This chronic inflammation leads to
vascular remodeling and further endothelial injury (McCance&Huether,
2006). Hypertensive patients also have
increased concentrations of norepinephrine, a potent vasoconstrictor (Reeder,
2001). Another factor that increases
vascular tone is insulin resistance, which was described earlier. Another important contributor to endothelial
dysfunction is oxidative stress.
Metabolic syndrome, which is a combination of hyperinsulinemia, dyslipemia
and hypertension, is believed to cause an increase in the generation of
reactive oxygen species (ROS) (Grossman, 2008). ROS decreases the
bioavailability of NO and also increase the expression of endothelin (Seccia, 2005).
Electrocardiography is critical tool in the diagnosis of myocardial ischemia (Huether & McCance, 2006). Electrocardiography (EKG) should be the first test to rule out acute myocardial infarction (AMI). The electrocardiography (EKG) records the electrical forces produced by the heart. P waves are produced by depolarization of the atria. Whereas, depolarization of the ventricles, produce the QRS complex. T waves are produced by repolarization of the ventricles (AHA, 2009). When there is myocardial damage or ischemia, there are EKG changes due to the changes in electrical current flow. Changes in an EKG can provide information about the site of coronary artery occlusion, myocardial ischemia and of the presence of tissue necrosis. Ischemia causes conduction abnormalities that lead to changes in EKGs and possible dysrhythmias.
Diagnostics
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