Coronary Artery Disease (CAD) Lecture - Part 1
Overview
- Presenter: Sarah from registerednursern.com
- Part of the NCLEX review series for the cardiovascular system
- Part 1 Focus: Definition, Pathophysiology, Signs/Symptoms, Risk Factors, Diagnosis
- Part 2 Focus: Nursing interventions, Medications
What is Coronary Artery Disease?
- Coronary arteries supply a constant blood supply to the heart muscle
- Development of fatty plaques restricts blood flow due to atherosclerosis
- Plaques can rupture, leading to thrombus formation and myocardial infarction
- Associated conditions: Hypertension, Chest pain, Heart failure
Anatomy of Heart Arteries
Key Arteries
- Aorta: Branches into left and right coronary arteries
- Left Coronary Artery (LCA): Branches into the left circumflex artery and left anterior descending artery (LAD)
- Left circumflex artery: Feeds left atrium, back, and side of left ventricle
- LAD: Feeds front and bottom of left ventricle, front of septum
- Right Coronary Artery (RCA): Branches into right marginal artery and posterior descending artery
- Right coronary artery: Feeds right atrium, right ventricle, back of septum, bottom of left ventricle
Collateral Circulation
- Occurs with chronic ischemia, body reroutes blood flow around blockages forming new tiny blood vessels
Pathophysiology of CAD
- Risk Factors: Smoking, Family history, Diabetes, High cholesterol, Obesity, Sedentary lifestyle
- Process:
- Healthy artery with normal blood flow including LDL (bad cholesterol) and HDL (good cholesterol)
- Damage to artery wall causes LDL to stick and form fatty plaques
- Plaques grow, limiting blood flow, leading to symptoms like chest pain during activity (stable angina)
- Plaques may rupture, causing thrombus formation and acute coronary syndrome, leading to unstable angina and myocardial infarction (heart tissue death)
Risk Factors
- Smoking, High cholesterol, Obesity, Sedentary lifestyle
- Diabetes, Family history
- Monitoring these factors is crucial
Signs and Symptoms
- Early stages: Typically asymptomatic
- Progression:
- Chest pain or heaviness with activity (stable angina)
- Shortness of breath, Fatigue
- Unstable angina: Intense chest pain not relieved by rest or nitroglycerin
Diagnosis
- Blood tests: Lipoprotein profile (LDL, HDL, total cholesterol, triglycerides)
- EKG (Electrocardiogram): Checks for issues with ST segment or T waves
- May also use a 24-48 hour Holter monitor
- Stress Test: Monitors EKG under exercise or chemical stress
- Possibly paired with nuclear imaging
- Heart Catheterization (Cath):
- Insertion of catheter into femoral or radial artery, dye injected for x-ray imaging
- PCI (Percutaneous Coronary Intervention) if blockage found, includes balloon angioplasty or atherectomy
- May lead to stent placement or coronary artery bypass graft if necessary
Conclusion
- Visit registerednursern.com for NCLEX review quiz
- Check out part 2 for nursing interventions and medications
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