Introduction;
- A sedentary individual may develop an atherosclerotic plague that occlude up to 50% of the lumen of coronary arteries and remain completely a symptomatic.
- If the individual becomes active they may experience symptoms, called and angina, which is directly associated with reduced blood flow to part of the heart.
- When the coronary arteries are occluded to the point that the blood flow to portion distal to the blockage is come promised the individual is said to have myocardial ischemia. The term ischemic ❤️ diseases( IHD )is often used interchangeably with the term (CAD)
- Severe and prolonged myocardial ischemia can precipitate a myocardial infarction auc(MI), during which necrosis of heart issues occurs due to the lack of oxygen.
Epidemiology;
It has been estimated that by the year 2020 IHD will be the leading cause of death and disability worldwide.
- Among individuals who have had an MI, the sudden cardiac death rate is 4to6 times greater than in the general population.
- Ischemia and MI can lead to heart failure and rhythmic abnormalities, which result in death
- Hindi videos over the age of 35 80% of a sudden cardiac death is related to IHD.
- Before the age of 35 , 80% of these deaths result from IHD and almost 50% result from hypertrophic cardiomyopathy
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Etiology;
- Acute coronary syndromes.
- Term used to describe the condition of a person who present with either and acute MI or unstable angina.
- Over half (55% to 60% )of sudden cardiac death cases are the result of plaque rupture, while ( 30% 235 ) are due to plaque erosion.
- The type of acute coronary syndrome depends on the duration of the occlusion.
- Traditional rest factor for AS supply to IHD.
Pathophysiology ;
- Any of the following for mechanism can initiate an MI or angina in an individual with IHD.
- Sudden blockage of a coronary artery
- Hemorrhage into an atherosclerotic plaque
- Increase in myocardial oxygen demand
Arterial spasm.
- One factor in common is an atherosclerotic plaque that is contributing to the occlution of the lumen of the artery.
Clinical manifestation;
- The majority of men and women who die from heart diseases have reported no previous symptom.
- In fact, less than 20% of coronary attacks are preceded by angina.
- Angina occurs as a result of an oxygen supply that does not match oxygen demand of the tissues.
- Stable angina is the subterminal pain experienced with the worked load on the heart is increased due to physical or emotional stress.
- Unstable angina is angina pain that is not associated with the increase in workload and may even occur in a person at rest.
- Nagina is a typically referred to as a dull ache in the substernal area radiating to the arm and neck it should be noted that individual experience angina pain differently.
- Other symptoms of angina may include in digestion ,nausea ,vomiting ,sweating, shortness of breath weakness and fatigue.
Nutrition intervention;
- During the immediate post - MI period oral intake may be decrease due to pain, anxiety, fatigue and shortness of breath.
- Many protocols limit initial oral intake to clear liquid without caffeine in order to decrease risk of vomiting or aspiration.
- Oral diet usually progress from liquid to soft, easily chewed foods with smaller, more frequent meals.
- As the patient stabilizes, the goal of Nutrition therapy will be individualized according to the patient's risk factors and should follow the therapeutic lifestyle change dietary recommendations.
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