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Coronary Artery Disease Megan McClintock Coronary Artery Disease • Definition • Etiology/Pathophysiology • Risk Factors – Unmodifiable – Modifiable • Signs & symptoms – Angina pectoris – Acute coronary syndrome – Sudden cardiac death Angina • • • • Types Etiology/Pathophysiology Diagnostic studies Drug therapy – – – – Aspirin Nitrates Beta-adrenergic blockers Calcium channel blockers • Surgical therapy – – – – – PCI Stent placement Atherectomy Laser Angioplasty Myocardial revascularization Angina Interventions • Health promotion – Management of risk factors – Nutrition therapy – Drug therapy for hyperlipidemia • Acute – – – – – – Administer oxygen Vital signs ECG Nitrate followed by narcotic Heart sounds Comfortable positioning • Ambulatory/Home Care – Prevention – Proper use of nitroglycerin Myocardial Infarction • Etiology/Pathophysiology • Signs & symptoms – – – – – – Angina Pain Nausea/vomiting Sympathetic nervous system stimulation Fever CV manifestations • Complications – – – – – – – – Arrhythmias CHF Cardiogenic shock Papillary muscle dysfunction Ventricular aneurysm Pericarditis Dressler syndrome Pulmonary embolism Myocardial Infarction • Diagnostic studies – ECG findings – Serum cardiac markers • Treatment – – – – IV Morphine sulfate Oxygen Reperfusion therapy • Fibrinolytics • Cardiac catheterization • PCI – Drug therapy • • • • • • Nitroglycerin Antiarrhythmics Morphine Beta-adrenergic blockers ACE inhibitors Stool softeners – Nutrition therapy MI Interventions • Nursing care plan (pg ______) • Acute – – – – – – Pain assessment Morphine Monitoring Rest Anxiety Denial • Ambulatory/Home Care – – – – Cardiac rehabilitation Teaching Exercise Resumption of sexual activity Sudden Cardiac Death • Definition • Etiology/Pathophysiology • Risk factors • Interventions – Diagnostic workup – Antiarrhythmics – ICD Congestive Heart Failure • Definition • Etiology/Pathophysiology • Types – Left-sided failure – Right-sided failure • Signs & symptoms – Acute • Pulmonary edema – Chronic • • • • • • • • • Fatigue Dyspnea Tachycardia Edema Nocturia Skin changes Behavioral changes Chest pain Weight changes Congestive Heart Failure • Complications • Diagnostic studies • Treatment – – – – – – – – Decreasing intravascular volume Decreasing venous return Decreasing afterload Improving gas exchange and oxygenation Improving cardiac function Reducing anxiety Biventricular pacing Cardiac transplantation Congestive Heart Failure • Drug therapy – – – – – – – – ACE inhibitors Diuretics Inotropic drugs Beta-adrenergic agonists Phosphodiesterase inhibitors Calcium sensitizers Vasodilators Beta-adrenergic blockers • Nutritional therapy – Sodium restriction – Fluid restriction – Weight reduction CHF Interventions • • • • Nursing care plan (pg _______) Health Promotion Acute Ambulatory/Home Care – Drug instructions – Symptoms of hypokalemia – Energy saving behaviors Cardiomyopathy • Definition • Types – Dilated • Etiology/pathophysiology • Signs & symptoms • Treatment – Hypertrophic • Etiology/pathophysiology • Signs & symptoms • Treatment – Restrictive • Etiology/pathophysiology • Signs & symptoms • Treatment Cardiac Transplantation • Indication • Surgery • Post operative care
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