Coronary artery disease

 CORONARY ARTERY DISEASE (CAD)

The commonest form of coronary artery disease is narrowing of the vessel lumen by atherosclerotic plaque(s).The most frequent symptom of CAD is chest pain (angina pectoris) due to myocardial ischemia.

Coronary Arteries

 There are two main coronary arteries which branch to supply the entire heart. They are named the left and right coronary arteries,and arise from the left and right aortic sinuses within the aorta.

Branches of Left coronary artery are:

1. Left anterior descending artery (LAD) or anterior

interventricular artery

2. Left marginal artery (LMA)

3. Left circumflex artery (Cx)

Branches of Right coronary artery are:

1. Right Marginal artery

2. Posterior interventricular artery


MYOCARDIAL ISCHEMIA

Ischemia results in immediate changes which can be detected by echo:

Abnormalities of wall motion (hypokinetic, akinetic, dyskinetic)

Abnormalities of wall Thickening Abnormalities of overall LV function (e.g. EF) These can be detected by 2-D echo but M-mode is also extremely good because it is very sensitive to wall motion and thickening abnormalities. 


The changes reverse if ischemia is reversed, e.g. by rest, antianginal medication, percutaneous transluminal coronary

angioplasty, thrombolysis or coronary artery bypass grafting.

 If the myocardium has its blood supply occluded for more than 1

hour, permanent changes occur which include MI and scarring.


Comments

Post a Comment

Popular posts from this blog

KUB Ultrasound

Image
Ultrasound of the Kidneys In medicine, KUB refers to a diagnostic medical imaging technique of the abdomen and stands for Kidneys, Ureters, and Bladder, although in fact the Ureters only show if they are abnormally distended.  A KUB ultrasound is an examination requested by your doctor to evaluate the urinary tract (which includes the kidneys, ureters, and urinary bladder). In the male patient, the prostate gland is also scanned. A KUB Ultrasound may be requested: 1/To look for changes in the bladder wall  2/To look for changes in the kidney size or structure 3/To look for stones in the urinary tract  4/To evaluate reasons why you have recurrent kidney infection 5/To identify the cause of renal or pelvic pain  KUB Ultrasound:- The urinary bladder can only be properly assessed when full or distended, as bladder volume measurements are taken whilst the bladder is full.   The bladder and both kidneys are also scanned after the bladder has been emptied to evaluate the volume of urine ret
Read more

THE EVALUATION AND MANAGENMENT OF HEMATURIA IN SURGICAL PRACTICE.

 Hematuria means blood in urine. It is not a disease but symptom of a disease. Management of hematuria depends underlying cause of hematuria.  UTI:-          Trimethorim/sulfamethoxazole, nitrofurantoin and fosfomycin are the most preferred antibiotics for treating UTI NEPHROLITHIASIS:-                                      Kidney stones (also called renal calculi) nephrolithiasis or urolithiasis are hard deposits made of minerals and salts that form inside kidneys. Diet excess body weight, some medical conditions and certain supplements and medications are among the many causes of kidney stones.        Investigation include imaging studies eg. Xray KUB and USG abdomen+ pelvis to make a definitive diagnosis.   Management options include: 1) Shock wave lithotripsy. The doctor can use shock wave lithotripsy link to blast the kidney stone into small pieces. 2) Cyctoscopy and ureteroscopy. 3) Percutaneous nephrolithotomy BLADDER CANCER:-                             Bladder cancer is a di
Read more