SlideShare a Scribd company logo
1 of 45
Case presentation on
coronary artery disease
Patient information
Mrs . Kottu sulochannamma
Age :75 years
Gender: female
IP no:1214
Department: cardiology
Date of admission :25/10/2022
History of present illness : shoulder joint pain , indigestion,mild headache,
Heavyness of chest
Past medical history: history of shortness breath ,chestpain, diabetes
mellitus, gastric acidity, hypertension
Social history
• Diet: mixed
• Sleep:disturbed
• Appetite:Normal
• Bowel and Bladder: Normal
Provisional diagnosis
Coronary artery disease .
Physical examination
• Temparature: Normal
• Respiratory Rate: 25cpm
• PluseRate:79bpm
• Blood pressure:160/90 mm of Hg
Diagnosis Test
1. History collection
2. Complete blood count
• Hb :. 10g/dl.
• ECG
• Echo
• CBP
• Angiogram- abnormal
Radiographic diagnosis
• Coronary angiogram report :
• Impression : CAD Mild (MCA+critical triple vessel disease)
Conformatory diagnosis:
Based on the information the final diagnosis of the
patient was found to be coronary artery disease.
Anatomy of the heart
• A hallow muscular organ located in
the thorax between two lungs.
• It has four chambers
• It has four valves
• Two atriums and Two ventricle
• Right side it receives blood from
the body and sends it to the
lungs(pulmonary)
• Left side receives blood from the
lungs and it sends it to the body
(systemic).
Heart
• the heart is surrounded
by the three membrane
called pericardium,
Myocardium and
epicardium
Pericardium
• The pericardium is a fibroserous
sac that encloses the heart and
roots of the great blood vessels.
The pericardium
• The pericardium lies within the
middle mediastinum.
• It’s function is to restrict
excessive movement of the
heart as a whole and to serve as
a lubricated container in which
the different parts of the heart
can contract .
Heart wall
• Endocardium
1. Deepest layer of the heart
2. Smooth lining to reduce friction
of blood flow.
Myocardium
1. Myocardium is the middle layer
of the heart .
2. It is the thickest layer which lies
between the single cell
endocardium layer.
The heart chambers
1. Four chambers
• Two atria ( right and left ).
• Two ventricle (right and left)
The heart chambers
Atria
Features
1. Atria are Small thin walled
Chambers .
Functions
1. Atria are the receiving
chambers for blood returning
to the heart from the
circulation.
• Atria push the blood into the
adjacent ventricles.
The heart chambers
Ventricle
Features
1. Make up most of the mass of the
heart.
2. The walls of the left ventricular 3x
thicker than those of the right one.
Functions
1. Discharging chamber of the heart.
2. Transfer blood to pulmonary
trunk(right ventricular) arota( left
ventricular).
• Right atrium receives
deoxygenated blood from
inferior vena cava below and
from the superior vena cava.
Right atrium
Right ventricle
1. Right ventricle receives blood
from the right atrium through
the tricuspid valve.
Left atrium
1. Left atrium receives
oxygenated blood from four
pulmonary veins which drains
posteriorly.
2. The mitral (bicuspid) valve
gaurds the passage of blood
from the left atrium to the left
ventricles.
Left ventricle
1. The wall of the left ventricle is
thicker than the right ventricle
but the structure is similar.
2. The thicker wall is necessary to
pump oxygenated blood at
high pressure through the
systemic circulation.
Heart valves
1. Heart valves ensure that
unidirectional blood flow
through the heart.
2. It composed of an
endocardium with a
connective tissue core
3. There are two major types of
valves
• Atrioventricular valves.
• Semilunar valves.
Atrioventricular Valves
• Atrioventricular valves lies ethe
atria and the ventricle.
• -R- AV – valve = tricuspid valve
• -L-AV – valve = bicuspid valve or
mitral valve.
• atrioventricular valves prevent
back flow of blood into the atria
when ventricles contract.
Pulmonary valve
Arterial supply of the heart
• Arterial supply of the heart is
provided by the right and left
coronary artery, which arise
from the ascending arota
immediately above the arotic
valve .
Right coronary arteries
Branches
• Right marginal arteries (acute
Marginal arteries)
• Posterior interventricular artery (lies
in the post Iv Sulcus)
• Sinoatrial nodal artery
• Atrioventricular nodal artery.
Left coronary
artery
Branches
• Left anterior descending (LAD) or
anterior interventricular artery (lies in
anterior IV sulcus)
• Left marginal artery (Obtuse marginal
artery)
• Left circumflex artery.
Venous drainage of the heart
1. Most blood from the heart
wall drains into the right
atrium through the coronary
sinus, which lies in the
posterior part of the
atrioventricular groove .
2. It is a continuation of the great
cardiac vein.
3. It open into the right atrium to
the left of the inferior vena
cava.
Nervous supply of the heart
1. The heart is innervated by sympathetic and parasympathetic fibers
of the autonomic nervous system via the cardiac plexuses situated
below the arch of the arota .
Coronary artery disease
• Definition: coronary artery disease is defined as narrowing or
blockage of the coronary arteries usually caused by atherosclerosis .
• etiology:
1. Smoking
2. High blood pressure
3. High cholesterol
4. Insulin resistance
5. Sedentary lifestyle.
Pathophysiology
B
Clinical manifestations
1. Ischemia
2. Low cardiac output
3. Hypertension
4. Diaphoresis ( excessive sweating)
5. Bradycardia
6. ECG changes - ST segment and T wave changes
7. pulmonary edema.
8. Chest Heavyness
Risk factors for coronary artery disease
• High blood pressure
• Diabetes
• Obesity
• Unhealthy diet
Diagnostic Test
1. Physical examination
2. History collection
3. Stress Test
• Chest X – ray
• Electrocardiogram
• Echocardiogram
• Cardiac catheterization( angiogram)
Complications
1. Chestpain
2. Heart attack
3. Heart failure
4. Abnormal heart rhythm (arrhythmias)
Standard Management
Pharmacological therapy
1. Anti anginal agents
2. Nitrates
3. Beta adrenergic receptor
blockers
4. Calicium channel blockers
5. ACE inhibitors
6. Statins
7. Diuretics
8. Imiprimine for analgesia.
• Surgeries
1. Coronary angioplasty
2. Heart transplantation
3. Stent
Current drug chart
S.no Brand name Generic name Dose Route of
administratio
n
Frequency Category Indications
1 Pantocid Pantaprazole 40mg P/o OD Proton pump
inhibitors
Gastric acidity
2 Lopressor Metoprolol 50mg P/o OD Beta blockers Treatment for
angina
3 Nitro -bid Nitrosat 2.6mg P/o BD Vasodilator Treatment for
angina
4 Duolin Ipratropium
Salbutamol
0.5mg
2.5mg
P/N TID Anticholinergi
c
Beta 2
receptor
blockers
Treatment for
shortness of
breath
5 Budecort Budesonide 12.5mcg P/N TID Corticosteroid Treatment for
Shortness of
breath
6 Enoxaparin Heparin 3000 IU IV BD Anticoagulant Treatment to
the blood colt
In heart
Drug interactions
• Heparin and aspirin
which has risk of increasing bleeding.
• Metoprolol and quinidine
increased removal of metoprolol from the body.
Patient counseling
• About disease.
• Coronary artery disease also called coronary artery disease.
1. The arteries,get plaque on their inner wall, which can then become straved of
oxygen .
2. The plaque could rupture, leading to a heart attack (or) sudden cardiac death.
3. It’s mainly cause due to
• Hypertention
• DM
• Obesity
• Smoking
• High cholesterol
Lifestyle modification
1. Stop smoking
2. Eat healthy diet
3. Get exercise
4. Reduce (or) avoid excess weight.
5. Avoid alcohol consumption.
6. Control blood pressure
REFERENCE
• WWW . Myoclinic .org
• WWW. coronary artery disease Wikipedia .org.
• WWW. Medscape .com
• WWW research gate .com
THE END

More Related Content

Similar to case presentation on coronary artery disease.

Human cardiovascular system
Human cardiovascular systemHuman cardiovascular system
Human cardiovascular systemSigfrid Mustapha
 
FUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptx
FUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptxFUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptx
FUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptxSujoy Tontubay
 
A presentation on structural and functional properties of heart
A presentation on structural and functional properties of heartA presentation on structural and functional properties of heart
A presentation on structural and functional properties of heartMahade Hashan
 
Seminar cvs physiology
Seminar cvs physiologySeminar cvs physiology
Seminar cvs physiologyShampy Sharma
 
myocardial infarction pcu_n.pptx
myocardial infarction pcu_n.pptxmyocardial infarction pcu_n.pptx
myocardial infarction pcu_n.pptxKanpfernando
 
Cardiac Emergencies
Cardiac EmergenciesCardiac Emergencies
Cardiac EmergenciesAsokan R
 
The Cardiovascular system
The Cardiovascular systemThe Cardiovascular system
The Cardiovascular systemminimedschool
 
Heart anatomy written copy
Heart anatomy written  copyHeart anatomy written  copy
Heart anatomy written copypuneet mahajan
 
ppt of anatomy of heart & ML imp
ppt of anatomy of heart & ML impppt of anatomy of heart & ML imp
ppt of anatomy of heart & ML impGopal Hargi
 
Case presentation on angina pectoris
Case presentation on angina pectorisCase presentation on angina pectoris
Case presentation on angina pectorisUmme Habeeba A Pathan
 
Circulatory disorder heart attack
Circulatory disorder heart attackCirculatory disorder heart attack
Circulatory disorder heart attackMahboob ali shaikh
 
4-lecture cardiovascular Pharmacy 2024.pptx
4-lecture cardiovascular Pharmacy 2024.pptx4-lecture cardiovascular Pharmacy 2024.pptx
4-lecture cardiovascular Pharmacy 2024.pptxKareemSaeed17
 
Cardiovascular system
Cardiovascular systemCardiovascular system
Cardiovascular systemNisha Mhaske
 
Blood circulatory system
Blood circulatory systemBlood circulatory system
Blood circulatory systemblue bird
 

Similar to case presentation on coronary artery disease. (20)

Human cardiovascular system
Human cardiovascular systemHuman cardiovascular system
Human cardiovascular system
 
FUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptx
FUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptxFUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptx
FUNDAMENTALS OF CARDIOVASCULAR SYSTEM, BHM 2ND SEM.pptx
 
A presentation on structural and functional properties of heart
A presentation on structural and functional properties of heartA presentation on structural and functional properties of heart
A presentation on structural and functional properties of heart
 
Seminar cvs physiology
Seminar cvs physiologySeminar cvs physiology
Seminar cvs physiology
 
myocardial infarction pcu_n.pptx
myocardial infarction pcu_n.pptxmyocardial infarction pcu_n.pptx
myocardial infarction pcu_n.pptx
 
Cardiac Emergencies
Cardiac EmergenciesCardiac Emergencies
Cardiac Emergencies
 
The Cardiovascular system
The Cardiovascular systemThe Cardiovascular system
The Cardiovascular system
 
Cardiovascular system
Cardiovascular systemCardiovascular system
Cardiovascular system
 
Heart anatomy written copy
Heart anatomy written  copyHeart anatomy written  copy
Heart anatomy written copy
 
Cardiovascular system
Cardiovascular systemCardiovascular system
Cardiovascular system
 
ppt of anatomy of heart & ML imp
ppt of anatomy of heart & ML impppt of anatomy of heart & ML imp
ppt of anatomy of heart & ML imp
 
Case presentation on angina pectoris
Case presentation on angina pectorisCase presentation on angina pectoris
Case presentation on angina pectoris
 
Cardiovascular
CardiovascularCardiovascular
Cardiovascular
 
Circulatory disorder heart attack
Circulatory disorder heart attackCirculatory disorder heart attack
Circulatory disorder heart attack
 
Cardiovasular system
Cardiovasular systemCardiovasular system
Cardiovasular system
 
4-lecture cardiovascular Pharmacy 2024.pptx
4-lecture cardiovascular Pharmacy 2024.pptx4-lecture cardiovascular Pharmacy 2024.pptx
4-lecture cardiovascular Pharmacy 2024.pptx
 
Functional Foods and Nutraceuticals in CVD
Functional Foods and Nutraceuticals in CVDFunctional Foods and Nutraceuticals in CVD
Functional Foods and Nutraceuticals in CVD
 
Cardiology 101 back to the basics
Cardiology 101 back to the basicsCardiology 101 back to the basics
Cardiology 101 back to the basics
 
Cardiovascular system
Cardiovascular systemCardiovascular system
Cardiovascular system
 
Blood circulatory system
Blood circulatory systemBlood circulatory system
Blood circulatory system
 

Recently uploaded

Types of Journalistic Writing Grade 8.pptx
Types of Journalistic Writing Grade 8.pptxTypes of Journalistic Writing Grade 8.pptx
Types of Journalistic Writing Grade 8.pptxEyham Joco
 
Alper Gobel In Media Res Media Component
Alper Gobel In Media Res Media ComponentAlper Gobel In Media Res Media Component
Alper Gobel In Media Res Media ComponentInMediaRes1
 
KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...
KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...
KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...M56BOOKSTORE PRODUCT/SERVICE
 
History Class XII Ch. 3 Kinship, Caste and Class (1).pptx
History Class XII Ch. 3 Kinship, Caste and Class (1).pptxHistory Class XII Ch. 3 Kinship, Caste and Class (1).pptx
History Class XII Ch. 3 Kinship, Caste and Class (1).pptxsocialsciencegdgrohi
 
Hierarchy of management that covers different levels of management
Hierarchy of management that covers different levels of managementHierarchy of management that covers different levels of management
Hierarchy of management that covers different levels of managementmkooblal
 
Proudly South Africa powerpoint Thorisha.pptx
Proudly South Africa powerpoint Thorisha.pptxProudly South Africa powerpoint Thorisha.pptx
Proudly South Africa powerpoint Thorisha.pptxthorishapillay1
 
POINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptx
POINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptxPOINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptx
POINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptxSayali Powar
 
Roles & Responsibilities in Pharmacovigilance
Roles & Responsibilities in PharmacovigilanceRoles & Responsibilities in Pharmacovigilance
Roles & Responsibilities in PharmacovigilanceSamikshaHamane
 
Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdf
Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdfEnzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdf
Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdfSumit Tiwari
 
Introduction to ArtificiaI Intelligence in Higher Education
Introduction to ArtificiaI Intelligence in Higher EducationIntroduction to ArtificiaI Intelligence in Higher Education
Introduction to ArtificiaI Intelligence in Higher Educationpboyjonauth
 
Historical philosophical, theoretical, and legal foundations of special and i...
Historical philosophical, theoretical, and legal foundations of special and i...Historical philosophical, theoretical, and legal foundations of special and i...
Historical philosophical, theoretical, and legal foundations of special and i...jaredbarbolino94
 
internship ppt on smartinternz platform as salesforce developer
internship ppt on smartinternz platform as salesforce developerinternship ppt on smartinternz platform as salesforce developer
internship ppt on smartinternz platform as salesforce developerunnathinaik
 
Computed Fields and api Depends in the Odoo 17
Computed Fields and api Depends in the Odoo 17Computed Fields and api Depends in the Odoo 17
Computed Fields and api Depends in the Odoo 17Celine George
 
Introduction to AI in Higher Education_draft.pptx
Introduction to AI in Higher Education_draft.pptxIntroduction to AI in Higher Education_draft.pptx
Introduction to AI in Higher Education_draft.pptxpboyjonauth
 
Meghan Sutherland In Media Res Media Component
Meghan Sutherland In Media Res Media ComponentMeghan Sutherland In Media Res Media Component
Meghan Sutherland In Media Res Media ComponentInMediaRes1
 
CELL CYCLE Division Science 8 quarter IV.pptx
CELL CYCLE Division Science 8 quarter IV.pptxCELL CYCLE Division Science 8 quarter IV.pptx
CELL CYCLE Division Science 8 quarter IV.pptxJiesonDelaCerna
 
How to Make a Pirate ship Primary Education.pptx
How to Make a Pirate ship Primary Education.pptxHow to Make a Pirate ship Primary Education.pptx
How to Make a Pirate ship Primary Education.pptxmanuelaromero2013
 

Recently uploaded (20)

Types of Journalistic Writing Grade 8.pptx
Types of Journalistic Writing Grade 8.pptxTypes of Journalistic Writing Grade 8.pptx
Types of Journalistic Writing Grade 8.pptx
 
Alper Gobel In Media Res Media Component
Alper Gobel In Media Res Media ComponentAlper Gobel In Media Res Media Component
Alper Gobel In Media Res Media Component
 
KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...
KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...
KSHARA STURA .pptx---KSHARA KARMA THERAPY (CAUSTIC THERAPY)————IMP.OF KSHARA ...
 
Model Call Girl in Tilak Nagar Delhi reach out to us at 🔝9953056974🔝
Model Call Girl in Tilak Nagar Delhi reach out to us at 🔝9953056974🔝Model Call Girl in Tilak Nagar Delhi reach out to us at 🔝9953056974🔝
Model Call Girl in Tilak Nagar Delhi reach out to us at 🔝9953056974🔝
 
History Class XII Ch. 3 Kinship, Caste and Class (1).pptx
History Class XII Ch. 3 Kinship, Caste and Class (1).pptxHistory Class XII Ch. 3 Kinship, Caste and Class (1).pptx
History Class XII Ch. 3 Kinship, Caste and Class (1).pptx
 
Hierarchy of management that covers different levels of management
Hierarchy of management that covers different levels of managementHierarchy of management that covers different levels of management
Hierarchy of management that covers different levels of management
 
Proudly South Africa powerpoint Thorisha.pptx
Proudly South Africa powerpoint Thorisha.pptxProudly South Africa powerpoint Thorisha.pptx
Proudly South Africa powerpoint Thorisha.pptx
 
POINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptx
POINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptxPOINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptx
POINT- BIOCHEMISTRY SEM 2 ENZYMES UNIT 5.pptx
 
Model Call Girl in Bikash Puri Delhi reach out to us at 🔝9953056974🔝
Model Call Girl in Bikash Puri  Delhi reach out to us at 🔝9953056974🔝Model Call Girl in Bikash Puri  Delhi reach out to us at 🔝9953056974🔝
Model Call Girl in Bikash Puri Delhi reach out to us at 🔝9953056974🔝
 
Roles & Responsibilities in Pharmacovigilance
Roles & Responsibilities in PharmacovigilanceRoles & Responsibilities in Pharmacovigilance
Roles & Responsibilities in Pharmacovigilance
 
Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdf
Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdfEnzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdf
Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdf
 
Introduction to ArtificiaI Intelligence in Higher Education
Introduction to ArtificiaI Intelligence in Higher EducationIntroduction to ArtificiaI Intelligence in Higher Education
Introduction to ArtificiaI Intelligence in Higher Education
 
Historical philosophical, theoretical, and legal foundations of special and i...
Historical philosophical, theoretical, and legal foundations of special and i...Historical philosophical, theoretical, and legal foundations of special and i...
Historical philosophical, theoretical, and legal foundations of special and i...
 
internship ppt on smartinternz platform as salesforce developer
internship ppt on smartinternz platform as salesforce developerinternship ppt on smartinternz platform as salesforce developer
internship ppt on smartinternz platform as salesforce developer
 
Computed Fields and api Depends in the Odoo 17
Computed Fields and api Depends in the Odoo 17Computed Fields and api Depends in the Odoo 17
Computed Fields and api Depends in the Odoo 17
 
Introduction to AI in Higher Education_draft.pptx
Introduction to AI in Higher Education_draft.pptxIntroduction to AI in Higher Education_draft.pptx
Introduction to AI in Higher Education_draft.pptx
 
Meghan Sutherland In Media Res Media Component
Meghan Sutherland In Media Res Media ComponentMeghan Sutherland In Media Res Media Component
Meghan Sutherland In Media Res Media Component
 
OS-operating systems- ch04 (Threads) ...
OS-operating systems- ch04 (Threads) ...OS-operating systems- ch04 (Threads) ...
OS-operating systems- ch04 (Threads) ...
 
CELL CYCLE Division Science 8 quarter IV.pptx
CELL CYCLE Division Science 8 quarter IV.pptxCELL CYCLE Division Science 8 quarter IV.pptx
CELL CYCLE Division Science 8 quarter IV.pptx
 
How to Make a Pirate ship Primary Education.pptx
How to Make a Pirate ship Primary Education.pptxHow to Make a Pirate ship Primary Education.pptx
How to Make a Pirate ship Primary Education.pptx
 

case presentation on coronary artery disease.

  • 2. Patient information Mrs . Kottu sulochannamma Age :75 years Gender: female IP no:1214 Department: cardiology Date of admission :25/10/2022 History of present illness : shoulder joint pain , indigestion,mild headache, Heavyness of chest Past medical history: history of shortness breath ,chestpain, diabetes mellitus, gastric acidity, hypertension
  • 3. Social history • Diet: mixed • Sleep:disturbed • Appetite:Normal • Bowel and Bladder: Normal Provisional diagnosis Coronary artery disease .
  • 4. Physical examination • Temparature: Normal • Respiratory Rate: 25cpm • PluseRate:79bpm • Blood pressure:160/90 mm of Hg
  • 5. Diagnosis Test 1. History collection 2. Complete blood count • Hb :. 10g/dl. • ECG • Echo • CBP • Angiogram- abnormal
  • 6. Radiographic diagnosis • Coronary angiogram report : • Impression : CAD Mild (MCA+critical triple vessel disease)
  • 7. Conformatory diagnosis: Based on the information the final diagnosis of the patient was found to be coronary artery disease.
  • 8. Anatomy of the heart • A hallow muscular organ located in the thorax between two lungs. • It has four chambers • It has four valves • Two atriums and Two ventricle • Right side it receives blood from the body and sends it to the lungs(pulmonary) • Left side receives blood from the lungs and it sends it to the body (systemic).
  • 9. Heart • the heart is surrounded by the three membrane called pericardium, Myocardium and epicardium
  • 10. Pericardium • The pericardium is a fibroserous sac that encloses the heart and roots of the great blood vessels.
  • 11. The pericardium • The pericardium lies within the middle mediastinum. • It’s function is to restrict excessive movement of the heart as a whole and to serve as a lubricated container in which the different parts of the heart can contract .
  • 12. Heart wall • Endocardium 1. Deepest layer of the heart 2. Smooth lining to reduce friction of blood flow. Myocardium 1. Myocardium is the middle layer of the heart . 2. It is the thickest layer which lies between the single cell endocardium layer.
  • 13.
  • 14. The heart chambers 1. Four chambers • Two atria ( right and left ). • Two ventricle (right and left)
  • 15. The heart chambers Atria Features 1. Atria are Small thin walled Chambers . Functions 1. Atria are the receiving chambers for blood returning to the heart from the circulation. • Atria push the blood into the adjacent ventricles.
  • 16. The heart chambers Ventricle Features 1. Make up most of the mass of the heart. 2. The walls of the left ventricular 3x thicker than those of the right one. Functions 1. Discharging chamber of the heart. 2. Transfer blood to pulmonary trunk(right ventricular) arota( left ventricular).
  • 17. • Right atrium receives deoxygenated blood from inferior vena cava below and from the superior vena cava. Right atrium
  • 18. Right ventricle 1. Right ventricle receives blood from the right atrium through the tricuspid valve.
  • 19. Left atrium 1. Left atrium receives oxygenated blood from four pulmonary veins which drains posteriorly. 2. The mitral (bicuspid) valve gaurds the passage of blood from the left atrium to the left ventricles.
  • 20. Left ventricle 1. The wall of the left ventricle is thicker than the right ventricle but the structure is similar. 2. The thicker wall is necessary to pump oxygenated blood at high pressure through the systemic circulation.
  • 21. Heart valves 1. Heart valves ensure that unidirectional blood flow through the heart. 2. It composed of an endocardium with a connective tissue core 3. There are two major types of valves • Atrioventricular valves. • Semilunar valves.
  • 22. Atrioventricular Valves • Atrioventricular valves lies ethe atria and the ventricle. • -R- AV – valve = tricuspid valve • -L-AV – valve = bicuspid valve or mitral valve. • atrioventricular valves prevent back flow of blood into the atria when ventricles contract.
  • 24.
  • 25.
  • 26.
  • 27. Arterial supply of the heart • Arterial supply of the heart is provided by the right and left coronary artery, which arise from the ascending arota immediately above the arotic valve . Right coronary arteries Branches • Right marginal arteries (acute Marginal arteries)
  • 28. • Posterior interventricular artery (lies in the post Iv Sulcus) • Sinoatrial nodal artery • Atrioventricular nodal artery. Left coronary artery Branches • Left anterior descending (LAD) or anterior interventricular artery (lies in anterior IV sulcus) • Left marginal artery (Obtuse marginal artery) • Left circumflex artery.
  • 29.
  • 30. Venous drainage of the heart 1. Most blood from the heart wall drains into the right atrium through the coronary sinus, which lies in the posterior part of the atrioventricular groove . 2. It is a continuation of the great cardiac vein. 3. It open into the right atrium to the left of the inferior vena cava.
  • 31. Nervous supply of the heart 1. The heart is innervated by sympathetic and parasympathetic fibers of the autonomic nervous system via the cardiac plexuses situated below the arch of the arota .
  • 32. Coronary artery disease • Definition: coronary artery disease is defined as narrowing or blockage of the coronary arteries usually caused by atherosclerosis . • etiology: 1. Smoking 2. High blood pressure 3. High cholesterol 4. Insulin resistance 5. Sedentary lifestyle.
  • 34. Clinical manifestations 1. Ischemia 2. Low cardiac output 3. Hypertension 4. Diaphoresis ( excessive sweating) 5. Bradycardia 6. ECG changes - ST segment and T wave changes 7. pulmonary edema. 8. Chest Heavyness
  • 35. Risk factors for coronary artery disease • High blood pressure • Diabetes • Obesity • Unhealthy diet
  • 36. Diagnostic Test 1. Physical examination 2. History collection 3. Stress Test
  • 37. • Chest X – ray • Electrocardiogram • Echocardiogram • Cardiac catheterization( angiogram)
  • 38. Complications 1. Chestpain 2. Heart attack 3. Heart failure 4. Abnormal heart rhythm (arrhythmias)
  • 39. Standard Management Pharmacological therapy 1. Anti anginal agents 2. Nitrates 3. Beta adrenergic receptor blockers 4. Calicium channel blockers 5. ACE inhibitors 6. Statins 7. Diuretics 8. Imiprimine for analgesia. • Surgeries 1. Coronary angioplasty 2. Heart transplantation 3. Stent
  • 40. Current drug chart S.no Brand name Generic name Dose Route of administratio n Frequency Category Indications 1 Pantocid Pantaprazole 40mg P/o OD Proton pump inhibitors Gastric acidity 2 Lopressor Metoprolol 50mg P/o OD Beta blockers Treatment for angina 3 Nitro -bid Nitrosat 2.6mg P/o BD Vasodilator Treatment for angina 4 Duolin Ipratropium Salbutamol 0.5mg 2.5mg P/N TID Anticholinergi c Beta 2 receptor blockers Treatment for shortness of breath 5 Budecort Budesonide 12.5mcg P/N TID Corticosteroid Treatment for Shortness of breath 6 Enoxaparin Heparin 3000 IU IV BD Anticoagulant Treatment to the blood colt In heart
  • 41. Drug interactions • Heparin and aspirin which has risk of increasing bleeding. • Metoprolol and quinidine increased removal of metoprolol from the body.
  • 42. Patient counseling • About disease. • Coronary artery disease also called coronary artery disease. 1. The arteries,get plaque on their inner wall, which can then become straved of oxygen . 2. The plaque could rupture, leading to a heart attack (or) sudden cardiac death. 3. It’s mainly cause due to • Hypertention • DM • Obesity • Smoking • High cholesterol
  • 43. Lifestyle modification 1. Stop smoking 2. Eat healthy diet 3. Get exercise 4. Reduce (or) avoid excess weight. 5. Avoid alcohol consumption. 6. Control blood pressure
  • 44. REFERENCE • WWW . Myoclinic .org • WWW. coronary artery disease Wikipedia .org. • WWW. Medscape .com • WWW research gate .com