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2.1
Coronary Ischemia
Ischemia Coronary Artery Origin

Presentation

Abstract Acute coronary syndrome and myocardial infarction have been described to present with atypical symptoms in certain subsets of patients. [ncbi.nlm.nih.gov]

Cardiovascular

  • Heart Disease

    Read about symptoms of coronary heart disease. [nhs.uk]

    Principles of Ischemic Heart Disease (Coronary Artery Disease) 1. Introduction to Coronary Artery Disease (Ischemic Heart Disase) Coronary artery disease is the number one killer worldwide. [ecgwaves.com]

    Poor Sleep Is Associated With Ischemic Heart Disease and Stroke Aug. 29, 2017 — Poor sleep is associated with ischemic heart disease and stroke, according to new research. [sciencedaily.com]

    Find out more about how your heart works Risk factors for coronary heart disease A risk factor is something that increases your likelihood of getting a disease. There are several factors that can increase the risk of developing CHD. [bhf.org.uk]

  • Chest Pain

    BACKGROUND: Chest pain is a frequent symptom in the emergency department and often presents a diagnostic challenge. [ncbi.nlm.nih.gov]

    Chest pain is a major indication of coronary ischemia. If chest pain occurs while exercising, or during sex, but it doesn't persist after rest, it may be coronary ischemia, or what is called, "angina". [en.wikipedia.org]

  • Tachycardia

    During follow-up (3.5 ± 0.5 years), death (n = 2), ventricular tachycardia (n = 3), supraventricular tachycardia (n = 4), heart failure (n = 3) and recurrent coronary ischemia (n = 25) were observed. [ncbi.nlm.nih.gov]

    If P waves occur after each QRS complex consider: junctional rhythms, ventricular rhythms with retrograde AV conduction, an AV nodal reentrant rhythm or AV reciprocating tachycardias. [acls.com]

  • Systolic Murmur

    A systolic murmur may occur with acute mitral regurgitation or ventricular/septal defect. Jugular venous distention (JVD) may be present in the setting of right ventricular infarct or when there is significant biventricular heart failure. [brown.edu]

    [心]収縮[期] systolic function収縮機能 systolic murmur (SM)収縮期雑音 t tachycardia 頻拍(脈) tachypnea呼吸頻数、頻呼吸 technetium (Tc)テクネシ(チ)ウム temporal resolution時間分解能 terminal portion終末部 tetralogy of Fallot (T/F, TOF) ファロー四徴[症] thallium (Tl)タリウム thoracic aorta 胸[部]大動脈 thoractomy [tokyo-med.ac.jp]

  • Heart Murmur

    During inferior ischemia, posteromedial papillary muscle dysfunction can cause mitral regurgitation, resulting in a holosystolic murmur at the cardiac apex radiating to the axilla; see Heart Murmurs Topic Review. [healio.com]

Musculoskeletal

  • Shoulder Pain

    The pain may radiate to the arms, shoulders, jaw, or even teeth. Depending on the mechanism, the pain may start acutely. [consultant360.com]

    Less common presentations include only shoulder pain, pain down both arms, left wrist pain, right-sided chest or jaw pain, radiation to the right arm, mid-thoracic pain and only dyspnea without chest pains. [healio.com]

Workup

Next, we have to define the patient’s diagnosis and risk of adverse outcomes to determine the urgency of the workup and treatment plan. [consultant360.com]

T Wave

  • T Wave Inversion

    The presenting electrocardiography (ECG) revealed sinus rhythm and T wave inversion on inferolateral wall. [ncbi.nlm.nih.gov]

    ST elevation myocardial ischemia – manifested by ST elevations or hyperacute T waves, followed by T wave inversions often associated with evolution of pathologic Q waves. [acls.com]

    wave inversion with pain or discomfort / Transient ST elevation of 0.5 mm or greater for less than 20 minutes Definition: Normal or non-diagnostic changes in ST segment or T wave that are inconclusive and require further risk stratification / Includes [acls.net]

    Other changes may also occur over time, especially with the T wave (e.g., T wave inversion). [cvphysiology.com]

    T-wave flattening and T-wave inversions are less specific for ischemia but may point to that diagnosis in the right clinical setting. [consultant360.com]

Treatment

This review will describe a variety of percutaneous coronary interventional techniques and technologies that are employed in the invasive treatment of ischemia under the guidance of clinical guidelines and evidence-based medicine. [ncbi.nlm.nih.gov]

Despite its prevalence both globally and in the United States, coronary ischemia, its causes and its treatments are not widely known by the American public. [orbisbio.com]

CI needs a comprehensive treatment since the condition will not improve on its own. The overall goal of the treatment is to increase blood flow to the heart and improve symptoms of angina. [clinicaltrials.gov]

Prognosis

Discussion Transient myocardial ischemia in acute coronary syndromes is a marker of adverse prognosis, 4 5 6 7 8 although its underlying pathophysiological basis is not fully understood. [circ.ahajournals.org]

Prognosis depends on severity of the coronary artery disease. [merckmanuals.com]

Cardiac troponins I and T: molecular markers for early diagnosis, prognosis, and accurate triaging of patients with acute myocardial infarction. Mol Diagn Ther. 2012; 16(6): 371-81. PubMed Twerenbold R, Jaffe A, Reichlin T, Reiter M, Mueller C. [arupconsult.com]

The prognosis of angina without obstructive CAD is indeed dependent on the underlying pathophysiological mechanisms. [interventions.onlinejacc.org]

Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med. 1993 Apr 8;328(14):981-8. [teikyo-cvs.com]

Etiology

Aimed at both the basic and clinical cardiovascular investigator, the book comprehensively reviews the rapid progress made in recent years in understanding the etiology of myocardial ischemia and reperfusion. [books.google.de]

The clinical evolution and the outcome of specific treatment during follow-up was used to establish the etiology of chest pain. [ncbi.nlm.nih.gov]

ICD-10-CM Codes › I00-I99 Diseases of the circulatory system › I20-I25 Ischemic heart diseases › Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology [icd10data.com]

TTE Myocardial ischemia may be the etiology for chest pain, especially if abnormalities of left ventricular wall motion are detected. 5 – 8 The most significant advantages of TTE are its portability and noninvasiveness. [aafp.org]

The difficulty in defining electrocardiographic criteria in pediatrics relates to age-dependent differences in the pediatric electrocardiogram, the presence or absence of congenital heart disease, and multiple and diverse etiologies of myocardial injury [pediatrics.aappublications.org]

Epidemiology

Epidemiology of CSX Most CSX-patients are women [ 4, 17 ]. Coronarography has shown that no flow-limiting CAD is detected in nearly 75% of women with typical AP [ 13, 17 ]. [omicsonline.org]

Pathophysiology

Known pathophysiologic mechanisms related to ED ( Table 2 ). [omicsonline.org]

Abstract The interventional treatment of ischemia is a complex issue grounded on an understanding of basic pathophysiology, but translated and implemented in practice by extensive clinical trial data representing patients with a spectrum of ischemia-causing [ncbi.nlm.nih.gov]

[…] definition describes spectrum of acute ischemic heart diseases including unstanble angina and myocardial infaction Types of Acute Coronary Syndromes Anginia Pectoris/ Myocardial Ischemia Myocardial Infarction MI Anginia Pectoris/ Myocardial ischemia pathophysiology [quizlet.com]

Discussion Transient myocardial ischemia in acute coronary syndromes is a marker of adverse prognosis, 4 5 6 7 8 although its underlying pathophysiological basis is not fully understood. [circ.ahajournals.org]

Prevention

Metoprolol, however, prevented a platelet aggregability increase and intracellular cAMP decrease during exercise stress testing in patients with stable angina pectoris. [ncbi.nlm.nih.gov]

Table 1 Mechanical therapeutic interventions for preventing myocardial reperfusion injury in patients undergoing PPCI Table 2 Pharmacologic therapies for preventing myocardial reperfusion injury in PPCI patients IPost. [jci.org]

Diet is a very important factor in getting coronary ischemia or coronary artery disease and preventing it. A heart healthy diet is low in saturated fat and cholesterol and high in complex carbohydrates. [en.wikipedia.org]

Summary Goals for the perioperative management of patients with coronary artery disease include: • Prevent increases in sympathetic nervous system activity: reduce anxiety preoperatively; prevent stress response and release of catecholamines by appropriate [anesthesiology.pubs.asahq.org]

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