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Coronary Artery Disease

Coronary Artery Disease

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Published by Darell M. Book

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Published by: Darell M. Book on Mar 11, 2010
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05/23/2012

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Coronary Artery Disease (CAD)Myocardial IschemiaAngina PectorisMyocardial InfarctionIrreversible damage to the myocardiumScar tissue formationCardiac dysfunctionHeart FailureCardiac Dysrhythmias/Arrest
CORONARY ARTERY DISEASE
An abnormal condition that may affect the heart’s arteries and produce various pathologiceffects especially reduced flow of oxygen and nutrients to the myocardium.
Angina Pectoris is the classic symptom of CAD and results from myocardial ischemia.
Coronary Atherosclesrosis an abnormal accumulation of lipid or fat substances andfibrous tissue in the lining of arterial blood vessel wall that blocks and narrows thecoronary vessels leading to a reduced blood flow in the myocardium.
Risk Factors:
 A. MODIFIABLEB. NON-MODIFIABL
-Hyperlipidemia- Family History-Smoking- Increasing Age-HPN, DM- Gender (men>women)-Obesity- Race (African American)-Physical Inactivity-Lack of estrogen in women
Management:
Control cholesterol abnormalities
 Diet:
LSLF, high fiber 
Smoking cessation
Managing HPN and DM
Physical Activity:a.30 mins. regular moderate exercise (brisk walking) b.5 mins. warm-up and cool down periodc.Instruct to wear loose fitting clothingd.STOP if chest pain, unusual SOB, dizziness, lightheadedness or nausea occurs
Medications:a.
Statins (HMG-CoA reductase inhibitors)
– blocks cholesterol synthesis, decreasesLDL & triglycerides, increases HDL levels. Eg. Simvastatin, Provastatin
Side Effects:
Myopathy, Hepatotoxic b.
Nicotinic Acid (Niacin)
– decreases lipoprotein synthesis, decreased LDL &triglyceride, increased HDL levels.
Side Effects:
GI upset, gout, flushing, & Hepatotoxicc.
Fibric Acid/Fibrates
– decreased synthesis of cholesterol, decreased triglycerides,increased HDL levels.
Side Effects:
Use cautiously with “statins” can cause Myopathy & ARF, dyspepsia, &gallstones.d.
Bile Acid Sequestrants/Resins (cholestyramines)
– bind cholesterol in theintestines, increase its breakdown & decrease LDL levels with little effect on HDL’sand no effect on triglycerides.

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