心血管系统急症课件_1.ppt

Emergency of Cardiovascular System Department of Emergency, Xuanwu Hospital of Capital Medical University Acute coronary syndrome Arrhythmia Acute heart failure Hypertensive emergency Part 1 Acute coronary syndrome A group of clinical syndrome caused by acute myocardial ischemia. Coronary atherosclerosis is the pathological basis of this kind of disease. It occurs because of acute myocardial hypoxia, and the imbalance of myocardial oxygen supply and demand. Most of the disease deteriorate from chronic stable angina Introduction ACS is a dynamic evolutionary process. It can be divided into unstable angina, non ST-segment elevation myocardial infarction and ST segment elevation myocardial infarction according to the severity of acute myocardial hypoxia, the duration and the imbalance of oxygen supply  The result of ongoing ischemia is myocardial infarction regardless of any kinds of myocardial ischemia. The pathogenesis of ACS is a dynamic process. So we will be able to save part of the ischemic myocardium, reduced infarct size, or even avoid the occurrence of myocardial infarction if early identification and rapid effective treatments are carried out. Type 1: Including unstable angina and non ST segment elevation myocardial infarction. The Lumen of blood vessel in Non-ST segment elevation myocardial infarction is incomplete occlusion because of the platelet thrombus, known as a white thrombus. Type 2: the ST segment elevation myocardial infarction. The thrombus is fibrin-based, also known as red thrombus, total occlusion of the lumen. ACS depends on two kinds of factors: One:the formation of coronary atherosclerotic plaques. Second: including plaque rupture, platelet activation, leading to thrombosis, resulting in lumen obstruction. Generally, atherosclerotic plaques can cause vascular stenosis, but not completely blocked, and if there is thrombosis, it is easy to block the vessel lumen. Diagnosis and differential diagnosis According to history and cl