Coronary Artery Disease

(Coronary Heart Disease)

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Is a condition in which plaque builds up inside the coronary arteries (atherosclerosis). These arteries supply oxygen-rich blood to your heart muscle. It is the most prevalent type of cardiovascular disease in adults. Atherosclerosis, an abnormal accumulation of lipid, or fatty substances, and fibrous tissue in the lining of arterial blood vessel walls. Atherosclerosis involves a repetitious inflammatory response to injury of the artery wall and subsequent alteration in the structural and biochemical properties of the arterial wall.

SIGN & SYMPTOMS The most common symptoms of coronary artery disease are:
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Chest pain or discomfort, also called angina. Shortness of breath when exercising or during another vigorous activity.

Other symptoms include:
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A fast heartbeat. Weakness, dizziness, and feeling sick to your stomach (nausea). Increased sweating.


Non-Modifiable Risk Factors

Modifiable Risk Factors

Family History Increasing Age Gender Race

Hyperlipidemia Tobacco Smoking Hypertension Diabetes Mellitus Metabolic Syndrome Obesity Physical Inactivity

A mesh tube (stent) may then be used to keep the dilated artery open. flexible tube (catheter) that is threaded through an artery. can help your doctor visualize your arteries. to the arteries in the heart. CT scan. For example. your doctor may do an ultrasound before and after you exercise on a treadmill or bike.   . to check for areas of narrowing or blockages. EBCT. your doctor may inject a special dye into your arteries (intravenously). your doctor may ask you to walk on a treadmill or ride a stationary bike during an ECG. During an echocardiogram. also can generate images of your heart arteries. An echocardiogram uses sound waves to produce images of your heart. If a substantial amount of calcium is discovered. The dye is injected into the arteries of the heart through a long. coronary artery disease may be likely. This may indicate coronary artery disease or various other conditions. usually in the leg. Magnetic resonance angiography (MRA). If your signs and symptoms occur most often during exercise. can detect calcium within fatty deposits that narrow coronary arteries. Or your doctor may use medication to stimulate your heart during an echocardiogram. Some stress tests are done using an echocardiogram. Computerized tomography (CT) technologies. Parts that move weakly may have been damaged during a heart attack or be receiving too little oxygen. This procedure uses MRI technology. your doctor can determine whether all parts of the heart wall are contributing normally to your heart's pumping activity. thin. If you have a blockage that requires treatment. in which you receive a contrast dye injected intravenously during a CT scan. often combined with an injected contrast dye.   Cardiac catheterization or angiogram. The dye outlines narrow spots and blockages on the X-ray images.DIAGNOSTIC TEST   Electrocardiogram (ECG) Echocardiogram. A CT coronary angiogram. a balloon can be pushed through the catheter and inflated to improve the blood flow in your coronary arteries. Stress test. To view blood flow through your heart. medication to stimulate your heart may be used instead of exercise. This procedure is called cardiac catheterization. This is known as an exercise stress test. such as electron beam computerized tomography (EBCT) or a CT coronary angiogram. This is known as an angiogram. In some cases. also called an ultrafast CT scan.

Identify specific activities patient may engage in that are below the level at which anginal pain occurs. Because omega 3 is unsaturated fatty acid which is thought to reduce inflammation throughout the body) 7. Monitor blood pressure. highlight those risk factors that can be modified and controlled to reduce the risk.) 5.) Lifestyle changes and understanding the symptoms of heart attack. NURSING INTERVENTION 1.) 6. Be alert to adverse reaction related to abrupt discontinuation of beta-adrenergic blocker and calcium channel blocker therapy.) 6. 2. tachycardia. and respirations every 5 minutes during an anginal attack. 4.) 3. Teach the patient relaxation techniques. Decrease risk factors by not smoking keeping cholesterol in check Exercise (if overweight. increase in chest pain. as directed. MEDICAL MANAGEMENT 1. 5.) 4. apical heart rate.) 4. monitor for arrhythmias and ST elevation. . 6. and hypertension.MANAGEMENT Manage Heart Disease through: 1.) 2.) Nitroglycerin widens arteries Aspirin can prevent clots Beta blockers improve blood flow Ranolazine helps chronic angina Ace inhibitors improve survival after heart attack Lipid management helps control cholesterol that can block arteries. if prescribed. 8. to lose weight but seek help from professionals) Managing Stress Eating healthfully (like eating foods rich in omega 3 like fish and fish oil. 7. Place patient in comfortable position and administer oxygen. Encourage supine position for dizziness caused by antianginals.) 2. Maintain continuous ECG monitoring or obtain a 12-lead ECG. to enhance myocardial oxygen supply.) 3. These drug must be tapered to prevent a “rebound phenomenon”. 9. Explain to the patient the importance of anxiety reduction to assist to control angina. 3. Reinforce the importance of notifying nursing staff whenever angina pain is experienced.) Take prescribed medications and see a cardiologist regularly.) 5. 10. Review specific factors that affect CAD development and progression.

) Garlic 5.nhlbi.webmd. This includes: 1.php? Cocoa    http://www.) Oat bran found it oatmeal 6.mayoclinic.ALTERNATIVE MEDICINE .) Omega 3 fatty acids rich foods http://www.) CoenzymeQ10 REFERENCES:  Brunner & Suddarth’s Medical-Surgical Nursing Volume 1 Twelfth Edition (page 756-762)  Medical-Surgical Nursing by Udan Concepts and Clinical Manifestation Secon Edition 2009 (page 159-170)  http://www.) Barley 3.Supplements that will reduce your blood pressure and cholesterol .nih.

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