DR Medhat MRCP

CORONARY ARTERY DISEASES
Definition :
- Group of cardiac diseases resulting from inadequate oxygenation of the
cardiac muscle due to either decrease blood supply and/or increase the
demands.
Epidemiology :
- 3% of population in UK.
Incidence :
- It`s responsible for 30% of male deaths in UK.
- It`s responsible for 22% of female deaths in UK.
Causes:
Decrease O2 supply by
coronaries
1- Coronary atherosclerosis. (the most common cause ,99%).
2- Coronary vasculitis. (SLE,PAN,Takayaso,……)
3- Coronary arterial wall thickning. (DM,Amyloidosis,Radiation therapy)
4- Coronary spasm.
5- Coronary embolism.
6- Aortic disection. (causing coronary disection)
7- Aortic stenosis.
Increase myocardial O2 demands
سؤال AS.HOCM) 1- Cardiomegaly e.g ( AR ,
2- Thyrotoxicosis.
Pathogenesis :
1) Atheromatous plaque formation (lipids + macrophages + sm. ms + fibrous
cap. cover) ( stable angina).
2) Erosion of the atheromatous plaque with Non-occlusive thrombus (
unstable angina).
3) Enlarging non-occlusive thrombus ( NSTMI).
4) large occlusive thrombus ( STMI).
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