Myocardial Ischemia, Injury

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Myocardial Ischemia, Injury InfarctionChapter
15

• Robert J. Huszar, MD
• Instructor
• Patricia L. Thomas, MBA, RCIS

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Outline

• Coronary Artery Circulation
• Coronary Artery Disease
• Acute Coronary Syndromes
• Acute Myocardial Syndrome

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Coronary Artery Disease/Risk Factors

• Family History
• Gender
• Race
• Age
• Cigarette Smoking
• Diabetes Mellitus
• Hypertension
• Elevated Cholesterol
• Obesity
• Lack of Exercise
• Stress
• Cocaine Use

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Pathophysiology of CAD

• Phase 1 Appearance of an atheromatous Plaques
• Phase 2 Formation of thrombus on the surface of
  the plaque after erosion or rupture
• Erosion endothelial covering of the plaque is
  torn away
• Rupture fibrous cap is weakened/surge of blood
  pressure/vasospasm
• Phase 3 Resolution or Occlusion

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Myocardial Ischemia, Injury Infarction

• Results from the failure of local CA to supply
  sufficient oxygenated blood to the myocardial
  tissue.
• Occlusion or obstructionatherosclerotic CA with
  blood clots
• CA Spasm caused by constriction of smooth muscle
  in the wall of the CA.
• Other reasons such as arrhythmia, PE, Hypotension
  or shock
• Increased Myocardial workload
• Decreased level of oxygen in blood delivered to
  the myocardium

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