Académique Documents
Professionnel Documents
Culture Documents
Clinical Manifestations
Some videos have had to be removed from the
presentation due to size regulations. If any would like
the original (1gb) presentation please contact Rob
Turnbull (ret23)
Dr Sameer Kurmani
BHF Clinical Research Fellow
Department of Cardiovascular Sciences
Email: sak36@le.ac.uk
Cardiovascular Disease
Coronary Heart Disease Statistics 2010. P Scarborough et al. BHF Health Promotion Research Group
Department of Public Health, Oxford
Underlying Pathology: Atherosclerosis
Thrombosis
Formation of clot in response to plaque rupture with
activation of coagulation cascade and platelets
Embolism
Occlusion of a vessel by an embolus created proximally
to the site of occlusion
Ischaemia
Reduction in oxygen delivery to target tissue as a result
of altered blood flow
Infarction
Necrosis of tissue resulting from Ischaemia
Aneurysm
Abnormal dilation of vascular wall
Heart Disease: Broad Classification
Arrythmias
Heart Failure
Other Diseases
Myopericarditis, Endocarditis, Congenital & Acquired
Structural Heart Disease, Cardiac Tumours,
Hypertension
History of Presenting Complaint
68yr old man presents to the General Practitioner
with a 3 month history of chest pain. He reports that
while gardening or walking the dog, he gets a
discomfort in the middle of his chest which feels
really heavy. After stopping for a couple of minutes,
this settles before he can carry on again.
Drug History
Simvastatin 40mg
Amlodipine 10mg
Management of Angina
Anti-Anginal Therapy
Nitrates, -blockers, Ca2+ channel antagonists, If channel
inhibitors, Ranolazine
Drug History
Simvastatin 40mg
Amlodipine 10mg
Stable Angina
Chest pain brought on predictably by exertion/stress which
is relieved by rest or GTN
Mechanical
Heart Failure, Papillary muscle rupture, Ventricular Septal
Defect, Mitral valve dysfunction, Aneurysms, Cardiac
Rupture
Arrhythmic
Atrial & Ventricular arrhythmias, AV nodal dysfunction
Embolic
Central Nervous System, Peripheral Vasculature
Inflammatory
Pericarditis, Dresslers Syndrome
Questions?