Ch. 38 Care of Patients with Acute Coronary SyndromesCoronary artery disease (CAD)is a broad term that includes chronicstable angina and acute coronary syndromesWhen blood flow through the coronary arteries is partially or completelyblocked, ischemia and infarction of the myocardium may result.Ischemiaoccurs wheninsufficient oxygenis suppliedInfarction(necrosis, or cell death) occurs when severe ischemia isprolonged and decreasedPERFUSIONcauses irreversible damage to tissue.Coronary artery disease (CAD), also calledcoronary heart disease (CHD)orsimplyheart diseaseWhen the arteries that supply themyocardium(heart muscle) are diseased,the heart cannot pump blood effectively to adequately perfuse vital organsand peripheral tissues.Chronic Stable Angina PectorisAngina pectorisis chest pain caused by a temporary imbalance betweenthe coronary arteries' ability to supply oxygen and the cardiac muscle'sdemand for oxygen.Ischemia(lack of oxygen)that occurs with angina is limited in duration anddoes not cause permanent damage of myocardial tissue.two main types: stable angina and unstable anginaChronic stable angina (CSA)is chest discomfort that occurs withmoderate to prolonged exertion in a pattern that is familiar to the patient.The frequency, duration, and intensity of symptoms remain the same overseveral months1.slight limitation of activity2.associated with afixedatherosclerotic plaque3.usually relieved by nitroglycerin or rest and often is managed withdrug therapy4.Rarely does CSA require aggressive treatmentAcute Coronary Syndromeacute coronary syndrome (ACS)is used to describe patients who haveeitherunstableangina or an acute myocardial infarctionatherosclerotic plaque in the coronary arteryruptures,resulting in plateletaggregation (“clumping”), thrombus (clot) formation, and vasoconstrictionUnstable angina (UA)is chest pain or discomfort that occurs at rest or withexertion and causes severe activity limitation
