教程四川大学病理学课件11.pptxVIP

Ischemic heart disease IHD refers to a group of closely related syndromes by an imbalance between the myocardial oxygen demand and the blood supply. The most common cause is narrowing of the lumen of the coronary arteries by atherosclerosis (Coronary heart disease );Syndromes: 1.angina pectoris 2.acute myocardial infarction 3.sudden cardiac death 4.chronic IHD ;Angina Pectoris Definition Intermittent chest pain caused by transient,reversible myocardial ischemia Type Stable (typical) Variant (prinzmetal) Unstable (crescendo) ;Myocardial Infarction Definition An area of myocardial necrosis caused by local ischemia. Location Determined by the site of the vascular occlusion and by the anatomy of the coronary circulation. Type Transmural infarct subendocardial infarct;pathogenesis;Pale,firm,well-defined region;Transmural Infarcts ;Myocardial Infarction;about 1 day;1-3days;Granulation tissue(7-10days);Weeks--months scar (Masson’s stain);COMPLICATIONSpapillary muscle dysfunctionRuptureVentricular aneurysmsAcute pericarditisMural thrombi;Rupture;hemopericardium;Ventricular aneurysm;Ventricular aneurysm with Mural thrombus;Clinical features;Chronic IHD The development of progressive heart failure as a consequence of long-term ischemic myocardial injury (ischemic cardiomyopathy) The heart is enlarged,dilation of all cardiac chamber,foci of transmural scar,hypertrophy of the remaining myocardium;Sudden Cardiac Death Sudden death caused by heart disease, the most common cause is IHD. Lethal ventricular fibrillation caused by acute plaque rupture,coronary thrombosis and vasospasm is the most common cause;Summary of IHD;Rheumatic Fever and Rheumatic Heart Disease ;Rheumatic Fever Definition RF is an acute, immunologically mediated multisystem inflammatory disease that follows an episode of group A streptococcal pharyngitis after an interval of a few weeks.;pathogenesis; pathologic changes Edema of connective tissue Fibrinoid necrosis of collagen