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In the developed world, IHD is the leading cause of death in both sexes,
accounting for 30% of all deaths. Because of that high mortality rate, it becomes a really
important topic of not just public health, but also every part of human society including
economics, food industry, health industry etc.
Myocardial ischemia refers to inadequate supply of oxygen and metabolic
substrate to the heart. The term myocardial ischemia covers a heterogeneous group of
clinical syndromes, globally called IHD, which includes chronic stable angina at one end
of the spectrum and acute myocardial infarction at the other end.
Clinical approach is an important factor in diagnosing IHD. Diagnosis is
suspected if chest discomfort is typical and is worsening by exertion and relieved by rest.
Some specific test include ECG, stress test ECG, echocardiography, radionuclide
imaging and coronary angiography. Treatment depends on the severity of the angina pain,
mostly it is treated with drugs like antiplatelet drugs, beta blockers, long-acting nitrates
and calcium channel blockers. In severe cases, i.e. if angina persists despite drug therapy,
PCI and CABG will be indicated. In patients who are not PCI or CABG candidates, or are not responding well on the
normal drug treatment, are very good candidates for trimetazidine. Trimetazidine is a
drug which acts on mitochondrial level and shifts cardiac metabolism.