Lesson Objectives:

• Explain the mechanisms of ischemic heart disease.

• Differentiate between types of heart failure.

• Understand arrhythmogenesis and valvular dysfunction.

Key Concepts

🔹 Ischemic Heart Disease (IHD):

• Caused by atherosclerotic plaque formation, leading to reduced coronary blood supply.

• Can present as stable angina, unstable angina, or myocardial infarction (STEMI/NSTEMI).

• Pathophysiology: Plaque rupture → thrombosis → ischemia → myocardial injury.

🔹 Heart Failure (HF):

• HFrEF (Heart Failure with Reduced Ejection Fraction): EF <40%, caused by ischemia, dilated cardiomyopathy.

• HFpEF (Heart Failure with Preserved Ejection Fraction): EF >50%, caused by hypertension, LVH, aging.

• Symptoms: Dyspnea, orthopnea, peripheral edema, elevated BNP levels.

🔹 Arrhythmias:

• Atrial Fibrillation (AF): Most common sustained arrhythmia; risks include stroke, CHF exacerbation.

• Ventricular Tachycardia (VT): Life-threatening; often seen in post-MI patients.

• Long QT Syndrome: Risk of torsades de pointes, triggered by medications (e.g., antiarrhythmics, antipsychotics).

🔹 Valvular Heart Disease:

• Aortic Stenosis: Systolic murmur, risk of syncope, angina, dyspnea.

• Mitral Regurgitation: Holosystolic murmur, leads to LV volume overload and HF.