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- 1. CORONARY ARTERY DISEASE Preparedby: Pallavi Pragya
- 2. DEFINITION Coronary arterydisease is the narrowing or blockage of the coronary arteries, usually caused by artherosclerosis.
- 3. CORONARY ARTERY DISEASEIS ALSO KNOWN AS Artherosclerotic heart disease Coronary artherosclerosis Coronary arteriosclerosis Coronary heart disease
- 4. Coronary artherosclerosis Itis the abnormal accumulation of lipid or fatty substances or fatty atheroma (plaque) in the lumen of coronary artery.
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- 6. MODIFIABLE High bloodcholesterol level Cigrette smoking Tobacco use Hypertension Diabetes mellitus Lack of estrogen in women Physical activity Obesity
- 7. NON MODIFIABLE Familyhistory of CAD Age(35-55 years) Gender (male) Race (non white populations)
- 8. PATHOPHYSIOLOGY Due to etiologicalfactors 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 monocytes that becomes as macrophages infiltrate
- 9. Occlusion of bloodvessels Decreased blood supply to myocardium Ischemia Necrosis of myocardial muscles CAD
- 10. CLINICAL MANIFESTATION Chestpain weakness or numbness in arms, wrist & hands Dyspnea Diaphoresis Fatigue Palpitation
- 11. Nausea andvometting ECG changes Ventricular aneurysms Dysarrthymias Hyperlipidemia
- 12. DIAGNOSTIC EVALUATION Historytaking Physical examination Blood investigation Urine analysis Chest x ray ECG
- 13. ECHO Angiography Tread mill test(TMT) PET Nuclear imaging studies CT scan
- 14. ECG Provide arecord of the heart’s electrical activity. This simple test records any abnormal findings in the heart’s electrical impulses. Electrodes are placed on the arms and chest to monitor electrical activity
- 15. ECHOCARDIOGRAMS It ismay be ordered if doctor suspects a problem with the heart muscles or one of the valves that channel blood through heart
- 16. SRESS TEST Theyare used to show how the heart reacts to physical exertion. Exercise stress tests are usually performed on a treadmill or exercise bicycle.
- 19. NUCLEAR CARDIAC IMAGING It involves the use of small amounts of short lived radioactive material, which is injected into the bloodstream. A special camera (live motion x ray) detects the radioactivity of these materials, and the images displayed show how heart pumps blood. This is useful in identifying any areas of abnormal motion or for assessing the blood supply to the heart muscle.
- 20. ANGIOGRAPHY It ismost accurate means to examine the coronary arteries. It requires a surgical procedure called catheterization. During the procedure, catheters(small thin plastic tubes) are placed in the artery of the leg or arm, and directed using an x ray machine to the opening of each of the coronary arteries.
- 22. MANAGEMENT NURSING MANAGEMENT Takehistory of the patients. Gather information about patient symptoms. Assess patients risk factors for CAD. Assess patients family’s understanding level for the disease. Identify patients and familys level of anxiety and use of appropriate coping mechanisms.
- 23. MEDICAL MANAGEMENT Antihypertensivemedicine Methydopa : this medicine is used alone or with other medicications to treat high BP. Lowering high BP 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 BP. Amlodipoine: it is used with or withput other medications to treat high BP. Lowering high BP helps prevent strokes , heart attacks, and kidney problems.
- 24. SURGICAL MANAGEMENT PTCA(Percutaneous Transluminal Coronary Angioplasty) It is a minimally invasive procedure that widens blocked coronary arteries to improve blood flow to the heart. CABG(Coronary Artery Bypass Graft Surgery) It is also known as bypass surgery, is a procedure that improves blood flow to the heart. It is used to treat CAD, which occurs when the coronary arteries narrow or become blocked due to a buildup of fatty material. it is a complicated surgery that can take several hours to complete.
- 30. COMPLICATION Chest pain(Angina) Heart attack Heart failure Abnormal heart rhythm( arrhythmia)
- 31. PREVENTION Quit smoking Control condition such as high BP , high cholesterol and diabetes. Stay physically active Eat a low fat, low salt diet that is rich in fruits, vegetables and whole grains. Maintain a healthy weight Reduce and manage stress.