Ischemic heart disease coronary blood flow

Ischemic heart disease (IHD) is also called coronary heart disease (CHD) or coronary artery disease. The term ischemic refers to a decreased supply of oxygenated blood, in this case to the heart muscle. Ischemic heart disease is caused by the narrowing of one or more of the major coronary arteries that supply blood to the heart, most commonly by atherosclerotic plaques. Atherosclerotic plaques may impede coronary blood flow to the extent that cardiac tissue distal to the site of the coronary artery narrowing is deprived of sufficient oxygen in the face of increased oxygen demand. Ischemic heart disease results from... 

Isoflurane (Forane) is a structural isomer of enflurane and produces similar pharmacological properties some analgesia, some neuromuscular blockade, and depressed respiration. In contrast, however, isoflurane is considered a particularly safe anesthetic in patients with ischemic heart disease, since cardiac output is maintained, the coronary arteries are dilated, and the myocardium does not appear to be sensitized to the effects of catecholamines. Also, blood pressure falls as a result of vasodilation, which preserves tissue blood flow. Isoflurane causes transient and mUd tachycardia by direct sympathetic stimulation this is particularly important in the management of patients with myocardial ischemia. 

Congestive heart failure (CHF) due to ischemic heart disease is a very common clinical situation, particularly in the elderly group of patients. It is however unclear how the myocardial cells behave metabolically when decreased blood flow in the myocardial tissue develops as a result of stenosis, or obstruction of coronary vessels, eventually leading to myocardial infarction. Myocardial metabolism was studied by microcalorimetry and oxygen consumption measurement in tissue from rats with CHF after a myocardial infarction, induced by ligation of the left coronary artery [89]. 

Abciximab is indicated in patients with heart disease caused by poor blood flow in the arteries of the heart (ischemic cardiac complications). It is also used in patients with unstable angina not responding to conventional treatment and for precutaneous coronary intervention. It can reduce the incidence of abrupt closure and restenosis... 

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