CORONARY ARTERY DISEASES

DEFINITION:-

It is also known as ischemic heart disease. It is partial or complete obstruction in coronary artery Blood flow due to atherosclerosis (develop fatty plague in inner walls of arteries).

TYPES:-

  • Atherosclerosis
  • Coronary vasospasm
  • Coronary embolism
  • Coronary arteritis


RISK FACTORS:-

  • Hypertension
  • Obesity
  • Diabetes mellitus
  • Smoking
  • Family historty
  • High fatty diet
  • Age
  • Oral contraceptives
  • Physical inactivity.


PATHOPHYSIOLOGY:-

    Due to causes (e.g., high fatty diet, hereditory or other)
    ↓
    Lipids/cholesterol formation on endothelium layer of artery
    ↓
    Formation of fatty streak
    ↓
    Proliferation
    ↓
    Formation of fibrous plaque
    ↓
    Partial/complete blockage in coronary artery


SIGNS AND SYMPTOMS:-

Asymptomatic in early stages.
In later stage: Sign and symptoms arises of heart disease.

  • Anginal Chest pain
  • Symptoms of myocardial infraction
  • Sign and symptoms of heart failure
  • Sudden death.


DIAGNOSTIC EVALUATION:-

  • Chest Pain
  • By ECG (ST elevation)
  • Nitroglycerin test (patient feel relief after taking nitroglycerine)
  • Coronary Angiography (it shows CAD)
  • Cardiac catheterization (it shows blockage site of coronary artery).


MEDICAL MANAGEMENT:-

  • Anticoagulates
  • Calcium channel blockers
  • Vasodilators (nitrates)

  • SURGICAL MANAGEMENT:-

    • CABG: (Coronary Artery Bypass Grafting)
      In which a segment of a coronary artery narrow by atheroma is by passed an autologous section of healthy saphenous vein.

    NURSING MANAGEMENT:-

    The first aim should be based on reduction of risk factors.
    Nurses should advice the patient about following:

    • Avoid fatty diet.
    • Control blood pressure.
    • Reduce cholesterol level.
    • Avoid cigarette smoking.
    • Control of diabetes.
    • Maintain exercises



    NURSING DIAGNOSIS

    • Decrease cardiac output related to process.
    • Acute Anginal pain related to ischemia in cardiac muscles.
    • Anxiety related to disease condition.

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