2024 NSC2500 Wk3_1 Coronary Heart Disease pt1

Coronary Heart Disease Overview

  • Presenter: Dr. Anna Chruścik

  • Email: anna.chruscik@unisq.edu.au

  • Course: NSC2500 – Pharmacology and Pathophysiology in Health

Acknowledgment of Country

  • Acknowledges traditional owners of the land of University of Southern Queensland.

  • Recognizes cultural diversity of Aboriginal and Torres Strait Islander peoples, paying respect to Elders past, present, and future.

  • Celebrates contributions made by Indigenous Australians to society.

Copyright Information

  • Highlights Commonwealth of Australia Copyright Regulations 1969.

  • Emphasizes the prohibition of sharing or distributing course content.

Course Theme Map

  • Major Themes:

    • Introduction to Pharmacology

    • Various Disease Categories:

      • Infectious Diseases

      • Cardiovascular Diseases (CVD)

      • Respiratory Diseases

      • Musculoskeletal Diseases

      • Neurological Conditions

      • Endocrinology

      • Cancer and Other Neoplasms

      • Organ Failure

Lecture Objectives

  • Goals:

    • Understand coronary heart disease and its mechanisms.

    • Comprehend the formation and treatment of atherosclerosis.

    • Analyze stroke factors and pathophysiology.

    • Explore demographic differences in cardiovascular diseases.

  • Learning Outcomes:

    • Identify disruptions in homeostasis leading to disease.

    • Understand pathological processes in major disease burdens.

    • Describe actions of major drug groups in disease treatment.

    • Explain interrelatedness of disease burdens and drug therapies.

Important Topics Covered in Lectures

  • Lecture 01: Coronary heart disease in Australia, Ischaemia, Angina, CVD medications.

  • Lecture 02: Atherosclerosis progression and treatment, Heart failure management.

  • Lecture 03: Statistics on stroke, stroke prevention and treatment.

  • Lecture 04: Disease burden in rural areas, Indigenous communities, age-related disease burden.

Importance of Cardiovascular Pharmacology

  • Cardiovascular Diseases include:

    • Heart diseases affecting blood vessels, leading to heart attack or stroke.

    • Conditions include acute myocardial infarction (heart attack) and angina.

    • Types of stroke: Ischaemic (blockage) and Haemorrhagic (rupture).

Cardiovascular Disease Hospitalization and Death Statistics

  • Causes of Hospitalisation:

    • Coronary heart disease: 160,047 persons

    • Heart failure and cardiomyopathy: 73,292

    • Atrial fibrillation: 76,197

    • Stroke: 67,933

    • Total CVD excluding congenital heart disease: 600,217

  • Causes of Death:

    • Coronary heart disease: 17,331

    • All cardiovascular disease: 42,686

Cardiovascular Disease in Australia

  • Statistics:

    • 25% of deaths were due to CVD (2021).

    • 6.2% of adults with cardiovascular diseases (2017-2018).

    • Approx. 155 acute coronary events daily (2020).

    • CVD represented 5.1% of all hospitalisations (2020-2021).

Coronary Heart Disease (CHD) Overview

  • Approximately 3% of the Australian adult population has CHD (2020-2021).

  • CHD accounted for 10% of all Australian deaths, ~40% of cardiovascular deaths (2021).

  • Death rates from CHD have decreased due to improved treatments and reduced risk factors.

    • Deaths by population and socioeconomic status highlighted.

Myocardial Ischaemia

  • Condition of imbalance in myocardial oxygen supply and demand, leads to hypoxia.

  • Caused primarily by atherosclerosis; symptoms include angina.

  • Pharmacotherapy aims to restore balance between O2 demand and supply.

Diagnosis of Myocardial Ischaemia

  • ECG Role: Crucial for diagnosis, often normal without pain.

    • Requires testing during angina or exercise stress.

    • Signs of ischaemia: ST segment depression and T wave inversion.

    • ST elevation indicates transmural ischaemia.

Cycle of Ischaemic Events

  • Described as critical in understanding the pathology and treatment of conditions related to myocardial ischaemia.

Therapeutic Strategies in Myocardial Ischaemia

  • Symptomatic Intervention: Aim to reduce O2 demand, include:

    • Nitrates, Ca2+ channel blockers, β-blockers.

  • Prophylactic Intervention: Slows development of ischaemia with:

    • Lipid-lowering drugs (statins, resins, fibrates).

    • Anticoagulants (Warfarin, Heparin).

    • Fibrinolytic (Streptokinase, Urokinase).

    • Antiplatelet medications (Aspirin, Ticlopidine/Clopidogrel).