天津医科大学内科学课件 Coronary Artery Disease.pptVIP

Coronary Artery Disease Bian Bo Tianjin Medical University General Hospital objective Understand the pathogen and etiology of atherosclerosis (CAD, AP, MI, ACS) Familiar the symptom and lab examination Be able to diagnosis UAP and AMI or ACS Be able to prescribe patients with UAP/AMI Test A kind of clinical vascular disease What should we know Epidemiology Pathogens Etiology Clinical manifestation (symptom and sign) Diagnosis and differential diagnosis Treatment Complication and prognosis What is coronary artery disease What--------------definition Who---------------character of patients Why---------------etiology How often-------incidence What is coronary artery disease Some cases case1 An old woman, 70 years old, suffered from intermittent breathlessness for 10 years, which was induced by meal, or exertion, and accompanied with palpitation, which released through rest. case2 A young male 48 years old, was admitted on continuous chest pain for 2 hours, which was accompanied with sweat. ECG demonstrated S-T segment elevating. case3 A young male 45 years old, suffered from sharp poststernal pain for 3 hours, with hypertension. The pain was unendurable without ECG changes. case4 A man with depressed ST segment ECG that was found in routing physical examination. CAD General definition Special definition Atherosclerosis Atherosclerosis means buildup of fatty plaques in the wall of a blood vessel, eventually causing obstruction. When atherosclerosis occurs in the coronary arteries, it is referred to as coronary artery disease. What Are the Results of Atherosclerosis? Trilogy: Narrow Thrombosis Block atherosclerosis damages the vessel surface the roughened surface of the plaque tends to signal to the clotting factors in the blood that they should become active and form a clot over the damaged area. Such a clot can form very rapidly and narrows the blood vessel much more than the plaque itself has This clotting of plaques probably is the final step in most hear