Medical surgical nursing

2. CORONARY ARTERY
DISEASE

3. At the end of the class, students will be able to gain knowledge regarding
coronary artery disease and develops desirable attitude in applying the knowledge
into practice in life to lead a healthy lifestyle.
SPECIFIC OBJECTIVES
At the end of the class students will be able to:
1.define coronary artery disease/atherosclerosis
2.discuss the risk factors for the development of CAD
3.explain the pathophysiology of CAD
4.enumerate the clinical manifestations of CAD
5.list down the diagnostic methods of CAD
6.elaborate the prevention of CAD
7.describe the management of CAD

4. Coronary Artery Disease:
CAD is a type of blood vessel disorder that is included in the general category of
atherosclerosis.
Atherosclerosis :
Abnormal accumulation of lipid, or fatty substances, and fibrous tissue in the
lining of arterial blood vessels, blocking and narrowing the coronary vessels thereby
reducing blood flow to the myocardium.

5.  Non-Modifiable risk factors:
1. Family history of CAD
2. Increasing age
3. Gender
4. Race
 Modifiable risk factors:
1. Hyperlipidemia
2. Cigaratte
3. Hypertension
4. Diabetes
5. Metabolic syndrome
6. Obesity

6.  Contributing factors:
1. Type A behaviour
2. Hard working
3. Depression
4. Stress
5. Increased homocysteine level in blood

7.  Stages:
1. Fatty streaks
2. Fibrous plaque
3. Complicated lesion

10. 1. Ischemia
2. Angina
3. Myocardial cell death
4. Myocardial cell dysfunction
5. Sudden cardiac death
6. Dysrrhythmia
7. Heart failure

11. 1. ECG
2. Cardiac enzymes
3. Echocardiogram
4. Exercise stress test
5. Angiogram

12.  Primary Prevention:
1. Control cholesterol abnormalities
2. Dietary measures
3. Physical activity
4. Medication(statins)- Atorvastatin, Simvastatin
5. Cessation of tobacco
6. Control of diabetes and hypertension

13.  Secondary prevention:
 Medical management:-
1. Statins
2. ACE inhibitors – Enalapril, Captopril
3. Antiplatelet agents – Aspirin
4. Treatment of angina
 Beta adrenergic blockers – Atenolol, Propanolol
 CCBs – Nifedipine, Amlodipine
 Nitrates - Nitroglycerin

14.  Surgical management:-
1. Percutaneous Coronary Intervention(PCI)/Percutaneous Transluminal
Coronary
Angioplasty (PTCA)
 Balloon angioplasty
 Stenting
2. Open heart surgery- CABG (coronary artery bypass graft)

16. CABG

17. Nursing management :-
1. Oxygen administration
2. Frequent assessment of vital signs
3. Physical rest
4. Head elevation
5. Regular pulmonary function assessment
6. Alleviate anxiety and depression
7. Monitor for complications
8. Health education

18. 1. Acute pain related to increased myocardial oxygen demand
2. Risk for decreased cardiac tissue perfusion related to reduced coronary blood
flow
3. Risk for imbalanced fluid volume
4. Risk for ineffective peripheral tissue perfusion
5. Anxiety related to cardiac event and possible death
6. Deficient knowledge related to heart healthy lifestyle

20.  Mr. X admitted in the CTVS ward has had a PCI procedure for the treatment of
coronary artery disease.
1. Discuss the nursing care for this patient
2. Prepare a relevant health education plan that can be given to this patient
 Form nursing process for a patient with CAD based on the nursing diagnoses
discussed.
Date of submission : 13/10/2023
Venue of submission : BSc. Nursing second year classroom
Time of submission : Before 4:00 pm

21. THANKYOU