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Coronary Artery Disease
Transcript of Coronary Artery Disease
• Coronary Artery Disease (CAD) can be defined as “the narrowing of the small blood vessels that supply blood and oxygen to the heart” (Herman, 2013)
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CAD generally occurs when artherosclorotic plaque(composed mainly of LDLs) deposits on the walls of the coronary artery, which supplies oxygen and nutrient rich blood to the cardiac muscle.
These plaque deposits cause the narrowing of the artery lumen which, as build up of plaque occurs over time, causes a significant decrease in the amount of blood and nutrients being delivered to the muscle
Additionally, the plaque can remain dormant on the walls of the artery, however, some plaque can become unstable and undergo thrombosis, where blood platelets adhere to the plaque and cause it form a thrombus
SYMPTOMS OF CAD
Typical symptoms of CAD can include unexplained fatigue and dizziness
The build up of these fatty deposits occur slowly over time since childhood
symptoms of angina (chest pain) can are also very common in persons with CAD. This is identified by a painful squeezing and burning feeling in and around the thoracic area of the body
Angina is often confused with indigestion by many persons with undiagnosed CAD, leaving them very vulnerable to more fatal aspects of the disease .
another sign of CAD is hypertension
“coronary heart disease is now the leading cause of death worldwide; it is on the rise and has become a true pandemic that respects no borders” (WHO, 2009)
Living with CAD
There are multiple methods of diagnosing CAD, some invasive and some non- invasive.
The main diagnostic techniques are:
PERSONS AT RISK
persons most at risk of developing CAD are commonly of the age of 55 and over
persons that have a high LDL cholesterol rating
persons who maintain an unhealthy diet of foods with high in LDLs
Persons with a family history of heart diseases
Persons who have been deemed clinically obese or overweight
Persons that smoke
EKGs are a non-invasive diagnostic procedure in which electrodes are attached to various parts of the body
these electrode pads measure the electrical activity of the heart which is picked up by a ECG machine which produces an ECG graph
The ECG pattern produced is interpreted by trained personnel and can indicate any abnormalities associated with CAD
while the non-invasive aspect of ECGs appeals to many patients, ECGs have a high level of specificity in detection, but a low sensitivity rating which leads to some inaccuracy and can result in misdiagnosis
According to epidemiological research
it is evident that the independent risk factors for CAD include:
In order to reduce the chances of CAD or the risks of CAD using treatment that are recommended for risk factors such as; cigarette smoking, diabetes, hyperlipidemia, and hypertension are recommended. It can control. These include :
• Quit smoking.
• Eat healthy foods.
• Exercise regularly.
• Lose excess weight.
• Reduce stress
How to reduce risk
CAD is the most common form of heart disease. CAD is defined as more than 50% angiographic diameter stenosis in one or more of the epicardial coronary arteries.
an ultrasound that essentially gives an image of the movement of the heart and its vessels
Why does it occur?
CAD is caused through the build up of plaque in the inner lining of an artery . Overall this is caused by lifestyle choices.
it is generally a 30 minute analysis where a transducer is run across the thoracic region using gel medium which helps sound wave transmission
based on the motion of the vessel, it can be determined if too little oxygen is being delivered to that reigon , which can indicated blockage or in this case CAD
Termed "the gold standard" for diagnosing CAD
-Calcium channel blockers.
-Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
it is an invasive technique where a catheter containing dye is inserted in to the body and maneuvered through blood vessels to the heart region
The dye is then released and travels through the heart . An X-ray of the heart and its vessels can pick up the presence of the dye and indicate where plaque blockages and blood clots are located
CAD can not be permanently removed but its state can be altered through:
life style alterations
Cholesterol modifying medicine decreases the amount of cholesterol in your blood, specifically targeting the low-density lipoprotein (LDL, or the "bad")cholesterol. The LDL is what In some cases the doctor might recommend boosting you HDL (High density lipoprotein, or the good cholesterol)
Cholesterol modifying medicine
Beta blockers significantly slow down your heart rate and decrease your blood pressure. This in return decreases the amount of oxygen you will require or demand.For patients that have had heart attack in the past beta blockers can reduce the risk of having future attacks.
Nitroglycerin comes in the form of tablets, sprays or patches and can be used to control angina or chest pain. This occurs by opening up your coronary arteries causing a dilation of the artery and reducing your heart's demand for blood.
ACE and ARBs in full is referred to as Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are similar drugs that decrease blood pressure and may help prevent progression of coronary artery disease. If you've had a heart attack, ACE inhibitors reduce the risk of future attacks.
ACE and ARBs
Calcium channel blockers are recommended by physicians to help relax the muscles that surround your coronary arteries. These medications cause the vessels to open, increasing blood flow to your heart. These drugs are also recommended by physicians for patients with high blood pressure
Calcium channel blockers
Aspirin is a blood thinner that is sometimes prescribed by doctors for CAD patients in order to reduce the chances of a blood clot. Reducing the risk of a blood clot can prevent obstruction of the patients coronary arteries. For patients that have had a heart attack sometime the aspirin can prevent future attacks.
•Angioplasty and stent placement
When perform in angioplasty the physician inserts a catheter into the part of the artery that is narrowed due to plaque buildup and slowly inflates the balloon at the end. This in return pushes against the walls of arteries and compresses the plaque against the walls during the process. Usually stent is left in that place during this process to keep the artery open while it slowly releases medications which helps keep the artery open.
In this procedure the surgeon creates an alternate pathway for blood to flow through. A vessel from another body part is used to divert the flow of blood through the blocked area. As this procedure requires open heart surgery it is not recommended until the severity of the condition rises to several narrowed coronary arteries.
surgical procedures cont...
Coronary Artery Bypass Surgery
By : Vithusha Sudhaskaran