3. CORONARY ARTERY DISEASE
*A narrowing of the coronary arteries that prevents
adequate blood supply to the heart muscle is called
coronary artery disease. Usually caused by
atherosclerosis, it may progress to the point where the
heart muscle is damaged due to lack of blood supply.
Such damage may result in infarction, arrhythmias, and
heart failure.
EAT LESS,MOVE MORE
4. ACUTE CORONARY SYNDROME(ACS):
ACS is a term used to define potential complications of
CAD.This syndrome includes;
Unstable angina
Myocardial infartion(ST segment elevation)
Myocardial infarction(non ST segment elevation)
5. ETIOLOGY:
Reduced blood flow in the coronary artery due to
atherosclerosis,increased oxygen demand and decreased
oxygen supply
Complete occlusion of artery by emboli or thrombus
Sudden narrowing of coronary artery (vasospasm)
Acute blood loss(Anemia)
7. T L
YMPHOCYTESAND MONOCYTESTHAT
BECOMESAS MACROPHAGES INFIL
TRATE
THEAREATO INGESTTHE LIPIDSAND DIE
PROLIFERATIONOFSMOOTH MUSCLECELLS
WITH INTHEVESSEL
FORMATIONOF FIBROUSCAPOVER DEAD
FATTYCORE (ATHEROMA)
PROTRUSIONOFATHEROMA INTOTHE
LUMENOFVESSEL
9. ECHOCARDIOGRAMS
It is may be ordered if doctor suspects a
problem with the heart muscle or one of the
valves that channel blood through the heart.
10. STRESS TESTS
•They are used to show how the heart
reacts to physical exertion. Exercise stress
tests are usually performed on a treadmill
or exercise bicycle.
11. NUCLEAR CARDIAC IMAGING
•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.
12. ANGIOGRAPHY
•Is the most accurate means by which to
examine the coronary arteries
• It requires a surgical procedure
During
cardiac catheterization.
procedure, catheters (small thin
called
the
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
13. DIAGNOSTIC TESTS
A doctor or nurse will perform a physical
exam and listen to your chest using a
stethoscope.
The doctor may hear abnormal sounds in
lungs (called crackles), a heart murmur, or
other abnormal sounds.
a fast or uneven pulse.
blood pressure may be normal, high, or low.
14. • Risk factors for CAD :
High BP & blood lipids
Diabetes
Obesity
High stress
Unhealthy diet
Lack of physical activity
17. S.NO BRAND
NAME
GENERIC
NAME
DOSE R.O.A FREQ CATEGO
RY
INDICATI
ON
1. Pantocid Pantoprazole 40mg P/0 OD Proton
pump
inhibitor
Prophyla
ctic
2. Lopressor Metoprolol 50mg P/O OD Beta
blocker
Treatme
nt for
angina
3. Nitro-bid Nitrostat 2.6mg P/O BD Vasodila
tor
Treatme
nt for
angina
4. Duolin Ipratropium
salbutamol
0.5mg
2.5mg
P/N TID Anticholi
nergic
Beta2
agonist
For SOB
5. Budecort Budesonide 128m
cg
P/N TID Corticost
eroid
For SOB
19. DRUG INTERACTIONS
• Moderate :
1,Metoprolol and Albuterol : Metoprolol can cause
narrowing of the airways, which may worsen breathing
problems
Management : Generally be avoided or the dosage should
start low, preferably in divided doses to avoid
2.Metoprolo and Budesonide : Corticosteroids may
antagonise the effect of anti-HTN medications by using
sodium and water retention
Management : Ptn should be monitored regularly for BP,
electrolytes levels and body weight
21. GOALS
To prevent signs and symptoms by
sympthamatic therapy
To avoid the further complications
To decrease the disease progression
And to increase the patients quality of life
22. PATIENT COUNSELING
• About Disease : CAD, also called coronary heart disease.
The arteries, get plaque on their inner walls, which can make them
more rigid and narrowed. This restricts blood flow to your heart
muscle, which can then become starved of oxygen.
The plaque could rupture, leading to a heart attack or sudden cardiac
death.
It is mainly caused due to
HTN
DM
Obesity
Smoking
High cholesterol
23. • About drugs :
Pantoprazole : Should b swallowed whole,donot split,
crush/chew. Should be taken 30 min before meal
Metoprolol : Administer with or immediately following
food
Nitrostat : Swallow it as whole, taken with or without food.
Duolin : Administer via jet nebulizer to an air compressor
with an adequate air flow, equipped with a mouthpiece.
Budesonide : Do not use ultrasonic nebulizers.
25. Timings Sunday Monday Tuesday Wednesday Thrusday Friday Saturday
Breakfast
(8:00-8:30AM)
Ragi dosa-3+2
tsp methi
chutney+1
glass milk
(toned)/1
cup tea
Dalia upma-1.5
cup with
vegetables(pota
to,onion,tomat
o,green peas,
carrot)+1 glass
milk(toned)/1
cup tea
Oats-1/2
cup+milk(toned)
-150ml
Idly-
4+sambhar-1/2
cup+green
chutney-2 tsp+1
glass
milk(toned)/1
cup tea
Soya and wheat
dosa-3+2 tsp
pudina
chutney+1 glass
milk(toned)/1
cup tea
Roasted oats
upma-1.5 cup
with
vegetables(potat
o,onion,tomato,g
reen peas,
carrot)+1 glass
milk(toned)/1 cup
tea
Paratha-
2(aloo/methi/moo
li/gobhi)+2 tsp
green chutney+1
glass
milk(toned)/1 cup
tea
Mid-Meal
(11:00-11:30AM)
1
medium banana
1 medium apple
1 medium
orange
1 medium
pomegranate
100gm water
melon
100gm musk
melon
1 medium pear
Lunch
(2:00-2:30PM)
1 cup brown
rice+2 roti+1/2
cup cabbage
dal+1/2 cup
capsicum sabji+1
glass buttermilk
4 roti+100gm
fish(tuna/sardin
e/salmon/macke
rel with little
olive oil)-
grilled/stewed+1
/2 cup rajmah
curry
1 cup brown
rice+2 jowar
roti+1/2 cup
tomato dal+1/2
cup cluster
beans curry+1
glass buttermilk
4 bajra roti+1/2
cup lauki
dal+1/2 cup
green peas and
capsicum
sabji+1 glass
buttermilk
1 cup brown
rice+2 bajra
roti+1/2 cup
methi dal+1/2
cup french
beans sabji+1
glass buttermilk
1 cup white rice+2
roti+100gm
fish(tuna/sardine/
salmon/mackerel)
curry+1/2 cup
soya chunk and
aloo sabji
4 roti+1/2 cup
palak dal+1/2 cup
bitter gourd
sabji+1 glass
buttermilk
Evening
(4:00-4:30PM)
1 glass almond
milk(toned)+2-3
oats biscuits
1 cup boiled
sprouted green
gram dal+1 cup
green tea
1 small fist of
peanuts,raisins,
almonds,walnut
s+1 cup green
tea
1 cup boiled
sprouted
bengal gram+1
cup green tea
1 glass walnut
milk(toned)+2-3
multigrain
biscuits
1 glass
avocado(75gm)
milkshake(milk-
150ml-toned)
1 glass
milk(toned)+2-3
ragi biscuits)
Dinner
(8:00-8:30PM)
3 roti+1/2 cup
ridge gourd
sabji+1/2 cup
vegetable
salad+1 glass
3 roti+1/2 cup
ivy gourd
sabji+1/2 cup
vegetable
salad+1 glass
3 roti+1/2 cup
bhindi sabji+1/2
cup vegetable
salad+1 glass
buttermilk
3 roti+1/2 cup
snake gourd
sabji+1/2 cup
vegetable
salad+1 glass
3 roti+1/2 cup
moolimethi
sabji+1/2 cup
vegetable
salad+1 glass
3 roti+1/2 cup
lauki sabji+1/2 cup
vegetable salad+1
glass buttermilk
3 roti+1/2 cup
cauliflower
sabji+1/2 cup
vegetable salad+1
glass buttermilk
7 DAYS DIET PLAN FOR CORONARY ARTERY DISEASE
26. LIFESYLE MODIFICATIONS
Stop smoking – smoking is toxic to your heart and
the blood vessels
Eat healthy diet – avoid food
containing fat,cholesterol,salt and sugar
Get exercise – do exercise 30 min / day or 5 times in
a week
Reduce excess weight or aviod
Discontinue alcohol consumption – alcohol may
increase the levels of TG in blood and can leads
to atherosclerosis
Control BP
27. FOODSTO BE INCLUDED:
Whole grain foods
Steamed foods
Fat free-milk
Fish ,skin care poultry
Egg whites
Olive oil
Brown rice
FOODSTO BE AVIODED:
Potato chips
Fried foods
Whole milk
Egg yolks
Pastries
Butter
Junk foods
(Oily foods)
28. Coronary artery disease (CAD) is the most common type of
heart disease. It is the leading cause of death in the United
States in both men and women.
CAD happens when the arteries that supply blood to heart
muscle become hardened and narrowed. This is due to the
buildup of cholesterol and other material, called plaque, on
their inner walls. This buildup is called atherosclerosis. As it
grows, less blood can flow through the arteries. As a result,
the heart muscle can't get the blood or oxygen it needs. This
can lead to chest pain (angina) or a heart attack. Most heart
attacks happen when a blood clot suddenly cuts off the
hearts' blood supply, causing permanent heart damage.
Over time, CAD can also weaken the heart muscle and
contribute to heart failure and arrhythmias. Heart failure
means the heart can't pump blood well to the rest of the
body. Arrhythmias are changes in the normal beating rhythm
of the heart.
CONCLUSION
