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0:04
VIVEK LAL: Now that we have
understood the pathology
and the diagnosis of
ischemic heart disease,
let us come to a very important
aspect of this discussion.
And that is the management of IHD.
Let us first discuss
the aims and objectives
of the management of IHD.
Initially, let us discuss what
are the aims and objectives
of the management of stable angina?
The first and foremost thing
in the management of angina
is allaying the anxiety, or
reducing the anxiety of the patient.
This is very important because
there is a sympathetic discharge
whenever there is an angina.
The patient is anxious.
And he's having a sympathetic
discharge in the body.
This sympathetic
discharge in the body,
or in other words, a liberation of
catecholamine hormones in the body
can further aggravate the situation.
So it is essential that
the patient is calmed down
and his anxiety is reduced.
Then is the actual
management of angina
followed by the management
of any coexisting
disorders like diabetes
mellitus, and hypertension.
Apart from that, a reduction of
the risk factors and other advice
has to be given to the patient.
For example,
he should reduce his weight.
He should quit smoking.
He should control the
blood cholesterol levels.
And he should also
go for regular exercise.
1:24
Let us now discuss the aims
and objectives of the management
of acute coronary syndrome.
The first step in the management
of acute coronary syndrome
is to estimate the risk in unstable
angina or NSTEMI, or non-STEMI.
This is followed by a
reduction of anxiety,
as we have already discussed,
in the management of angina.
Then the relief of
pain is very important.
Because the pain can be very severe.
And it can contribute to
the anxiety of the patient.
Next step is to take the patient to
a specialized cardiac care center.
Because the definitive
management can
only be initiated in such a center.
This is followed by the
definitive management
of acute coronary syndrome
that is thrombolysis or dissolution
of the clot which is blocking
the coronary arteries,
or a percutaneous
coronary intervention called
a PCI or a placement of stent.
This we will discuss later on.
This is followed by a
supportive management
and monitoring the
prognosis of the patient.
In addition, early
management of complications
is a very important
step in the management
of acute coronary syndrome.
And also, a regular
follow up of the patient.
