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    Oxy Cad

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    rlinao
    This document discusses coronary artery disease and myocardial infarction. Coronary artery disease occurs when the coronary arteries become narrowed or blocked, limiting blood flow to the heart and potentially causing chest pain or a heart attack. Risk factors include family history, age, gender, hypertension, smoking, obesity, diabetes, and physical inactivity. A heart attack occurs when an area of the heart muscle dies due to lack of oxygen from a blockage of blood flow. Symptoms include chest pain and potential complications are addressed through medications, surgery, monitoring, and lifestyle changes to manage risk factors and prevent future events.

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    Oxy Cad

    Uploaded by

    rlinao
    65 views21 pages
    This document discusses coronary artery disease and myocardial infarction. Coronary artery disease occurs when the coronary arteries become narrowed or blocked, limiting blood flow to the heart and potentially causing chest pain or a heart attack. Risk factors include family history, age, gender, hypertension, smoking, obesity, diabetes, and physical inactivity. A heart attack occurs when an area of the heart muscle dies due to lack of oxygen from a blockage of blood flow. Symptoms include chest pain and potential complications are addressed through medications, surgery, monitoring, and lifestyle changes to manage risk factors and prevent future events.

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    This document discusses coronary artery disease and myocardial infarction. Coronary artery disease occurs when the coronary arteries become narrowed or blocked, limiting blood flow to the heart and potentially causing chest pain or a heart attack. Risk factors include family history, age, gender, hypertension, smoking, obesity, diabetes, and physical inactivity. A heart attack occurs when an area of the heart muscle dies due to lack of oxygen from a blockage of blood flow. Symptoms include chest pain and potential complications are addressed through medications, surgery, monitoring, and lifestyle changes to manage risk factors and prevent future events.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    65 views21 pages

    Oxy Cad

    Uploaded by

    rlinao
    This document discusses coronary artery disease and myocardial infarction. Coronary artery disease occurs when the coronary arteries become narrowed or blocked, limiting blood flow to the heart and potentially causing chest pain or a heart attack. Risk factors include family history, age, gender, hypertension, smoking, obesity, diabetes, and physical inactivity. A heart attack occurs when an area of the heart muscle dies due to lack of oxygen from a blockage of blood flow. Symptoms include chest pain and potential complications are addressed through medications, surgery, monitoring, and lifestyle changes to manage risk factors and prevent future events.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 21

    CORONARY ARTERY DISEASE

    The disorder of the coronary arteries that


    disrupts bld supply to the myocardium.
    Permanent disruption of bld flow causes
    myocardial dysfxn, including sudden death.

    CARDIOVASCULAR RISK FACTOR PROFILE
    family hx of heart dse
    sex Males: 35-55yrs
    - Females: > 50 yrs or p menopause
    hpn
    smoking
    overwt or obesity
    elevated serum level of lipids & fats
    DM
    physical inactivity; sedentary lifestyle
    stress
    for women < 50 yrs: use of estrogen & smoking
    ATHEROSCLEROSIS the basic underlying dse
    affecting coronary lumen size, is marked by
    changes in the intimal lining of the arteries.
    - obstructions of more than 75% of the
    lumen of one or more of the three coronary
    arteries inc. the risk of death.

    ANGINA PECTORIS chest pain
    - used to describe pain as a symptom of
    myocardial ischemia w/c is the result of an
    imbalance bet myocardial O2 supply & demand.

    MYOCARDIAL INFARCTION development of
    ischemia & necrosis of myocardial tissue. It results
    from the sudden decrease in coronary perfusion
    or an increase in myocardial O2 demand w/o
    adequate coronary perfusion

    PATHOPHYSIOLOGY
    Waxy cholesterol plaque
    - Pearly grey mounds of tissue
    Deposit in the inner lining of the arteries
    Rough surface
    Attract platelet & fibrin
    Narrowing & less vessel wall surface
    Prevent absorption of
    nutrients by vessel wall
    Vessel wall weakens
    Distension of the vessel
    wall
    aneurysm
    Depress
    adjacent
    tissues
    rupture
    hemorrhage
    Blocking of vessel
    amt of bld the different
    parts of the heart
    Myocardial ischemia
    Angina
    pectoris
    Sudden
    cardiac death
    Myocardial
    infarction
    Area of
    concern
    Stable angina
    pectoris
    Variant
    (Prinzmetals)
    angina
    Unstable angina
    pectoris
    Myocardial
    infarction
    Chest
    Pain
    quality
    Aching, sharp,
    tingling or
    burning
    Similar to
    stable angina
    Similar to
    stable angina
    Crushing,
    squeezing,sta
    bbing,
    oppressive or
    as if a heavy
    obj sitting on
    the chest
    location
    &
    radiation
    Substernal w/
    radiation to L
    shoulder, down
    the inner
    aspect of L or
    both arms;
    neck, jaw, &
    scapula
    Similar to
    stable angina
    Similar to
    stable angina
    Retrosternal
    & L precordial
    radiating
    down L arm &
    to the neck,
    jaws, teeth,
    epigastric
    area, & back
    Area of
    concern
    Stable angina
    pectoris
    Variant
    (Prinzmetals)
    angina
    Unstable
    angina
    pectoris
    Myocardial
    infarction
    Precipitating
    factors
    Exercise or
    activity that
    myocardial
    O2 demand
    Onset at rest;
    pain is cyclic,
    often occuring
    during sleep
    Pain may be
    brought on w/
    less than
    usual
    exertion; may
    occur at rest
    May occur at
    reat or during
    exercise
    Duration &
    alleviating
    factors
    3-15 mins;
    relieved by
    rest, stopping
    pain-inducing
    activies,
    nitroglycerine
    SL
    Pain
    intensifies
    quickly, tends
    to last longer
    than angina &
    subsides w/
    exercise
    Prolonged &
    not ususally
    as quickly
    relieved by
    rest or taking
    nitroglycerine
    Continuous,
    lasting more
    than 30 mins,
    unrelieved by
    rest, position
    change or
    taking
    nitroglycerine
    Diagnosis
    ECG
    Cardiac enzymes
    CBC, ESR
    lipid levels
    Exercise Stress Test
    Cardiac catherterization & angiography
    Cardiac profile
    Cardiac
    enzyme
    Normal value with Acute Myocardial Infarction
    onset peak Duration
    Troponin I 0 ng/ml
    (> 1.5 ng/ml is dx
    for MI)
    3.5 7 hrs 4 6 days
    CPK 96 140 IU/L (F)
    38 174 IU/L (M)
    4 6 hrs 12 - 24 hrs 3 -4 days
    CPK MB 0 24 48 hrs 12 24 hrs 2 3 days
    SGOT 6 18 IU/L (F)
    7 21 IU/L (M)
    12 18 hrs 24 48 hrs 3 -4 days
    LDH 70 180 mg/dl 24 48 hrs 3 6 days 7 10
    days
    Other associated manifestations
    anxiety
    dyspnea
    nausea & vomiting
    cold clammy skin
    epifastric pain
    low grade fever
    leucocytosis
    ECG changes
    - injury: elevated ST
    - ischemia: inverted T wave
    - infarction: significant or
    deep Q wave
    Management
    medications
    - vasodilators
    - antihyperlipidemic agents
    - streptokinase
    - antiplatelet agent (aspirin)
    - diperidamole
    surgery
    - CABG (Coronary Artery Bypass Grafting)

    - PTCA (Percutaneous Transluminal
    Coronary Angioplasty)
    general mgt
    - CV monitoring: arrhythmias, heart failure, extension of
    MI, cardiogenic shock, ventricular muscle rupture
    - ECG
    - IABP (Intra-Aortic Balloon Pump)
    - admission to CCU
    - Diet: Acute phase NPO or clear liquids progressing
    to 1500 cal, soft, low salt; no caffeine; small
    frequent feedings
    Discharge diet reduced saturated fats, cholesterol,
    Na restriction, limit total caloric consumption to
    maintain IBW
    - oxygenation
    Angina Pectoris
    1. Stop activity. Rest
    2. Nitroglycerine SL
    3. Pearls of Amyl nitrate
    4. Whiskey or brandy
    5. Beta-blockers
    6. Ca channel blockers
    Myocardial infarction
    1. Reduce pain & promote
    comfort Morphine SO4; O2;
    semifowlers
    2. Maintain adequate bld
    circulation
    3. CBR
    4. Diet
    5. Facilitate fecal elimination
    6. Promote adequate sexual
    expression
    7. Encourage gradual return to
    usual activities
    NSG MGT

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