coronaryheartdisease

1、.Coronary Atherosclerotic Coronary Atherosclerotic Heart Disease (CHD)Heart Disease (CHD) . Definition .Clinical Type.Silent Myocardial Ischemia.Ischemic Cardiomyopathy.Sudden Cardiac Death.Acute Coronary Syndromes（ACS）.Risk Factor.Candidate Risk Factor.Angina Pectoris A clinical syndrome due to myo

2、cardial ischemia characterized by episodes of precordial discomfort or pressure, typically precipitated by exertion and relieved by rest or sublingual nitroglycerin. .Mechanism and Pathophysiology. 心绞痛发生机制心绞痛发生机制疼疼 痛痛.牵涉痛发生机制反映在反映在1-5胸交感神经胸交感神经节相应脊髓段脊神经节相应脊髓段脊神经.Clinical Presentation:Clinical Presen

3、tation:Symptom:Symptom:.Clinical Presentation:Clinical Presentation:Signs:Signs:. ElectrocardiogramElectrocardiogram.ECG at ECG at .Coronary Angiography.Other Diagnostic Testing. Clinical Type of Angina.Typing by stability or quiescence of an atherosclerotic plaque: Clinical Type of Angina.Classific

4、ation of Angina Classification of Angina Canadian Class:Canadian Class:.Differential DiagnosisDifferential Diagnosis.Therapy of AnginaTherapy of Angina.Therapy of AnginaTherapy of AnginaPharmacologic therapy:Pharmacologic therapy:.Pharmacologic therapyPharmacologic therapy.Pharmacologic therapyPharm

5、acologic therapy.Pharmacologic therapyPharmacologic therapy.Pharmacologic therapyPharmacologic therapy.Therapy of AnginaTherapy of Angina.Acute Myocardial Infarction.PathologyThe role of acute plaque changesThe role of acute plaque changes.Pathology.Pathology.PathophysiologyLeft ventricular function

6、:Left ventricular function: dyssynchronydyssynchrony hypokinesishypokinesis akinesisakinesis dyskinesis(paradoxical expansion)dyskinesis(paradoxical expansion)Ventricular remodeling:Ventricular remodeling: infarct expansion infarct expansion ventricular dilation ventricular dilation.Pathophysiology.

7、Pathophysiology.Symptoms. Signs.AMI KillipAMI Killip Heart Heart Function ClassFunction Class. Complications.ECG Diagnosis.Definitive ECG diagnosisDefinitive ECG diagnosis.Dynamic Evolvement of ECGDynamic Evolvement of ECG.Localized Diagnosis of MILocalized Diagnosis of MI. Proximal Left Anterior De

8、scending Artery Occlusion.Right Coronary Artery Occlusion.Left Circumflex or OM Artery LAD diagonal branch Artery.Acute Inferior MI.Old Inferior MI.Serum Markers of Cardiac Damage.Serum Markers of Cardiac Damage.Diagnosis.Differential Diagnosis of AMI.AMI Therapy.AMI Therapy Relaxing Relaxing Oxygen

9、 Oxygen Monitoring Monitoring Nursing Nursing Chest pain Chest pain Analgesics Analgesics Nitrate Nitrate Beta-blocker Beta-blocker Aspirin Aspirin Nursing and general treatmentNursing and general treatment.AMI TherapyNursing and general treatmentNursing and general treatmentReperfusionReperfusionAn

10、tiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart failureManagement of heart failureSecondary prevention of AMISecondary prevention of AMI.AMI TherapyNursing and general treatmentNursing and general treatmentReperfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatm

11、entShock treatmentManagement of heart failureManagement of heart failureSecondary prevention of AMISecondary prevention of AMI.AMI TherapyNursing and general treatmentNursing and general treatmentReperfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart fa

12、ilureManagement of heart failureSecondary prevention of AMISecondary prevention of AMI.AMI TherapyNursing and general treatmentNursing and general treatmentReperfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart failureManagement of heart failureSecondar

13、y prevention of AMISecondary prevention of AMI.AMI TherapyNursing and general treatmentNursing and general treatmentReperfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart failureManagement of heart failureSecondary prevention of AMISecondary prevention

14、of AMI.AMI TherapyNursing and general treatmentNursing and general treatmentReperfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart failureManagement of heart failureSecondary prevention of AMISecondary prevention of AMI.AMI TherapyNursing and general tr

15、eatmentNursing and general treatmentReperfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart failureManagement of heart failureSecondary prevention of AMISecondary prevention of AMI.AMI TherapyNursing and general treatmentNursing and general treatmentRepe

16、rfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart failureManagement of heart failureSecondary prevention of AMISecondary prevention of AMI.AMI TherapyNursing and general treatmentNursing and general treatmentReperfusionReperfusionAntiarrhythmicsAntiarrhythmicsShock treatmentShock treatmentManagement of heart failureManagement of heart failureSecondary prevention of AMISecondary prevention of AMI.AMI Therapy.AMI Therap