1. coronary artery disease (CAD)

-ischemic heart disease

-coronary heart disease

2. cerebrovascular disease

3. peripheral artery disease

1. CV disease
2. CHF
3. HTN
4. valvular disease
5. cardiomyopathy
6. infections
7. auto-immune processes
8. congenital defects
9. CP toxicity of drugs
10. arrhythmias

• coronary blood flow
  • DBP
  • vasomotor tone
  • resistance to flow
  • LVEDP
• 02 carrying capacity of blood
• coronary artery anatomy
• diastolic filling time
• net driving pressure

Myocardial 02 demand is closely related to myocardial 02 consumption (MV02)

What are the determinants of myocardial 02 demand?

HR

SBP

myocardial wall tenison

contractility

LV characteristics (volume, wall thickness, diameter)

• relative changes in MV02 can be estimated by using an indirect index such as the rate pressure product
• RPP: HRXSBP

• myocardium extracts ___ of 02 from coronary bf

• heart's energy needs are met by AEROBIC METABOLISM
• heart receives blood from external surface (epicardial)

condition in which fatty material and plaque are deposited in the wall of an artery, resulting in narrowing of the arterial lumen eventual impairment of BF

• endothelial injury
• fatty streaks
• foam cells
• endothelial separation
• platelet aggregation
• decreased compliance
• encrustation/plaque

Major risk factors

• HTN
• smoking
• HLP
• sedentary lifestyle

Minor

• age
• gender
• hereditary
• obesity
• stress
• diabetes

HTN: >140/90

LDL: >130mg/dL

HDL: <40mg/dL

TC: >200mg/dL

TC/HDL: >4.5

triglycerides >150mg/dL

BMI>30

waist circumference>40min males, >35 in in females

waist hip ration: >95 males, >86 women

• death within one hour of symptoms
• may or may not have diagnosed heart disease
• due to life threatening arrhythmias

• insufficent 02 supply to meet metabolic demands of myocardium
• occurs with:luminal narrowing, exercise or emotional stress

• angina pectoris (stable vs. unstable)
• characteristic ECG changes: ST depression, T wave inversion
• arrhythmias
• hypotension