Ischemic heart disease 1

Published on September 30, 2015   25 min

A selection of talks on Clinical Practice

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DR. VIVEK LAL: Hi, this is Dr. Vivek Lal from the King Faisal University in Saudi Arabia. I'm a pharmacologist and a medical teacher. Today, I will speak at length on Ischemic Heart Disease, or IHD, which is a major clinical problem globally.
So before we begin the discussion, let's first get acquainted with the problem and understand its epidemiological ramifications. Coronary artery disease or ischemic heart disease is a major cause of morbidity and mortality in both the developed and the developing countries. It is a cause of 17.3 million deaths worldwide, as per a study which was done in 2013 which is called the Global Burden of Disease Study. Since 1990, that has been a 41% increase in the prevalence of ischemic heart disease. And it has been observed that the lifetime risk of ischemic heart disease in men is 49% and 32% in women at 40 years of age. And it is 35% and 24% in men and women at the age of 70 years.
Now let us understand what exactly is myocardial ischemia. Myocardial ischemia is basically an imbalance between the supply of oxygen to the heart, so also the other nutrients, and the myocardial demand for these new nutrients and for oxygen. Now, the main reason for myocardial ischemia is a partial or a total block in the blood supply to the myocardium, which is the heart muscle. Now, the blood supply through the heart muscles is through the coronary arteries. Any block in the coronary arteries will lead to myocardial ischemia. Now obviously, the degree of the block will be proportional to the severity of the disease. Now, the main reason of coronary artery block is because of atheroma or an atherosclerotic plaque which develops in the intimal lining of the coronary arteries. The process of deposition of an atherosclerotic plaque is a relentless and a slow process. And the block in the coronary arteries is basically dependent on the extent of the block created by atherosclerotic plaque.