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Cardiovascular Monitoring
Coronary Artery Disease
Outline
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What is Coronary Heart Disease?
Who is at Risk for Coronary Heart Disease?
Signs and Symptoms of Coronary Heart Disease.
How Is Coronary Heart Disease Diagnosed/ treated
?
What Is Coronary Artery Disease?
• (CAD) is one type of heart disease that occurs when the
blood vessels that supply blood to the heart muscle
(coronary arteries) are narrowed or blocked. This
narrowing or blockage is most often caused by the
buildup of fat (cholesterol) and calcium inside the walls
of the arteries leading to the heart. This process is
called atherosclerosis, or hardening of the arteries. The
buildup of fat and calcium inside the arteries is called a
plaque.
• Coronary artery disease leads to Myocardial ischemia
(angina)and myocardial infarction.
AHA
• 10 Factors That Increase the Risk of Heart
Disease and Heart Attack:
• 1) Tobacco Smoke
• 2) High Blood Cholesterol
• 3) High Blood Pressure
• 4) Physical Inactivity
• 5) Obesity and Overweight
• 6) Diabetes Mellitus
• 7) Stress
• 8) Alcohol
• 9) Diet and Nutrition
• 10) Age
What Are the Symptoms of Coronary
Artery Disease?
• Angina, can be described as a heaviness, pressure, aching,
burning, numbness, fullness, squeezing or painful feeling.
usually felt in the chest, but may also be felt in the left
shoulder, arms, neck, back, or jaw.
• Chest pain (character ,site , increase by, decrease by,
association).
• Shortness of breath
• Palpitations (irregular heart beats)or a faster heartbeat.
• Weakness or dizziness
• Nausea
• Sweating
What Is Ischemia?
• Cardiac ischemia occurs when plaque and fatty matter
narrow the inside of an artery to a point where it cannot
supply enough oxygen-rich blood to meet your heart's
needs.
• Reversible condition
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Ischemia is most commonly experienced during increase
by:Exercise
Eating
Excitement or stress
Exposure to cold
Myocardial Infarction
• Irreversible damage to the myocardium caused by
lack of blood supply as a result of occluded arteries.
• Can occur with no signs or symptoms(silent).
• Can cause sudden death.
Myocardial Infarction
How Is Coronary Artery Disease
Diagnosed?
Your doctor can tell if you have coronary artery
disease by:
 Talking to you about your symptoms, medical history, and
risk factors.
 Performing a physical exam.
 Performing diagnostic tests, including an
electrocardiogram (ECG or EKG), exercise stress tests,
electron beam (ultrafast) CT scans, cardiac
catheterization.
 Radionuclide imaging .
Other Diagnostic Tests
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LDH
CK-MB
Tropp- I
Radionuclide studies
Myocardial perfusion scintigraphy
Exercise radionuclide ventriculography
Echocardiography
Ambulatory ECG monitoring
Coronary arteriography
Complications following acute MI
 Congestive heart failure
 Myocardial rupture
 Arrhythmia
 Pericarditis
 Cardiogenic shock
How Is Coronary Artery Disease
Treated?
 Treatment for coronary artery disease involves making lifestyle
changes, taking medications, possibly undergoing invasive and/or
surgical procedures, and seeing your cardiologist for regular
checkups.
• Reduce risk factors. Quit smoking. Avoid high-cholesterol foods and
adopt a low-fat, low-salt diet. Keep blood sugar in control if you
have diabetes. Exercise more to maintain a healthy weight.
• Medications. If making lifestyle changes isn't enough to control
heart disease, medications may be needed to help heart work more
efficiently and receive more oxygen-rich blood. The drugs you are
on depend on you and your specific heart problem.
How Is Coronary Artery Disease
Treated?
• Surgery and other procedures. Common procedures
to treat coronary artery disease include balloon
angioplasty (PTCA), stent placement, and coronary
artery bypass surgery.
• All of these procedures increase blood supply to the
heart, but they do not cure coronary heart disease.
You will still need to decrease your risk factors to
prevent future disease.
Percutaneous Transluminal Coronary
Angioplasty
, Cardiovascular System
15
stent placement
Coronary artery By-pass Graft
(CABG)
Chapter 18, Cardiovascular System
17
• Angioplasty is a procedure to open narrowed or
blocked blood vessels that supply blood to your legs.
• A stent is a small, metal mesh tube that keeps the
artery open.
• CABG a harvested great saphenous vein of the leg,
attaching the proximal end to the aorta or one of its
major branches, and the distal end to immediately
beyond a partially obstructed coronary artery.
Assignment
Group 1 :How patient history and physical exam.
Group 2 :Signs and symptoms of angina & myocardial
infraction
Group 3: Lab test for angina & myocardial infraction
Reference
• http://www.nursingceu.com/courses/398/ind
ex_nceu.html
• https://www.nlm.nih.gov/medlineplus/ency/a
rticle/007393.htm