Coronary artery disease (CAD) mind map

1. Cardiovascular disease (CVD) is a leading cause of death in Canada, accounting for 32% of all deaths. Coronary artery disease (CAD) is the most common type of CVD

1. 1, Pain or discomfort of the upper body
2. 2, Difficulty breathing or shortness of breath
3. 3, Sweating or “cold sweat”
4. 4, Fullness, indigestion, or choking feeling
5. 5, Nausea or vomiting
6. 6, Light-headedness, dizziness, extreme weakness or anxiety
7. 7, Rapid or irregular heart beats

1. 1, History
2. 5, Nuclear imaging studies
3. 6, Electron beam CT
4. 7, Positron emission tomography (PET)
5. 8, Coronary angiography
6. 3, Chest radiograph
7. 4, Echocardiogram
8. 9. Lab study: CK-MB; cardiac troponin; myoglobin; lipid panel; CBC; C-reactive protein; homocysteine
9. 2, 12-lead ECG

1. Atherosclerosis is the major cause of CAD
2. Characterized by a focal deposit of cholesterol and lipid, primarily within the intimal wall of the artery
3. Endothelial lining altered as a result of inflammation and injury

Nota:

• Nonmodifiable factors are age, gender, family history, ethnicity, and genetic inheritance. While modifiable factors include elevated serum lipids, hypertension, tobacco use, physical inactivity, obesity, diabetes, metabolic syndrome, psychological states, and homocysteine level etc.

1. Age. Heart disease is the number 1 cause of death in Canada for women over 55 years
2. Gender. Women are more affected than men
3. Ethnicity. South Asian background people have higher risk of developing CAD
4. Family history and genetic predisposition. Family history such as hypercholesterolemia and other disease has been strongly related with CAD
5. Elevated serum lipids.This is one of the four most firly established risk factors
6. Hypertension. The second major risk factor of CAD
7. Tobacco use. The third major risk factor of CAD
8. Physical inactivity is the fourth major risk of CAD
9. Obesity. Obese individual has higher mortality rate from CAD
10. Diabetes. Incidence of CAD in diabetic people can be 2-4 times greater
11. Metabolic syndrome.Insulin resistance is a shared underlying pathology among various metabolic risk factors
12. Psychological states. Depression, anxiety, and other psychological issues increases the risk of CAD
13. Homocysteine level. High HCY level contributes to atherosclerosis by different mechanisms

1. Identify people of high risk. Risk screening includes obtaining personal and family health histories, and knowing client's belief and value of health and life. Education might be needed
   1. Nutritional therapy
      1. Therapeutic lifestyle changes. Therapeutic lifestyle changes is important for all people to reduce the risk of CAD by lowering LDL cholesterol
      2. For people with CAD, Omega-3 fatty acids is helpful
   2. Drugs
      1. Cholesterol-lowering drugs. This includes drugs that can restrict lipoprotein production such as statins, niacin, and drugs that removes lipoprotein such as bile acid sequestrants
      2. Antiplaelet therapy drugs, such as Aspirin and Clopidogrel (Plavix)
      3. Antihypertension drugs, such as Beta blocker
   3. Surgical interventions. For example, coronary artery bypass grafting and percutaneous transluminal coronary angioplasty
   4. Physical fitness. Any regular physical activity such as walking, hiking, swimming and biking is helpful for weight reduction, reducing blood pressure etc. Basic formula of exercise: 30 minutes each time and at least five days every week