardiography and echocardiography: On the heart doppler ultrasound can see regional movement disorders, reduce or lose movement of the myocardial area according to the blood level of the artery rim. If normal echocardiography can perform an echocardiography, the patient will be transmitted to the myocardial contraction (Dobutamin). If there is a dynamic dysfunction when doing exertion ultrasound, there is also a diagnosis of anemia heart disease.

  • Multi -sequence of computers: Evaluate coronary artery images, narrow level, narrow position. However, it may not be accurate in cases
  • Coronary angiography through the skin: is an invasive measure, high technology. The catheter will be taken through blood vessels to capture coronary arteries. It is possible to determine the degree of narrow, coronary artery reserves through ultrasound (IVUS) and FFR measurement.
  • Testing: heart enamel (troponin t or troponin I, CK, CK-MB) to eliminate acute rims, cholesterol tests, triglycerides, LDL-C, HDL-C , Glucose, HBA1C, liver, kidney function, etc. to diagnose diseases and risk factors attached.

    • Myocardial ischemia's disease treatments

    Treatment of myocardial ischemia includes medical treatment and coronary rejection by intervention, surgery.

  • Medical treatment
  • Platelet assembly: low -dose aspirin is the first recommended drug. Clopidogrel can be replaced if not tolerated with aspirin
    • Statin therapy: Statin helps stabilize atherosclerotic plaques, which plays a very important role. Can use rosuvastatin, atorvastatin ..
  • Sympathetic beta blockers: Metoprolol, Bisoprolol ... are an important group of drugs in treatment, used to increase exertion, reduce heart frequency, improve chest pain symptoms
  • Nitrate group: Nitroglycerin has a quick, short coronary dilatation effect, which can be used immediately to reduce pain immediately when it appears. Oral, leaked, sprayed preparations under the tongue or intravenously. Prolonged vasodilators like Nicorandil, Ranolazin are also used
  • AT1 receptor inhibitors/inhibitors: Priority is used when heart failure, hypertension, diabetes attached to
  • Predict coronary re -connection: In patients with stable coronary coronary artery, when optimal medical treatment without improving symptoms can be re -circuited Ring through the skin or surgery to connect the bridge, depending on the specific case. It is also possible to re-connect coronary arteries in patients with 2-3 coronary pathology, the left coronary body narrowing> 50%, with heart failure attached ... to improve prognosis.

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