心肌梗死本课件

第三篇循环系统疾病第七章冠状动脉粥样硬化性心脏病(CoronaryAtheroscleroticHeartDisease,CHD)第三篇循环系统疾病1二、心肌梗死(myocardialinfarction,MI)定义:心肌缺血性坏死;冠状动脉血供急剧减少或中断使得心肌严重而持久的缺血导致心肌坏死概述:冠心病的严重类型发病率逐年上升死亡率极高二、心肌梗死2病因和发病机制基本病因:冠脉AS→冠脉狭窄且侧枝循环尚未充分建立→急剧减少或中断→心肌持久缺血达2030min以上>不稳定的粥样斑块破溃、出血,急性血栓形成,或冠状动脉持续痉挛,使冠状动脉完全闭塞。急性冠脉综合征的共同发病机制。其它病因:冠状动脉栓塞,主动脉夹层累及冠状动脉,冠状动脉炎,冠状动脉先天崎形病因和发病机制3促使斑块破裂及血栓形成的诱因6Am~12Am交感活性增加时,HR↑、BP↑●饱餐后(脂肪餐),血粘度↑●重体力活动,情绪激动或用力大便时●休克、脱水、出血、手术严重心律失常等、COAM也可发生在无心绞痛病史的患者促使斑块破裂及血栓形成的诱因4心肌梗死本课件5心肌梗死本课件6心肌梗死本课件7心肌梗死本课件8心肌梗死本课件9心肌梗死本课件10心肌梗死本课件11心肌梗死本课件12心肌梗死本课件13心肌梗死本课件14心肌梗死本课件15心肌梗死本课件16心肌梗死本课件17心肌梗死本课件18心肌梗死本课件19心肌梗死本课件20心肌梗死本课件21心肌梗死本课件22心肌梗死本课件23心肌梗死本课件24心肌梗死本课件25心肌梗死本课件26心肌梗死本课件27心肌梗死本课件28心肌梗死本课件29心肌梗死本课件30心肌梗死本课件31心肌梗死本课件32心肌梗死本课件33心肌梗死本课件34心肌梗死本课件35心肌梗死本课件36心肌梗死本课件37心肌梗死本课件38心肌梗死本课件39心肌梗死本课件40心肌梗死本课件41心肌梗死本课件42心肌梗死本课件43心肌梗死本课件44心肌梗死本课件45心肌梗死本课件46心肌梗死本课件47心肌梗死本课件48心肌梗死本课件49心肌梗死本课件50心肌梗死本课件51心肌梗死本课件52心肌梗死本课件53心肌梗死本课件54心肌梗死本课件55心肌梗死本课件56心肌梗死本课件57心肌梗死本课件58心肌梗死本课件59心肌梗死本课件60心肌梗死本课件61心肌梗死本课件62心肌梗死本课件63心肌梗死本课件64心肌梗死本课件65心肌梗死本课件66心肌梗死本课件67心肌梗死本课件68心肌梗死本课件69心肌梗死本课件70心肌梗死本课件71心肌梗死本课件72心肌梗死本课件73心肌梗死本课件74心肌梗死本课件75第三篇循环系统疾病第七章冠状动脉粥样硬化性心脏病(CoronaryAtheroscleroticHeartDisease,CHD)第三篇循环系统疾病76二、心肌梗死(myocardialinfarction,MI)定义:心肌缺血性坏死;冠状动脉血供急剧减少或中断使得心肌严重而持久的缺血导致心肌坏死概述:冠心病的严重类型发病率逐年上升死亡率极高二、心肌梗死77病因和发病机制基本病因:冠脉AS→冠脉狭窄且侧枝循环尚未充分建立→急剧减少或中断→心肌持久缺血达2030min以上>不稳定的粥样斑块破溃、出血,急性血栓形成,或冠状动脉持续痉挛,使冠状动脉完全闭塞。急性冠脉综合征的共同发病机制。其它病因:冠状动脉栓塞,主动脉夹层累及冠状动脉,冠状动脉炎,冠状动脉先天崎形病因和发病机制78促使斑块破裂及血栓形成的诱因6Am~12Am交感活性增加时,HR↑、BP↑●饱餐后(脂肪餐),血粘度↑●重体力活动,情绪激动或用力大便时●休克、脱水、出血、手术严重心律失常等、COAM也可发生在无心绞痛病史的患者促使斑块破裂及血栓形成的诱因79心肌梗死本课件80心肌梗死本课件81心肌梗死本课件82心肌梗死本课件83心肌梗死本课件84心肌梗死本课件85心肌梗死本课件86心肌梗死本课件87心肌梗死本课件88心肌梗死本课件89心肌梗死本课件90心肌梗死本课件91心肌梗死本课件92心肌梗死本课件93心肌梗死本课件94心肌梗死本课件95心肌梗死本课件96心肌梗死本课件97心肌梗死本课件98心肌梗死本课件99心肌梗死本课件100心肌梗死本课件101心肌梗死本课件102心肌梗死本课件103心肌梗死本课件104心肌梗死本课件105心肌梗死本课件106心肌梗死本课件107心肌梗死本课件108心肌梗死本课件109心肌梗死本课件110心肌梗死本课件111心肌梗死本课件112心肌梗死本课件113心肌梗死本课件114心肌梗死本课件115心肌梗死本课件116心肌梗死本课件117心肌梗死本课件118心肌梗死本课件119心肌梗死本课件120心肌梗死本课件121心肌梗死本课件122心肌梗死本课件123心肌梗死本课件124心肌梗死本课件125心肌梗死本课件126心肌梗死本课件127心肌梗死本课件128心肌梗死本课件129心肌梗死本课件130心肌梗死本课件131心肌梗死本课件132心肌梗死本课件133心肌梗死本课件134心肌梗死本课件135心肌梗死本课件136心肌梗死本课件137心肌梗死本课件138心肌梗死本课件139心肌