CORONARY OCLUSSION.

CORONARY OCLUSSION.

Coronary oclussion generally occurs within the heart vessels that give rise to a myocardial infarct due to a thrombus causing obstruction of the flow of blood; it may or may not be associated with atherosclerosis.

Phagocytic cells may bring about an oclussion, HOW? If an area is deprived with blood, the fibres of the muscles undergoes necrosis and there is an intrusion of phagocytic cells, with time fibroblasts and blood vessels grow from the surrounding tissue into the area, necrotic tissue is absorbed and collagen fibres laid down, after several weeks scar tissue will replace destroyed muscle fibre, fibroblast and blood vessels will have disappeared.

A fibrous scar is formed if the affected area is small, if the scar is extensive tissue becomes thin and which may stretch into a saccular aneurysm or a diffuse bulge. In aneurysm build up of calcium and formation of a thrombus may show.

Where lot of tissue is lost there is ineffective pumping machinery by the heart. The extend of heart failure greatly depends on the severity of damage to the muscles, in many instances shock leads to patient kicking the bucket and if survives will never be able to live a normal life.

Mild necrosis is controlled with introduction of oxygen, diuretics and digitalis to enable the victim almost live a near normal life.

SYMPTOMS OF CORONARY OCLUSSION.

  

• Chest pain and discomfort that lasts longer than that of angina effort.

• Pale.

• Sweating.

• Vomiting.

• Low and rapid pulse pressure.

• Leucocytosis.

• Slight increase in temperature.

• Shortness of breath.

OTHER COMPLICATIONS ASSOCIATED WITH CORONARY OCLUSSION.

Disorders of rhythm- this is due to differences in electrical potential between necrotic myocardium and healthy myocardium. This potential difference brings about ventricular fibrillation and consequent cardiac arrest.

Rhythmic disorders occurs even where there is very small infarcts, patients suffering from myocardial infarcts are nursed in a cardiac monitor for detection of rhythmic disorders that is treated with ventilation and defibrillation.

Emboli – it is a thrombus that is life threatening that may rise from endocardial thrombosis or from deep vein or arterial thrombosis.

A thrombus may be found in the systemic circulation or in pulmonary circulation.

Thrombosis occurs due to the following reasons ; hypotension, shock and from a slow clotting mechanism, lack of clotting factors, hemiplegia is cerebral emboli causing mental problems.

If emboli forms at the peripheral it blocks abdominal aorta or iliac vessels leading to gangrene

TREATMENT OF CORONARY OCLUSSION.

• Anticoagulants to dissolve a thrombus.

• Provide oxygen and rest.

• Morphine.

• Treat arrhythmia and hypotension.

• Surgical procedures to open blocked arteries may be performed.