Learning Objectives

• Define cardiac ischemia and state its causes
• Describe the consequences of cardiac ischemia on cardiomyocytes
• Explain angina pectoris, the most common symptom developed in ischemic heart disease (IHD)
• Compare and contrast chronic and acute coronary syndromes
• Describe the following IHD syndromes (describe symptoms, underlying causes, diagnosis, basis for therapy of each syndrome) chronic stable angina, unstable angina, myocardial infarction

Coronary Circulation & Oxygen Supply

• what features of coronary circulation are important in ischemia?
• what region of the heart is most susceptible to ischemia? why this area?
• what are the 2 major determinants of $O_2$ supply?
• what are the 4 major determinants of $O_2$ demand?
• why is it important for $O_2$ supply to be increased during increased cardiac activity?
• what is the most common cause for an imbalance between $O_2$ supply and demand?

Myocardial Ischemia

• what is myocardial ischemia?
• what is the main cause of ischemic heart disease (IHD)? why?
• most patients who die suddenly from IHD do so as a result of?
• Effect of Myocardial Ischemia
• what are the effects of severe prolonged ischemia?