Handout - Cardiac - CAD (4).rtf - 1 Cardiac CAD Chronic Stable Angina Nursing 2106 \u2013 Adult Health I Coronary Artery Disease(CAD Most common

Handout - Cardiac - CAD (4).rtf - 1 Cardiac CAD Chronic...

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1 Cardiac: CAD: Chronic Stable Angina Nursing 2106 – Adult Health I Coronary Artery Disease (CAD): Most common cardiovascular problem Due to atherosclerosis Asymptomatic or chronic stable angina More serious manifestations of CAD termed acute coronary syndrome (ACS) Unstable angina (UA) Myocardial infarction (MI) Coronary Artery Disease (CAD): Atherosclerosis Blood vessel disorder that is included in the general category of atherosclerosis Begins as soft deposits of fat that harden with age Referred to as “hardening of arteries” Atheromas (fatty deposits) have a preference for coronary arteries Terms to describe the disease process Arteriosclerotic heart disease Cardiovascular heart disease Coronary artery disease (CAD) Coronary Artery Disease: Etiology and Pathophysiology: Collateral circulation: Normally some arterial anastomoses (or connections) exist within the coronary circulation Growth and extent of collateral circulation is attributed to two factors Inherited predisposition to develop new vessels (angiogenesis) Presence of chronic ischemia When occlusion of the coronary arteries occurs slowly over a long period, there is a greater chance of adequate collateral circulation developing Risk Factors for CAD: Risk factors can be categorized as Nonmodifiable risk factors Age Gender Ethnicity Family history Genetic predisposition Modifiable risk factors *Elevated serum lipids *Hypertension *Tobacco use *Physical inactivity Obesity Diabetes Cigarette Smoking: Inhalation of smoke increases the blood carbon monoxide level… Hemoglobin combining with carbon monoxide; therefore, carrying less O2 Chemical irritant, thus causing injury to the endothelium Nicotine triggers release of catecholamines…
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2 Increases HR, peripheral vasoconstriction and BP Increases platelet adhesion… May lead to thrombus formation Linked to decrease levels of estrogen Smoking Cessation Dramatic and almost immediate CAD mortality rates drop to those of nonsmokers within 12 months Nicotine highly additive Follow-up calls and home counseling Nicotine replacement therapy Lipoproteins : (Vehicles for fat mobilization and transport) HDL (high density lipoproteins) Contains more protein and fewer lipids Carry lipids away from arteries and to the liver for metabolism Prevents lipid accumulation within the arterial walls Therefore, ↑ HDL, the ↓ risk for CAD LDL (low density lipoproteins) Contain more cholesterol than other lipoproteins, and has an affinity for arterial walls ↑ levels correlate with ↑ risk for CAD VLDL (very-low –density lipoproteins) Contain both cholesterol and triglycerides May deposit cholesterol directly on the walls of arteries Serum Lipid Levels: Desired levels of LDL… No risk factors < 160 mg/dl Moderate risk < 130 mg/dl Multiple risk factors or CAD < 100 mg/dl
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