definition,etiology,signs and symptoms,evaluations

1. PRESENTED BY: SONIA DAGAR

2.  Coronary artery disease (CAD) is characterized by
accumulation of fatty deposits (atheroma and plaque)
along the inner most layer (intima) of coronary
artery.
 It can cause a critical narrowing (75% occlusion) of
the coronary artery lumen, resulting in a decreased
coronary blood flow and inadequate supply of
oxygen to the heart muscle.

5.  Atherosclerosis is an abnormal accumulation of the
lipid or fatty substances and fibrous tissue in vessel
walls.
 These deposits, called atheromas or plaque, protrude
into the lumen of the vessel, narrowing it and
obstructing or reducing blood flow to the
myocardium.
 Artery and arteriole walls become thickened and
hardened and lose elasticity.
 Arteriosclerosis is referred to as hardening of the
arteries.

6. MODIFIABLE RISK
FACTORS
 High blood cholesterol
level (Hyperlipidemia).
 Cigarette smoking
 Tobacco use
 Hypertension
 Diabetes mellitus
 Physical inactivity:
sedentary life style
 Obesity
 Stress and type A
personality
NON-MODIFIABLE RISK
FACTORS
 Family history
 Increasing age
 Gender
 Race

7.  Elevated serum homocrystein: foods that contain
folic acid (fruits, green leafy vegetables) reduce
homocrysteine levels.
 Lack of estrogen in women

8.  Inadequate blood supply to heart muscle cells
(ischemia)
 Chest pain
 Inadequate cardiac output
 Diaphoresis: Excessive sweating
 Dyspnea
 Changes on the electrocardiogram (ECG)
 High level of cardiac enzyme
 Dysrhythmias
 Angina pectoris, MI or congestive heart failure
 Sudden cardiac death

9.  Electrocardiogram
 Exercise thallium test
 Echocardiography
 Coronary angiography
 Positron emission tomography (PTE) scanning
 Blood test

10.  NON-PHARMACOLOGIC INTERVENTIONS:
 Stop smoking
 A healthy diet and low in cholesterol and fat
 Physical exercise
 OXYGEN ADMINISTRATION: Oxygen therapy
initiated at the onset of chest pain to increase oxygen
amount in myocardium and to decrease chest pain.

11.  Nitrates: nitroglycerin
 Beta blockers such as propranolol & metaprolol
 Calcium channel blockers such as amlodipin &
verapmil
 Antiplatelet and anticoagulant medications such as
aspirin & heparin
 Cholestrol lowering agents such as statins.
 Antihypertensive agents

12.  Coronary angioplasty
 Coronary artery bypass surgery
 Atherectomy
 Coronary stent
 Surgical revascularization of affected artery:
 Embolectomy: Removal of blood clot from artery
 Thrombectomy: Removal of thrombus from the
artery
 Endarterectomy: Removal of atherosclerotic plaque
from the artery