Cethombosis10 10

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Unformatted text preview: Heart Attack: the Fluid Heart Mechanics of How and Why Cutting Edge Technologies David N. Ku, MD, PhD Regents’ Prof and L.P. Huang Chair Prof Engineering Entrepreneurship Georgia Institute of Technology Dept of Surgery Emory School of Medicine Clinical Problem Clinical MI and CVA: MI • 90+% from insufficient blood flow Atherogenesis governed by hemodynamics Plaque grows over decades but not flow limiting Plaque cap rupture Acute thrombotic occlusion kills in kills minutes – Can we stop this? Cholesterol only? Cholesterol Framingham study Framingham AS Related to: • Cholesterol • Age • Males • High Blood Pressure • Smoking • Diabetes • Less Physical Activity Problem Problem French and Swiss have higher LDL, yet ½ the heart disease Australians have lower LDL, but higher Ht disease Diet does not help Drugs can lower cholesterol but little/no effect on CHD Clinical Presentation Clinical Focal Disease - only affects specific arteries • • • • • Coronary – Heart Attacks Coronary Carotids – Strokes Carotids Abdominal aorta and iliacs Arteries to the knee – Claudication Arteries Rarely affects arms Cholesterol, age, smoking, endothelial cells should be uniform in endothelial uniform distribution Atherosclerosis Atherosclerosis Strokes Strokes Carotid Bifurcation • Branch • Sinus • Resistance Thrombosis - Coagulation V...
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