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Myocardial Ischemia

Myocardial Ischemia. Present the moment there is a decrease of complete absence of blood supply to myocardial tissue Mild or moderate anoxia can be tolerated for a short time by the cardiac cells without greatly affecting their function.

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Myocardial Ischemia

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  1. Myocardial Ischemia • Present the moment there is a decrease of complete absence of blood supply to myocardial tissue • Mild or moderate anoxia can be tolerated for a short time by the cardiac cells without greatly affecting their function. • Upon return of adequate blood flow and reoxygenation, these cells usually return to a normal or near normal condition

  2. Myocardial Injury • If ischemia is severe or prolonged, the anoxic cardiac cells sustain damage and stop functioning normally, unable to contract or generate or conduct electrical impulses properly. • Damage cells still remains reversible so that the injured cells remain viable, and salvageable for some time. • Cells may return to normal or near normal after the return of adequate blood flow and reoxygenation.

  3. Myocardial Infarction • Severe myocardial ischemia continues because of continued complete absence of blood supply, the anoxic cardiac cell will sustain irreversible injury and die • Necrosis is present • After occlusion of a CA the myocardium evolves through various stages and degrees of severity of impairment.

  4. Acute Coronary Syndromes • Silent Ischemia • ST depression with or without pain • Stable Angina • Exertion induced angina that remains unchanged • Unstable Angina • New onset of angina, increase of existing angina, angina at rest > 20 minutes • Acute MI • Plaque rupture with thrombus formation • Sudden Cardiac Death • V-Tach or V-fib is the most common cause of 80% of population • Asystole or EMD is the cause of the other 20%

  5. Acute Myocardial Infarction After occlusion of a CA, the myocardium evolves through various stages and degrees of severity of impairment: • Myocardial Ischemia-zone of ischemia • Myocardial Injury-zone of injury • Myocardial Infarction-zone of infarction (dead tissue)

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