DR Medhat MRCP

Risk factors of CAD:
High risk factors:
Non-modifiable
Modifiable
1) +ve family history. 1) DM ( risk by 2-3 folds)
- male,1 st degree,less than 55y.
- female,1 st degree,less than 65y.
2) Old age. 2) HTN( risk by 2-3 folds)
3) Male sex. 3) Dyslipidemia.
4) Syndrome –x
(obesity,HTN,dyslipidemia,insulin
resistant DM).
5) Life style
- Smoking, Stress
- Sedentary life
- Alcohol intake
Weaker risk factors:
1) Oral contraceptives.
2) Premature menopause.
3) Bilateral oophorectomy.
Clinical syndromes of CAD :
- i.e. ischemic chest pain.
- Types :
1) Stable(chronic) angina (= angina of effort).
2) Nocturnal angina (during sleep d.to vivid dreams). Nitrates
3) Variant (prinzmetal) angina (d.to coronary spasm) e.g cocaine abuse→ TTT : CCB
4) Decubitus angina (pain on lying down usually in HF d.to strain on the heart resulting
from ↑ intravascular volume).
5) Unstable angina.
Angina pectoris
- Cocaine abuse is the commonest cause of MI
(coronary spasm) in yoyng age by ++ of α-
adrenergic receptors ,↑ endothelin & ↓ NO
Myocardial infarction (M.I.)
1) Non STMI. (2) STMI.
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