2. Coronary artery disease is the narrowing
or blockage of the coronary arteries,
usually caused by atherosclerosis.
DEFINITION
3. INCIDENC
E:
The overall prevalence of CAD
(95% CI) was 26.9% (22.3%-
32.0%): 23.7% (17.8%-30.9%)
in men vs 30.0% (23.4-37.5%)
in women (P = . 12). Risks did
not differ substantially by age
group.
4. MODIFIABLE RISK FACTORS:
Tobacco use
High blood cholesterol or triglyceride levels
Lack of exercise
Obesity
Stress
NONMODIFIABLE RISK FACTORS:
Family history of heart disease
Older age
Diabetes
High blood pressure
RISK FACTORS:
5. CAUSES
Development of atherosclerosis;
Coronary artery disease is thought to begin with damage or
injury to the inner layer of a coronary artery, sometimes as
early as childhood. The damage may be caused by various
factors, including:
Smoking
High blood pressure
High cholesterol
Diabetes or insulin resistance
Sedentary lifestyle
6. PATHOPHYSIOL
OGY
Due to causes (e.g high fatty diet, hereditary or other
Lipids/ cholesterol formation on endothelium layer of
artery
Formation of fatty streak
Proliferation
Formation of fibrous plaque
Partial/complete blockage in coronary artery
7. SYMPTOMS:
CARDIOVASCULAR-
Angina pectoris
Ischemia
Low cardiac output-
Bradycardia (Decrease pulse rate)
Hypertension
Myocardial infarction-
Diaphoresis –excessive sweating
ECG changes – ST segment and T wave changes, also show tachycardia,
bradcardia, or dysrhythimas.
Dysarrithmias
15. Quit smoking
PREVENTION:
Control conditions
such as high blood
pressure, high
cholesterol and
diabetes
Stay physically
active
Eat a low-fat, low-
salt diet that's rich
in fruits,
vegetables and
whole grains
Maintain a healthy weight
Reduce and manage stress
16. (These drugs acts as
blood vessel dilator):
• Nitrates
(Decrease work load in
heart): • Propranolol 20-
40 mg
• (They improve
coronary blood flow):
• Nifedipine
• Verapamil
Vasodilator
s
Calcium channel
blocker
Beta-
Blockers
MEDICAL MANAGEMENT:
Various drugs can be used to treat coronary artery
disease, including:
18. ANTIHYPERTENSIVE
MEDICINES-
Methydopa- This medication is used alone or with other
medications to treat high blood pressure (hypertension). Lowering
high blood pressure helps prevent strokes, heart attacks, and
kidney problems. Methyldopa works by relaxing blood vessels so
blood can flow more easily.
Sodium nitroprusside- It is used for lowering the blood pressure.
Amlodipine- Amlodipine is used with or without other medications to
treat high blood pressure. Lowering high blood pressure helps
prevent strokes, heart attacks, and kidney problems. Dose-10
mg,20 mg.
21. NURSING MANAGEMENT
Instruct the client regarding the purpose of diagnostic
medical & surgical procedures and the pre- & post
procedure expectations.
Assist the client to identify risk factors that can be
modified, and set goals that will promote change in
lifestyle to reduce the impact of risk factors.
Instruct client regarding a low-calorie, low-sodium, low-
cholesterol, low-fat diet with a increase in dietary fiber.
Stress that dietary changes are not temporary and must
be maintained for life.
Provide community resources to client regarding
exercise, smoking cessation and stress reduction.
22. NURSING
DIAGNOS
IS
• Impaired gas exchange
related to decreased blood
flow as evidenced by
breathlessness
• Acute pain related to disease
condition as evidenced by
patient verbalization
• Impaired physical mobility
related to weakness as
evidenced by patient is unable
to perform daily activity.
• Imbalanced nutrition less than
body requirement related to
less intake of food as
evidenced by weight loss
23. Nature of the
Medical
Condition? HEART
ATTACK
• A heart attack occurs when
there is a sudden, complete
blockage of a coronary artery
that supplies blood to an area
of the heart. As a result, some
of the heart muscle begins to
die. Without early medical
treatment this damage can be
permanent
24. What causes a
heart attack?
• The heart is a muscular pump that needs a
continuous supply of oxygen. It gets this
oxygen from the blood, which flows to the
heart muscle through arteries on the heart's
surface. These arteries are called the coronary
arteries.
• The most common cause of heart attack is
coronary heart disease (CHD) - the slow build-
up of fatty deposits on the inner wall of the
arteries that supply the heart muscle with
blood. These fatty deposits, called plaque,
gradually clog the inside channel of the
arteries causing them to narrow. It is a
Nature
of the
Medical
Conditi
on?
25. CONTINUATI
ON
• A heart attack usually begins when
an area of plaque cracks. Blood
cells and other components of the
blood stick over the damaged area
and form a clot that suddenly and
completely blocks the blood flow to
the heart muscle. If the artery
remains blocked, the lack of blood
flow through that artery permanently
damages the area of heart muscle
that it supplies blood to.
26. What are the symptoms
of heart attack?
Chest
pain or
discomfo
rt.
Feeling
weak,
light-
headed, or
faint.
Pain or
discomfort
in the jaw,
neck, or
back.
Pain or
discomfort in
one or both
arms or
shoulders.
Shortness
of breath.
27. PRIMARY MANAGEMENT
TEQNIQUE OF HEART
ATTACK
Have the person sit down, rest, and
try to keep calm.
Loosen any tight clothing.
Ask if the person takes any chest pain
medicine, such as nitroglycerin for a
known heart condition, and help them
29. Heart Failure
Heart failure occurs when the
heart muscle doesn't pump blood
as well as it should. Blood often
backs up and causes fluid to build
up in the lungs (congest) and in the
legs. The fluid buildup can cause
shortness of breath and swelling of
the legs and feet. Poor blood flow
may cause the skin to appear blue
(cyanotic).
30. Symptom
s:
-Shortness of breath with activity or
when lying down.
-Fatigue and weakness.
-Swelling in the legs, ankles and feet.
-Rapid or irregular heartbeat.
-Reduced ability to exercise.
-Persistent cough or wheezing with
white or pink
blood-tinged mucus.
-Swelling of the belly area (abdomen)
Treatment:
Medicines are the main treatment
for heart failure, but for some
people surgery may help.
Operations that can help with heart
failure include: heart valve surgery.
a coronary angioplasty or bypass.
31. CARDIO VASCULAR
REFLEXS
The cardio vascular reflexes which impact
cardiovascular structures either through direct
innervation or secondarily, for example by influencing
the release of substance such as ADH.
LOCATION
In humans, reflex sympathetic output to the
cardiovascular system originates most immediately in
the rostral ventrolateral medulla (VLM), and
incorporates input from the hypothalamus and brain
stem nuclei.
32. CV reflexes involves(heart & blood vessels) autonomic control( symphathetic &
parasymphathetic) medullary control(cardiac vagal system , vasomotor center)
Cardiac vasular reflex include HEART,blood vessels,cirulatory
adjustment, minimize fluctuation of MABP,maintain perfusion
01
02
03
04
Components: afferent nerves, CNS, efferent nerves(containing cardiac &
pulmonary function maintaining hemostasis)
Processes such as breathing, digestion, and the maintenance of the heartbeat can also
be regarded as reflex actions, according to some definitions of the term.
05
Stimulation of left atrial receptors, by distension of the pulmonary vein/left atrial
junctions, is known to cause a reflex increase in heart rate; the efferent pathway is known to be
solely in the sympathetic nerves.
33. There are at least three
neural mechanisms
participating in this
cardiovascular regulation:
(1)the exercise pressor
reflex,
(2) the central command
(3) the arterial baroreflex.
