coronary artery disease Flashcards
whats happening with coronary artery disease
- arterial damage
- cholesterol/fats/lipids infiltrate
- atheroma
- block/narrow arterial wall
- palque rupture
- blood clot/cholesterol embolus
- blockage of coronary vessels (MI)
- blockage of cerebral vessels (CVA)
- permanent damage (atherosclerosis, arteriostenosis)
whats an atheroma
- big buildup over the plaque in an artery
- if it breaks, build up escapes and clot forms, and can cause MI or stroke
what are some causes of coronary artery disease?
- hyperlipidemia
- HTN
- smoking
- DM
- sedentary lifestyle; obesity
- genetic predisposition
- metabolic syndrome
- other shit
name some different types of angina
- stable
- unstable
- intractable/refractory
- variant/prinzmetals
- silent ischemia
describe stable angina
predictable, goes away with rest
describe unstable angina
unpredictable, dont know when it will come or go
describe intractable/refractory angina
wont go away
describe MI presentation
- back/shoulder/jaw/ arm pain
- N/v, indigestion
- general malaise/SOB/dizzy
- diaphoresis
- CP
hwo will a CAD patient present
- angina
- activity intolerance
- MI
what are some labs and diagnostics for CAD
- CBC, BMP
- troponin (serial/high sensitivity)
- D-dimer
- EKG
- echo
- stress test
- coronary angiogram
what does troponin indicate
heart damage
what does D-dimer indicate
- r/o blood clot
- picks up breakdown of clots
if its positive, conform with CTA
what is coronary angiogram
- 30-45minutes
- dye insertion, may feel warm and like you pissed yourself
- 3hr recovery time
what meds may be used for CAD
- statins (atorvastatin)
- aspirin (baby)
- beta blockers (metoprolol)
- calcium channel blockers (diltiazem)
- nitroglycerin (nitro-stat/nitro bid)
- ACE-I (lisinopril)
what do statins do
decrease lipids
what does baby aspirin do
reduces risk of clot formation
what do beta blockers do for CAD
protects the heart and slows it down
what do clacium channel blockers do for CAD
vasodilate and improve blood flow
what does nitroglycerin dor for CAD and describe administration
- potent vasodilator for angina
- given sublingual, give 3x 5min apart
- check blood pressure and HR before
- what to expect: burning and headache
- can aslp be given transdermal, which is long lasting (nitrobid)
what do ACE-Is do for CAD
prevent vasoconstriction
what are some acute interventions for acute coronary syndrome
- line/labs
- EKG
- ntro/baby aspirin 324mg/heparin
- CXR
- cardiac monitor
- possible cardiac catheterization: stent/balloon
what are some complications of CAD
- MI (NSTEMI/STEMI)
- HF
- arrhythmias
- CVA (hemorrhagic, ischemic)
- death
what are some nursing considerations for coronary artery disease
- quit smoking
- med compliance (HTN, hyperlipidemia, DM)
- monitor diet (low fat and sodium)
- monitor weight
- reduce stress
