Coronary Artery Disease

Diagnosis
1. due to less blood supply heart can't get the Oxygen or blood it requires
  1. Due to build up of cholestrol and fatty deposits called plaque
    1. Arteries that supply blood to heart muscle become weakened and narrowed
    2. build up is called Atherosclerosis
  2. Leads to Angina and Heart failure
2. Electrocardiogram
  1. Detects Heart rate/rythm/strengh
3. Stress Test
  1. Exercise makes your
4. Echocardiography
  1. uses sound waves to make a moving picture of heart
5. MRI
  1. Detailed picture of heart
6. Blood Test
  1. Checks levels of fat, cholestrol, sugar and protein
7. Diagnostic studies
  1. Non-modifiable Risk factors
8. Angoigram
  1. a cathetar is passed into an artery in groin & guided into the cornoary artereis using X-rays. A dye is injected into the catheter
Complication
1. Psychological complications
  1. Depression
  2. Anxiety
2. Inability to tolerate stress
3. chest pain
4. Arrhythmia
5. Ruptured plaque formation leading to blood clots
6. fatigue
7. Heart Failure
8. Myocardial Infarction
9. Stenonsis
10. Total occulusion
11. Cerebral Vascular accident
  1. Refractory Angina ( unaffected by medications, angioplasty,or CABG)
Assessment
1. Symptoms
  1. Angina
  2. Heart Attack
  3. Heart failure
  4. Arrhythmia
  5. Fatigue
  6. Shortness of breath
  7. Sweating & dizziness
  8. Some people have no signs called silent CAD
2. Risk factors
  1. High cholestrol
  2. Obesity
  3. Smoking
  4. Diabetes
  5. Lack of physical activity
  6. High LDL and low HDL
  7. family history
Treatment
1. Exercise
  1. Regular physical activity + diet can prevent quarter of CAD
  2. Maintain a healthy weight
    1. BMI < 25
  3. Moderate intensity aerobic excercise for 2 hours and 30 minutes per week
    1. Weight loss lowers BP, decreases LDL and increases HDL
2. Drug Therapy
  1. Anticoguants
    1. Aspirin
    2. Warfarin
  2. Beta-blockers
    1. Metaprolol
      1. Lowers BP
  3. Ca channel blocker
    1. Amlodipine
      1. Dilates Coronary artries
3. Nutritional therapy
  1. Heart healthy eating
    1. Avoid trans and saturated fat
    2. Limit Alcohol intake
      1. Raises BP & tryglycerides levels which leads to weight gain
      2. Women < 1 drink
      3. Men < 2 drinks
4. Quit smoking
  1. Harms blood cells
  2. Damages structure of heart and blood vessels
5. Managing stress
6. Surgical treatment
  1. PCI (Angioplasty)
    1. Non-surgical procedure
      1. opens blocked Coronary artries
        A tube with a ballon on the end is threaded through a blood vessel to the blocked artery
        ballon compresses the plaque against wall of the artery
  2. Coronary artery bypass grafting
    1. A healthy vein or artery from the body is connected to the blocked artery
      1. grafted artery bypasses the blocked artery
        creates new path for oxygen rich blood to enter the heart
  3. Cardiac Rehab
    1. Medically supervised program that helps improve the well-being of heart patients
      1. Doctors
      2. Nurses
      3. Exercise specialist
      4. PT and OT
      5. Dietician
      6. Nutritionist
    2. Doctors prescribe rehab after Angioplasty or heart attack
    3. there is two types of Rehab
      1. Education & counciling
        Help client understand heart condition
        how to adjust to new life style
      2. Exercise training
        Helps clients to exercise safely
        Improves stamina
        Care plan
Development of CAD
1. Injury to epithelium
  1. Local Inflammatory response
    1. C-reactive protein level rise
      1. Unstable plaque formation
      2. LDL oxidation
    2. LDL enters through endothelium lesion
      1. Phagocytosis of LDLs via macrophages
        Foam cell formation
        Fatty streak
        Thickening of arterial wall
        platelet formation and LDL
        smooth muscle proliferation
        Collagen covers the fatty streaks
        Fibrous cap (plaque)
        Inflammation
        Plaque rupture
        Thrombus formation
        Further narrowing artery
        Total occulasion
        Complicated lesion

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Coronary Artery Disease

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	Creado por Sadaf Popal hace más de 7 años