BATHOLOGY

Coronary artery disease

 NUMB ER CONTE NT
I N D EX
1 Introduction

2 Aetiology and pathogenesis

3 Prognosis

4 Treatment

5 Clinical manifestation

6 Epidemiology

7 Diagnosis

8 Role of ct and mri

 INTRODUCTION

Coronary artery disease represents aspectrum of clinical syndromes causedby

insufficient coronary blood flow tothe myocardium. It is almost always dueto
subintimal atheroma deposition,leading to arterial luminal stenosis orocclusion and
wall thickening. Affectingmore than 1.5 million Americansannually, it is the most
common form ofheart disease, and its complications arethe leading cause of death for
both menand women. According to the AmericanHeart Association, about every
29seconds, someone in the United Statessuffers from a coronary artery disease-related
event, and about every minutesomeone dies from such event.
 What causes coronary artery disease?
CAD is caused by plaque buildup in the walls of the
arteries that supply blood to the heart (called coronary
AETIOLOGY AND arteries) and other parts of the body.Plaque is made up
PATHOGENSES of deposits of cholesterol and other substances in the
artery. Plaque buildup causes the inside of the arteries to
narrow over time ,which can partially or totally block
the blood flow. This process is called atherosclerosis.
 EPIDEMIOLOGY

Coronary artery disease

Coronary heart disease is the most common type of heart disease, killing360,900
people in 2019.4About 18.2 million adults age 20 and older have CAD (about
6.7%).3About 2 in 10 deaths from CAD happen-in adults less than 65 years old.
 CLINICAL MANIFESTATION

• 1-Chest pain (angina):

You may feel pressure or tightness in your chest, as if someone were standing on your chest. This pain, called
angina, usually occurs on the middle or left side of the chest.
• 2-Shortness of breath:
If your heart can’t pump enough blood to meet your body’s needs, you may develop shortness of breath or
extreme fatigue with activity.
• 3-Heart attack:
A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack
include crushing pressure in your chest and pain in your shoulder or arm ,sometimes with shortness of breath
and sweating.
 CT and MR are two noninvasive imaging techniques
that are capable of detecting different aspects of
coronary artery disease (CAD). Both techniques can
ROLE OF CT directly and noninvasivelay visualise the coronary
AND MRI artery tree, allowing detection of atherosclerotic
plaques , coronary stenosis, or occlusion. In addition to
direct anatomic visualization,MR also allows
assessment of stress-induced ischemia.
 Both dobutamine stress and dipyridamole or
adenosine perfusion MR can be used for this
purpose with high sensitivity and specificity.
Both MR and multi detector ct can also reveal the
• CT functional consequences of CAD, that is, reduced
regional and global cardiac function, as well as
the presence of myocardial infarction. Finally,
there is promise that in the future, both techniques
• MRI may predict individual risk of unstable CAD by
identifying vulnerable plaques that are prone to
rupture.
 TREATMENT
1-Lifestyle changes:
• A-Don’t smoke.
• B-Manage health problems like high cholesterol, high
blood pressure and diabetes.
• C-Eat a heart-healthy diet.
• D-Limit alcohol use.
• F-Increase your activity level. Exercise helps you lose
weight, improve your physical condition and relieve
stress.
2-Medications:
• A-Medication to lower your cholesterol levels, such as
statins.
• B-Medications to lower blood pressure , such as beta
blockers.
• C-Medications to stop angina, such as nitrates.
• D-Medications to reduce the risk of blood clots, such
as anticoagulants .
 PROGNOSIS

Coronary Artery Disease (CAD) is treatable, but there is no cure. This means that
once diagnosed with CAD , you have to learn to live with it for the rest of your
life.
 A-Diagnostic tests may include:
1-Electrocardiograph tests (EKG): This test records the
electrical activity of the heart.
2-Exercise stress tests: This is a treadmill test to determine
how well your heart functions when it’s working the
hardest.

DIAGNOSIS 3-Pharmacologic stress test: Instead of using exercise to

test your heart when it is working its hardest, medication is
given to increase your heart rate and mimic exercise.
4-Coronary calcium scan: This test measures the amount of
calcium in the walls of your coronary arteries.
5-Echocardiogram: This test uses sound waves to see how
well the structures of your heart are working and the
overall function of your heart.
6-Blood tests: Many blood tests are ordered for factors that affect arteries, such as
triglycerides, cholesterol, lipoprotein.
7-Cardiac catheterization: This test involves inserting small tubes into the blood vessels of
the heart to evaluate heart function including the presence of coronary artery disease.
B-Other diagnostic imaging tests may include:
1-Nuclear imaging: This test produces images of the heart after administering a radioactive
tracer.
2-Computed tomography angiogram: Uses CT and contrast dye to view 3D pictures of the
moving heart and detect blockages in the coronary arteries.
 • What causes coronary artery disease?

• Is there cure for this disease?

• mention one treatment?

HOT SEAT🪑🔥 • List three clinical manifestations?

 ANY
QUESTIONS?
Student work:
Faisal alrasheed
Mohhamed alzaid
Abdulhamid almoalim
Fahad awaji
 REFERENCES

• https://www.sciencedirect.com/topics/medicine-and-dentistry/coronary-artery-disease
• https://www.cdc.gov/heartdisease/coronary_ad.htm
• https://www.narayanahealth.org/blog/coronary-artery-disease-life-expectancy-and-prognosis/amp/
• https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease
• https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
• https://www.cdc.gov/heartdisease/facts.htm
• https://pubmed.ncbi.nlm.nih.gov/17362688/