Coronary Artery Disease Flashcards
• definition
Coronary artery disease (CAD) is a condition in which the coronary arteries responsible for supplying blood to the heart muscles are blocked by fatty plaques.
Blood supply to heart
Right coronary artery -> RA , RV, 1/3 interventricular septum
Left coronary artery ->
Main cause of CAD
Atherosclerosis main one
Modifiable risk factors of atherosclerosis
• Smoking
• Alcohol
• Obesity
• Hypertension
• Diabetes Mellitus
• Smoking
• Alcohol
Lipid abnormalities
Non-Modifiable Risk Factors of atherosclerosis
Age (> 45 years men, > 55 years women)
Family history
Less common causes of CAD
Vasculitis
Emboli
Vasospasm
Left / right ventricular hypertrophy
Pathophysiology
Buildup of fat (LDL Too high can deposit in damaged vessels like in smoking) in endothelium of wall ( endothelium) of blood vessel
Partially or complete occlusion of blood vessels
LDL get oxidized and get engulfed by macrophages -> thrombus formation -> complete blockage of artery
Clinical features of CAD
Chest pain ( Classifying the pain, Stable angina)
Shortness of breath
Easy fatigability
Dizziness
Palpitations
Restlessness
Investigations
Resting ECG
Exercise ECG
Stress test - stress echocardiography, Myocardial perfusion scanning
Coronary angiography
Complications
Arrythmias
Acute coronary syndrome ( unstable angina , STEMI , NSTEMI
Heart failure
Management
• Antiplatelet therapy: low dose aspirin (75mg), Clopidogrel(75mg)
• Anti-anginal drugs: five classes of drugs can be used
Stent
Antianginal drugs used
Nitrates(sublingual glyceryl trinitrate, relieves angina attack in 2-3mins.
Isosorbide di- and mono-nitrate)
• Beta-blockers(Metoprolol, Bisoprolol)
• Calcium-channel blockers( Nifedipine, Nicardipine)
• Potassium channel activators(Nicorandil)
• If channel antagonist(Ivab: dine)
Prevention
Control high blood pressure, high cholesterol and diabetes
Quit smoking
Exercise often
Healthy weight
Low fat , low salt diet , fruits , vegetatbkes
Manage stress
