Ischemic Heart Diseases
Robbins page (376, 377, 384)
Objectives:
● Understand the pathogenesis and clinical consequences of atherosclerosis.
● Be able to discuss pathology and complications of ischemic heart diseases with special emphasis on
angina and myocardial infarction.
● Know how lifestyle modifications can reduce the risk of ischemic heart disease.
1
, Ischemic Heart Disease (IHD) - (coronary heart disease).
IHD are group of closely related conditions (syndromes) caused by an imbalance between the myocardial
oxygen demand and blood supply. it occurs when the myocardium need oxygen and there is no enough blood
supply. Usually caused by decreased coronary artery blood flow, so it’s called also (coronary artery disease).
IHD can cause these four conditions/syndromes:
1. Angina pectoris (chest pain).
2. Acute myocardial infarction (MI) = heart attack.
3. Sudden cardiac death. due to ventricular arrhythmia.
4. Chronic ischemic heart disease (IHD) with congestive heart failure (CHF). It is the reduction in heart
power to pump blood to the body. It usually happens after MI. Because some of the heart muscle dies
after a heart attack (MI), its power to squeeze out blood is reduced and heart failure develops.
Epidemiology.
Peak incidence: 60y for males and 70y for females, Men are more affected than women. The main
cause of ischemic heart disease is (coronary atherosclerosis) → 90% of cases.
Contributing factors: are same as that of atherosclerosis e.g.
● Hypertension because it’s results in a thickening and inelasticity of arterial walls and hypertrophy of the left
heart ventricle, also because high blood pressure put added forced against arterial walls.
● Diabetes mellitus the hyperglycemia itself increases lipid and lipoprotein, the excessive glucose in the blood
act with protein to form advanced glycation end product [AGE], this AGE cause inflammation in the vessels
which lead to IHD.
● Other factors: Smoking, High levels of LDL, Genetic factors (direct or indirect), Lack of exercise.
● Less commonly: due to vasospasm: it is blood vessel reducing its (diameter) and blood flow. & vasculitis:
it is inflammation of a blood or lymph vessel—called also angiitis.
2
Robbins page (376, 377, 384)
Objectives:
● Understand the pathogenesis and clinical consequences of atherosclerosis.
● Be able to discuss pathology and complications of ischemic heart diseases with special emphasis on
angina and myocardial infarction.
● Know how lifestyle modifications can reduce the risk of ischemic heart disease.
1
, Ischemic Heart Disease (IHD) - (coronary heart disease).
IHD are group of closely related conditions (syndromes) caused by an imbalance between the myocardial
oxygen demand and blood supply. it occurs when the myocardium need oxygen and there is no enough blood
supply. Usually caused by decreased coronary artery blood flow, so it’s called also (coronary artery disease).
IHD can cause these four conditions/syndromes:
1. Angina pectoris (chest pain).
2. Acute myocardial infarction (MI) = heart attack.
3. Sudden cardiac death. due to ventricular arrhythmia.
4. Chronic ischemic heart disease (IHD) with congestive heart failure (CHF). It is the reduction in heart
power to pump blood to the body. It usually happens after MI. Because some of the heart muscle dies
after a heart attack (MI), its power to squeeze out blood is reduced and heart failure develops.
Epidemiology.
Peak incidence: 60y for males and 70y for females, Men are more affected than women. The main
cause of ischemic heart disease is (coronary atherosclerosis) → 90% of cases.
Contributing factors: are same as that of atherosclerosis e.g.
● Hypertension because it’s results in a thickening and inelasticity of arterial walls and hypertrophy of the left
heart ventricle, also because high blood pressure put added forced against arterial walls.
● Diabetes mellitus the hyperglycemia itself increases lipid and lipoprotein, the excessive glucose in the blood
act with protein to form advanced glycation end product [AGE], this AGE cause inflammation in the vessels
which lead to IHD.
● Other factors: Smoking, High levels of LDL, Genetic factors (direct or indirect), Lack of exercise.
● Less commonly: due to vasospasm: it is blood vessel reducing its (diameter) and blood flow. & vasculitis:
it is inflammation of a blood or lymph vessel—called also angiitis.
2
