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Definition:
irreversible destruction of heart muscle (myocardial necrosis) caused by insufficient oxygen supply, usually by thrombotic occlusion of the supply section of the coronary vessels.
Cause:
# 95% CHD
# breaking an ulcerated atherosclerotic plaque and thrombus formation of a vessel closure
process of atherosclerosis

	What happened?	What occurs?
1.	fats are deposited on arterial inner wall plaques arise from
second	fat deposits are covered by a connective tissue layer harden	fat deposits are
third thicken form	new muscle cells within the sediments, the vessel walls
4th	caused cracks in hardened deposits	particles dissolve and form a blood clot
5th	Blood clots seal the already narrowed artery, or plaques on break and bleeding occurs	blood supply in the following modified tissue is closed

Drug treatment

• acute phase: analgesics / opioids
• continuous therapy:
  
• CSE inhibitor / lipid lowering agents [CSE = cholesterol synthesis inhibitors]
• antiplatelet anticoagulants

HEART ATTACK DRUG

drug	effect	acute phase	term therapy
morphine analgesia		5-20 mg diluted with NaCl	-
diazepam	sedation	5-10 mg, sc / iv	-
nitrates	dilation of the vessels	Spray Perfusor	tablets
beta-receptor blockers	preventing tachycardia	oral; iv	tablets
heparin (high dose)	preventing thrombus formation, anticoagulation	5000 IU iv bolus; Perfusor 1000 IU / h	-
heparin (low dose)	- "-	1-2 times daily sc	- iv
ASS	platelet aggregation inhibitors	Aspisol;	oral tablet 1 time daily
OR (based on long-term treatment)
warfarin / Falithrom	Vitamin K - antagonist	-	tablet
ADP receptor antagonist	platelet aggregation inhibitors	oral	tablet, about 1 year
thrombolytics	resolution of the thrombus	iv; syringe pump for 1 h	-
ACE inhibitors	-	-	tablets
lipid lowering	lowering cholesterol	-	tablets