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THE CARDIOVASCULAR SYSTEM

CORONARY ARTERY DISEASE


By : Group 3

ANATOMY AND PHYSIOLOGI THE CARDIOVASCULAR SYSTEM


Heart The heart is greatest in the cardiovascular system. The heart has 2 sides: Right side & left side The heart have 4 roows: right atrium, left atrium, right ventricle, left ventricle

BLOOD VESSEL

The blood vessel:

Arteries arterioles Capilllaries Venules Veins

CORONARY ARTERY DISEASE

PATOPHYSIOLOGI
Pathophysiology disorder as the discussion of abnormalities in other organs, the discussion of abnormalities in the arteries is also differentiated by the underlying process, namely: congenital abnormalities, inflammatory disorders, degenerative disorders, immunologic disorders, neoplasms and other disorders is unclear pathophysiology.

TYPES AND CLASIFICATION


Acute Coronary Syndromes . Advanced Ischemic Heart Disease . Bifurcation Blockage Heart Attack (Myocardial Infarction) Microvessel Disease Stent Restenosis Total Coronary Occlusion

ETIOLOGY
Causes
Atherosclerosis Congenital defects to become trapped narrowing the vessels

Why
Fatty plaques deposit and narrow the arteries over time Irregular vessel shapes can cause plaques and other debris

Coronary artery spasm

Creates a temporary vessel blockage


An aneurysm creates a bulging out of the vessel wall due to pressure. This can cause atherosclerotic plaque formation at

Dissecting aneurysm

the site of the aneurysm, which causes further weakening of

the artery wall. A blood clot may form at the site and
dislodge, increasing the chance of stroke Inflammation of the vessels contributes to growth of plaque Infectious vasculitis in the arteries

If left untreated, syphilis can cause inflammation of the


Syphilis vessels, which leads to growth of plaque in the arteries CRP levels rise when there is protein (CRP) inflammation. High blood levels of C-reactive The inflammation process contributes to the growth of protein (CRP)

plaque in arteries

Unhealthy blood cholesterol levels. High blood pressure. Smoking. Insulin resistance Diabetes Family history of early heart disease. Lack of physical activity Overweight or obesity. Age Unhealthy diet

CLINICAL APPEARANCES
Signs and symptoms Why The arteries become narrowed due to fatty plaque buildup (atherosclerosis) and MI not enough oxygen reaches the heart, causing ischemia The arteries become narrowed due to fatty plaque buildup (atherosclerosis) and Angina not enough oxygen reaches the heart, causing ischemia. The ischemia causes chest pain High blood pressure

Atheromas grow, causing narrowing of the arteries and calcium accumulation in


the arteries Decreased elasticity of the arteries and the narrowed lumen contribute to

Decreased peripheral pulses

decreased peripheral circulation Angina Decreased blood flow prevents oxygenation of the brain Angina Decreased peripheral circulation Decreased cardiac output leads to decreased lung perfusion

Nausea and vomiting Fainting Sweating Cool extremities

Shortness of breath

DIAGNOSTIC ASSESMENT
EKG (Electrocardiogram) Blood Tests Chest X Ray Ankle/Brachial Index Echocardiography Computed Tomography Scan Stress Testing Angiogram Electron beam computerized tomography (EBCT): Magnetic resonance angiography (MRA): Myocardial perfusion imaging with thallium 201 during treadmill exercise

Risk

factor for Coronary Artery Disease include dyslipidemia, smoking, hypertension, male gender (women are protected until menopause), aging, nonwhite race, family history, obesity, sedimentary lifestyle, diabetes mellitus, metabolic syndrome, elevated homocysteine, and stress.

THE THERAPY
blockers,

and angiotensin converting enzyme inhibitors) to promote a favorable balance of oxygen supply and demand. Antilipid medications to decrease blood cholesterol and tricglyceride levels in patients with elevated levels. Antiplatelet agents to inhibit thrombus formation. Folic acid and B complex vitamins to reduce homocysteine levels

......
Coronary

angioplasty, or balloon angioplasty Coronary artery bypass graft operation: Atherectomy, Laser angioplasty

Monitor blood pressure, apical heart rate, and respirations every 5 minutes during an anginal attack. Maintain continuous ECG monitoring or obtain a 12-lead ECG, as directed, monitor for arrhythmias and ST elevation. Place patient in comfortable position and administer oxygen, if prescribed, to enhance myocardial oxygen supply. Identify specific activities patient may engage in that are below the level at which anginal pain occurs. Reinforce the importance of notifying nursing staff whenever angina pain is experienced. Encourage supine position for dizziness caused by antianginals.

NURSING INTERVENTION

Be alert to adverse reaction related to abrupt discontinuation of beta-adrenergic blocker and calcium channel blocker therapy. These drug must be tapered to prevent a rebound phenomenon; tachycardia, increase in chest pain, and hypertension. Explain to the patient the importance of anxiety reduction to assist to control angina. Teach the patient relaxation techniques. Review specific factors that affect CAD development and progression; highlight those risk factors that can be modified and controlled to reduce the risk.

TERIMA KASIH ATAS

PERHATIANYA