PATHOPHYSIOLOGY OF ACUTE MYOCARDIAL INFARCTION

Predisposing Factors Precipitating Factors

>Gender: male >Lifestyle
>Age: 40-70 -High Fat and sugar intae
>Genetics - !moing
>"ace
# deposition of $lood cholesterol in the arteries %
deposition of fi$rous proteins& comple' car$ohydrates
products ( calcium
Lipid streas attracts Lo)-density protein
!mooth muscle cells enter intima ( attach
!* muscle produce collagen& )ith muscle cells
( lipids form PLA+,-!
!mall .lood /essels gro) into the
pla0ue

"upture of small $lood
/essels
.leeding1 hemorrhage
#si2e pla0ue
a
a 3hrough sear tissue formation
( fi$rosis
Further enlargement of
plague
3hrom$us formation 4arro)ing of artery lumen
"upture of
throm$us
# .lood flo)
resistance
5 .lood supply to the myocardial
-m$olism
5 67 supply to the heart tissue1 67 star/ation of heart tissue
8yocardial 9schemia
8yocardial cell death
Anaero$ic glycolysis !u$sternal1precordial pain radiating to
the $ac1shoulder :a) or do)n left arm
# Lactic acid production ;enricular atrophy
<H-!3 PA94 ( tightness or
A4G94A P-<36"9!
b
=yspnea
c
!timulation of sympathetic
4er/ous !ystem
d
d
c
b
Afterload # H" # 8yocardial 67
<onsumption
;asoconstriction1#
.P
>=yspnea on e'ertion
>;entricular hypertrophy
!u$sternal pressure
Acute 8yocardial 9nfraction
> 3achycardia& palpitations& ;omiting&
Hiccoughs& >eaness& 4ausea& Fatigue in
arms ( legs
<ircumfle' $ranch
of left coronary
artery
Anterior descending $ranch of Left
coronary artery
"ight coronary artery
Lateral )all
infraction
Anterior )all
infraction
Posterior1 inferior )all infraction
5 <ardiac 6utput
9nade0uate tissue
perfusion
e
hypo/olemic "enal Hypo'ia 6liguria
5 Plasma Pressure
!e/ere pulmonary
congestion
Acute pulmonary
edema
f
e
f
8yocardial necrosis1 destruction of
myocardial tissue
9nflammatory process
> lo)-grade fe/er accompanied $y
leuocytosis& ele/ated
sedimentation rate& L=H ( A!3
5 stoe /olume ( # residual
/olume
9nade0uate $lood to meet
meta$olic needs of the $ody
<HF
?left1 right sided@
Ano'ia
=-A3H
PATHOPHYSIOLOGY of BRONCHIAL ASTHMA
.ronchoconstriction
Production of 9g- anti$odies
Precipitating Factors:
- allergies
- irritants
- smoing
- pollution
!timulation of .-lymphocytes
Predisposing Factors:
- age
- gender ?female@
- history of allergies
-tiology:
- unno)n

=ifferentiation into plasma cells
.ronchospasm 9ncrease mucus
production
!)elling of mem$ranes
lining the air)ays
9nflammatory "esponse
"elease of chemical mediators
Attach to mast cells and
$asophils in $ronchial )alls
9ncrease <hemical 8ediators
=ecrease cyclic adenosine monophosphate ?<A8P@
!timulation of Adrenergic "eceptors
<irculatory 6$struction
A
9ncrease )orload of $reathing
?prolonged e'piration@
A
<ough >hee2ing =yspnea Hyper/entilition
,ne/en Lung aeration 3achycardia La$ored $reathing1 use of
accessory muscles
Fatigue
9ncomplete -mptying of
Al/eoli
<67 "etention
Hypo/entilation
<hest 3ightness
Hypo'emia
3rapping of Air
Hypercapnia "espiratory
Acidosis
9ncrease <hest
=iameter
Hyperinflation of
Al/eoli
"espiratory Failure
=ecrease L6< <yanosis
B
9ncrease "espiratory
)or demand
<ompensatory
8echanism Failed
=-A3H
B
<ellular 9schemia
=ecrease 3issue Perfusion
Hypo'emia
9mpaired gas e'change
Hypo'ia
3issue 4ecrosis
;ital 6rgans Failure1 =eath