Coronary artery disease occurs when plaque builds up in the coronary arteries, narrowing the arteries and reducing blood flow to the heart. This document outlines the definition, risk factors, pathophysiology, signs and symptoms, diagnosis, and treatment of coronary artery disease. The modifiable risk factors include hyperlipidemia, smoking, hypertension, diabetes, obesity, and physical inactivity. The pathophysiology involves injury to endothelial cells, inflammation, lipid accumulation in artery walls, and formation of thrombus. Diagnosis involves history, physical exam, ECG, and lab tests. Treatment focuses on lifestyle changes, medications like statins, and procedures like angioplasty, stents, or bypass surgery.

1. SUDESHNA BANERJEE DUTTA
LECTURER
S.R.S.V.M B.SC NURSING COLLEGE

2. Definition
 It is the abnormal deposition of lipid or fatty
substances and fibrous tissues in the lining of arterial
blood vessel walls, called as plaques, which blocks or
narrows the lumen and reduces blood supply to the
myocardium causing injury to the arterial wall. There
is deprivation of oxygen supply to the cells causing
ischemia.

3. Modifiable risk factors:
 Hyperlipidemia
 Cigarette /bidi smoking
 Tobacco use
 Hypertension
 Diabetes mellitus
 Metabolic syndrome
 Obesity
 Physical inactivity and sedentary lifestyle
 Dietary intake(increased salt, using palm oil, unrefined oil
for cooking, excessive intake of non vegetarian food)
 Mental stress

4. Non-modifiable risk factors are:
 Family history of CAD ( 1st degree relatives)
 Increasing age 45 yrs and above, but it has now
occurrence in young adults of age 20-40 years also.
 Gender ( males are more prone than females)
 Race ( higher incidence in African-Americans than in
Asians)

6. Due to etiological factors
Injury to the endothelial cell that lining the artery
Inflammation and immune reactions
Accumulation of lipids in the intima of arterial wall
T lymphocytes and monocytes that becomes as
macrophages, infiltrate the area to ingest the lipids and
die there ( after ingestion macrophages can’t get
removed from that area due to inflammation)

7. Formation of fibrous cap over the dead fatty core
Protrusion of atheroma into the lumen of vessel (fatty
material which forms deposition)
Narrowing and obstruction
If cap is thin the lipid core may grow causing it to rupture
Hemorrhage into plaque allowing thrombus to devolop

9. Thrombus and atheromatous plaque obstructs the
blood flow leading to ischaemia & further necrosis of
cardiac myocytes
Angina and other symptoms

10. Chest pain (Angina pectoris)
Diaphoresis
Chest heaviness
Dyspnea
Fatigue
Radiation of pain to the left arm and neck
A burning sensation in the chest or upper
abdomen
Nausea

11.  ECG changes
 Hypertension or hypotension
 Dysrythmias
 Elevated cardiac enzymes

12.  History taking
 Physical examination
 ECG
 Laboratory routine blood tests
 Stress test (treadmill testing)

14.  Statins, which reduce cholesterol, reduce risk of
coronary disease
 Nitroglycerin
 Calcium channel blockers and/or beta-blockers
 Antiplatelet drugs such as aspirin.

15. CORONARY STENT

16. ANGIOPLASTY

17. CORONARY ARTERY BYPASS GRAFTING (CABG)

18.  MANAGING BP: BP should be monitored every 2
hourly & client should be encouraged to measure
weight every month, limit salt intake, moderate
alcohol intake.
 Antihypertensive medications have to be started if
BP is > 140/90 mmHg; after 6 months of lifestyle
modification.

19.  SMOKING CESSATION: Patient should stop
smoking & avoid passive smoking also.
 CONTROLLING CHOLESTEROL: Total LDL & HDL
should be monitored anually for adults older than 20
years. Client should be encourage to exercise atleast
5times weekly for 30 minutes & to increase their physical
activity in their daily life.
 CONTROL DIABETES: FBS should be maintained near
normal level in clients with DM.