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1.

CAUSES/
2. RISK FACTORS /
3. CLINICAL PRESENTATIONS /
4. DIFFERENTIAL DIAGNOSIS/
5. COMPLICATIONS/
6. PROGNOSIS
causes
Primary cause : Atherosclerosis
Increase in cardiac demand of oxygen
In presence if high-grade fixed coronary obstruction due to
increase in myocardial Oxygen and nutrition requirement
Reduction in blood/oxygen supply
Require new impairment in blood supply
Due to thrombosis and or plaque hemorrhage
RISK FACTORS

NON-MODIFIABLE
&
MODIFIABLE
NON-MODIFIABLE
AGE SEX FAMILY HISTORY
1stdegree Male or
>55 YEARS OLD Female relative
(Developed coronary
artery disease before age
55 or 65 respectively)
Family history of
premature CAD/sudden
>65 YEARS OLD death
MODIFIABLE
SERUM HD
CHOLESTR TG
OL LDL L
SEDENTAR TYPE 2
OBESIT HYPERTENSI
Y DIABET ON
LIFESTYLE ES Y
CIGARET STRES
TE
SMOKING S
Activities precipitating angina
Clinical presentations
(SYMPTOMS)
SYMPTOMS
Prolonged cardiac pain: chest,
throat, arms, epigastrium or
Back
Anxiety and fear of impending
death
Nausea and vomiting
Breathlessness
Collapse/syncope
Clinical presentations
(SIGNS)
Signs of sympathetic Signs of impaired
activation: Pallor, Sweating, myocardial function
Tachycardia
o Hypotension, oliguria,
cold peripheries
Signs of vagal activation: o Narrow pulse pressure
Vomiting, Bradycardia o Raised JVP
o Third heart sound
Signs of tissue damage: Fever
o Quiet first heart sound
Signs of complications: Mitral o Diffuse apical impulse
regurgitation, Pericarditis o Lung crepitations
Differential
diagnosis
MI
PERICARDITIS
MYOCARDITIS
PULMONARY EMBOLISM

I A C LESS COMMON
AORTIC DISSECTION
RD ANEURYSM OF THORACIC
CA AORTA
SEVERE AORTIC STENOSIS
Differential diagnosis
GIT Disorder Lungs/Pleura
MSK Disorder Neurological
a) Esophageal a) Bronchospasm
sorder b) Pulmonary
a) Prolapse
disorder
infarct intervertebral
b) Peptic ulcer a) Chostochondritis
disc
ribs c) Pneumonia
disease
d) Pneumothorax b) Herpes zoster
c) Biliary disease b) Psychogenic
chest pain e) Pulmonary
d) Pancreatitis embolism
f) TB
Complicati
ons
1. Arrhythmias
1. Ventricular fibrillation
2. Atrial fibrillation
3. Bradycardia
2. Ischaemia
3. Acute circulatory failure
4. Pericarditis
Complications
Mechanical complication
Rupture of papillary muscle
Rupture of interventicular septum
Rupture of Ventricle
Embolism
Impaired ventricular function
Ventricular remodeling
Ventricular aneurysm
progn

osis
of MI cases causes Death in few minutes without medical care
death occur after 24 hours onset of symptoms
40% died in 1st month after symptoms came
Suvive: After received care 28 days at hospital
of MI cases death are because Unstable Angina

EARLY DEATH ARRHYTHMIA/ Extend MI


LATE OUTCOME Extend of myocardial damage
Poor left ventricular function
AV block (worse for ant> inferior infarct)