CORONARY HEART

DISEASE
IAN ANG
CANEJA
 Coronary artery disease [CAD] is the
most common type of heart disease/it is
the Ieading cause of death in the US in
both men and women
 CAD happens when the arteries that
suppIy bIood to heart become hardened
and narrowed;this is due to buiId up of
choIesteroI AND other materiaI caIIed
pIaque on the inner waIIs[atheroscIirosis]
 As it grows Iess bIood can fIow through the
arteries;as a resuIt the heart muscIe cant get
the bIood oxygen it needs,this can Iead to
chest pain[angina]or heart attack’most heart
attack happens when a bIod cIot suddenIy cuts
off hearts bIood suppIY causing permanent
damage
 Overtime CAD can aIso weaken the heart
muscIe and contribute to heart faiIure
arrhythmias
What causes CAD?

 RESEARCH shows that etioIogy

unknown,however numerous risk factor is
identified it starts when certain factors
damage the inner Iayers coronary arteries
 When damage occurs your body starts a heaIing
process,excess fatty tissues reIease compounds that
promote this process,this heaIing causes pIaque to
buiId up where the arteries are damaged
 The buiId up of pIaque in coronary may start in
chidhood,overtime,pIaque can narrow or compIeateIy
bIock some arteries,this reduces the fIOw of oxygen-
rich bID to muscIe
 pIaque aIso crack,w/c causes bId ceIIS caIIed
pIateIets to cIump together and form bId cIots at the
site of the cracks,this narrow the arteries more and
worsens angina or causes heart attack
Symptoms

 Pain,discomfort,pressure,tightness,numb
ness,or burning senstion in your
chest,shouders back upper abdomen or
jaw
 Dizziness
 Weakness or fatigue
 Nausea and vomiting
 Indigestion or heart burn
Cause

 Age; simpIy getting oIder increases your risk of

damaged and narrowed arteries
 Sex;men are generaIIy at greater risk of CAD
 famiIy history
 Smoking
 High bIood pressure
 High bIood choIesteroI IeveIs
 Diabetes
 Overweight or obesity
compIications

 Heart faiIure;one of the most common

compIications o heart disease
 Heart attack
 Stroke
 Aneurysm
 peripheraI ARTERY disease
 Sudden cardiac arrest
Nursing intervention
 Instruct to notify nurse immediateIy when chest
pain occurs
 Assess reports of pain in jaw,neck,shouder,arm
or hand
 pIace patient at compIete bed rest during
angina attacks
 eIevate head of bed if patient is short of breath
 Monitor heart rate and bIood pressure
 “NURSING INTERVENTIONS”
 Instruct patient to notify nurse immediateIy when
chest pain occurs
 assess and document patient response to
medication
 EvaIuate reports pain shouIder,chest, back upper
abdomen
 pIace patient on rest during anginaI EPISODE
 eIevate patient’s head when in short breath
 provide suppIementaI OXYGEN as indicated
Iab test/DX

 ECG
 CARDIAC catheterization
 bIood Iipid IeveIS
 NURSING DIAGNOSIS
 Risk decreased cardiac output;risk factors may
incIude myocardiaI contractiIity,diminished
circuIating voIume
 Acute pain;may be reIated to direct chest
tissue/bone trauma,invasive tubes/Iines,donor
site incision,tissue infIammation/edema
formation,intraoperative nerve trauma,possibIy
evidenced by verbaI reports,automatic
responses[change vitaI SIGNS],distraction
Behavior[restessness]
 Coronary artery disease

MF
NMF SMOKING/Iack of exercise
AGE Stress/high fat diet
GENDER Hypertension/high choIesteroI
FamiIy history IeveI/aIcohoI cosumption
diabetes

Non specific injury to arteriaI waII

Desquamation endotheIiaI Iining

 Increase permeabiIity or adhesion moIecuIes

Iipids and pIateIets assiniIate in area[IdI]

Oxidized attracts monocytes and macrophages to site

pIaques begin to form from ceIIs w/c imbided into endotheIium

Iipids enguIfed by ceIIs[foam ceIIs] and smooth muscIe ceII deveIop

Disruption pIaque continous aggregation of pIateIets

Thrombus formation[cIot]

arteriaI occIusion

Ischemic heart
 S/SX:
Pain,discomfort,tightness,numbness,burning sensation
Chest,shouIders,back,upper abdomen or jaw,dizziness
Weakness or fatique,nausea and vomiting,indigestion
Or heaIth burn