Coronary Artery Disease 2 SV - Coronary Heart Disease Coronary Blood Supply Right Coronary(RCA Right Side of Heart Left Coronary Divides into Left

Coronary Artery Disease 2 SV - Coronary Heart Disease...

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Coronary Heart DiseaseDr. Sue Bhati
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Coronary Blood SupplyRight Coronary (RCA)Right Side of HeartLeft Coronary - Divides into Left circumflex (LCX)Posterior heartAnterior Descending (LAD)•Anterior MyocardiumLeft ventricle
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Coronary AtherosclerosisNarrowing and/or Blockage of Coronary VesselsD/T Accumulation of Lipids, Fatty Substances, & Fibrous TissuesSlow chronic Process – May begin in ChildhoodGenetic & Environmental FactorsInflammatory Process (Macrophages, Monocytes, WBCs)Plaque Ruptures Thrombus Formation ObstructionMyocardial Infarction (MI)
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Coronary Artery Disease (CAD)EtiologyCardiovascular Disease (CVD) is leading cause of death in U.S. •Balance Between O2Supply & DemandAtherosclerosis Narrowing or BlockingVasospasms, Congenital Anomalies, Trauma, Hypovolemia, O2DemandBlood flow to the heart is inadequate Possibility of ischemia or injury
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Coronary Artery Disease (CAD)Risk Factors - Non-ModifiableAge - M > 45 Years & F > 55 Years Race -Risk African Americans, Mexican Americans, Native Americans Genetics - Family HxRisk Factors – ModifiableHypertension (HTN)Smoking↑ Serum Cholesterol Diabetes MellitusObesity – Metabolic Syndrome - BMIPhysical inactivity
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Metabolic SyndromeDiagnostic Criteria – Three (3) of the FollowingInsulin Resistance – Fasting glucose > 100 Abdominal Obesity – WC > 35” for & > 40” for Dyslipidemia HypertensionProinflammatory State - (C-Reactive Protein CRP) Prothrombotic state- (Fibrinogen)
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Coronary Artery DiseaseClinical ManifestationsSilent CAD Weakness - More common in ElderlyAngina Pectoris Chest Pain d/t Myocardial IschemiaMyocardial Infarction Death of Myocardial CellsAcute onset C/P Sub-sternal, but also Jaw, back Arm, shoulder esp. Left Arm, Epigastric discomfortShortness of Breath Extreme fatigueDiaphoresisN/VPersistent damage over time Remodeling & Scar tissue Formation Cardiac Output Sudden Cardiac Death
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Treatment- AnginaSurgicalPTCALaser AngioplastyVascular StentCABGMedicationsNitritesCalcim chnnel blockersCholesterol lowering medicationsbetablockers9
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Coronary Artery DiseasePreventionCholesterol ManagementFasting Lipid Profileevery 5 Years or more frequently if warrantedAfter Acute Event (MI, PCI, CABG)HDL – Protective EffectDiet – Limit or eliminate saturated/trans FatsPhysical ActivityPharmacology - Statins
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Coronary Artery DiseasePreventionHypertensionEarly DetectionManagement of HTNWeight LossExercisePharmacologyDiabetes MellitusHyperglycemia Thrombus FormationEarly Detection & Management of BGLDietAnti-Glycemic Pharmacology
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Patterns of AnginaStable Angina: Predictable & Consistent Pain relieved by rest or nitroglycerin
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  • Fall '14
  • acute myocardial infarction, coronary artery

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