CAD_Angina 2014_Student.pptx - Coronary Atherosclerosis and...

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Coronary Atherosclerosis and Coronary Artery Disease CVD CAD Angina Pectoris
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Coronary Artery Disease Restriction of blood flow in the coronary arteries Myocardium is deprived of oxygen- rich blood Most common cause of restriction of blood flow is atherosclerosis Main symptom of CAD is Angina Pectoris
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Atherosclerosis Characterized by atheroma (plaque deposits): an abnormal accumulation of lipid or fatty substances and fibrous tissue in the vessel wall. This process results in CAD It is a progressive disease which can be curtailed and in some cases reversed.
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A Cross-Section of Atherosclerotic Coronary Artery Slide 40.1 Back Back
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Risk Factors of CAD Non-modifiable Age Gender Genetic factors Family behaviors Family history Ethnic background Modifiable Smoking Poor nutrition Obesity Stressful life- style Physical inactivity
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Risk Factors: Others Hypertension Hyperlipidemia: excessive amounts of lipids (fats) in the blood stream Diabetes: Glucose intolerance Metabolic syndrome: abdominal obesity, hyperlipidemia, insulin resistance, > tendency for clotting and inflammation Female risk factors: oral contraceptives, HRT, premature menopause
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Lipid Profile Standard lipid profile measures total cholesterol high density lipoprotein (HDL) low density lipoprotein (LDL)
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Cholesterol Levels > 240high risk for cardiac event 200-239 borderline high risk for cardiac event <200 low risk for cardiac event Cholesterol is produced by the liver- helps to build healthy cells. Present in some foods
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Lipoproteins: LDL Carry cholesterol in the blood stream LDL :“bad cholesterol”: increased levels, increased risk Desirable low levels <100 mg/dl Methods to lower LDL: diet, exercise, pharmacological agents
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Lipoproteins: HDL Carry cholesterol in the blood stream HDL: “good cholesterol”, believed to assist in the removal of excess cholesterol from the body and block uptake of LDL Desirable level: > 60 mg/dl Methods to raise HDL: diet exercise, weight loss
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Medications Please refer to Smeltzer text p. 761 Medications affecting lipoprotein metabolism. If diet alone does not control cholesterol, medication might need to be added.
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Antihyperlipidemic Agents (2) 1. HMG-CoA Reductase Inhibitors (statins) Simvastatin /Zocar Lovastatin / Mevacor Pravastatin / Pravachol Decrease the manufacture of cholesterol in the liver by enzyme inhibition. Contraindicated in liver disease Maximum effects may take up to 6
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Antilipids 2. Bile-Acid Sequestrants Cholestramine / Questran Binds bile acids (Cholesterol) in the intestines into insoluble complexes for excretion in the stool.
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  • Spring '14
  • Brinkley
  • Atherosclerosis, angina pectoris, Simvastatin, Total calories, Include intake of fiber

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