Coronary Artery Disease (CAD)

Introduction

• Coronary Artery Disease (CAD): Abbreviation for coronary artery disease, characterized by fatty deposit buildup within coronary arteries.
• Relevant Text: Starts in Chapter 27, page 430.

Pathophysiology

• Fatty Deposit Buildup: Impedes blood flow, reducing perfusion, leads to ischemia in parts of the heart.
• Atherogenesis: Buildup of cholesterol and lipids within the artery.

Risk Factors

Modifiable Risk Factors

• Hypertension: Can be controlled by diet, medication.
• Smoking: Cessation is important.
• Obesity and Diabetes Mellitus: Maintain glycemic control.
• Dyslipidemia: Elevated plasma cholesterol (triglycerides and cholesterol are primary forms of blood lipids).
  • HDL vs LDL:
    • HDL (High-Density Lipoproteins): Good cholesterol, desired to be higher.
    • LDL (Low-Density Lipoproteins): Bad cholesterol.
• Physical Inactivity: Encouraged to become more active.
• Diet: Lower salt and fat, increase vegetables and fiber.

Non-Modifiable Risk Factors

• Age and Gender: Males at greater risk, pre-menopausal females also at risk.
• Ethnicity: Caucasians at higher risk than African Americans.
• Genetic Predisposition: Family history of heart disease.

Management

• Lifestyle Changes: Important for modifiable risk factors.
• Pharmacologic Treatment: Adherence to prescribed regimens.
• Monitoring: Blood pressure, glucose, and lipid control.

Nursing Actions

• Risk Factor Assessment: Evaluate patient's risk factors and compliance.
• Patient Education:
  • Teach about lifestyle changes, medication compliance.
  • Discuss potential severe outcomes of non-compliance.
• Facilitate Referrals: Weight reduction, cardiology, endocrinology if diabetic.