coronary artery disease Flashcards
What is CAD?
it is the most common type of heart disease
- it is when the arteries that supply blood to the heart muscle become stiff and narrow
what causes CAD
accumulation of plaque in the coronary artery
risk factors of CAD
- Elevated LDL and tryglycerides
- Hypertension
- High fat and salt diet
- Obesity
- Ethnicity
- Family history of HF
modifiable risk factors of CAD?
- Hypertension
- Elevated serum lipids (high cholesterol)
- Tobacco use
- Alcohol intake
- Physical inactivity
- Psycological state (anxiety depression)
- Obesity
- Nutrition (high fat and sodium)
- Type 2 diabetes
- Use of illict drugs (meth)
non-modifiable risk factors of CAD?
- Male gender
- Ethnicity
- Genetic dispostiton
- Family history
how much does diabetes increase the risk of CAD?
four times more likely
what is the etiology of CAD
- atheriosclerosis is the main cause of CAD
- it is characterised by the deposition of cholesterol and lipids primarily in the intimal wall of the artery
in terms of the pathophysiology of CAD, what are the 3 main stages?
- fatty streaks
- fibrous plaque
- complicated lesion
what are fatty streaks?
- early lesion of atherosclerosis
- the can be observed in the coronary artery
- it is thought to be reversible
what is fibrous plaque?
- develop over time
- the smooth muscles are stimulated by low density lipoproteins and platelets that proliferate, migrating over the fatty streaks
- this forms a fibrous plaque that is whitish/grey in colour
what is a complicated lesion?
- development of an ulceration or rupture of plaque
- platelets adhere to the lesion
- this triggers the coagulation cascade with the development of thrombus that obstructs the artery
what are some clinical manifestations of CAD
- angina pectoris
- acute coronary syndrome
- dizziness
- dyspnoea
- anxiety
- nausea
- vomiting
- tachycardia
- dysrhythmia
what are some diagnostic tests that can be used for CAD?
- chest x-ray for cardiac enlargement
- aortic calcifications and pulmonary congestion
- ECG
- lab test for lipid profile
what should be assessed in a physical examination of CAD
- posture indicating for chest pain
- change in vital signs (tachycardia, bradycardia, hypo/hypertension
- dyspnea, crackles
- level of conciousness
- vomiting
- decline in urine output
nursing interventions for CAD
- encourage physical activity
- Nutritional therapy – low saturated fat, high fibre diet
- Support with medication management
- Reduce the effects of risk factors (such as smoking)
- Help identify precipitating factors for angina
- Teach clients the signs of an acute cardiac event and what to do
- encourage annual flu and 5 year pneumonia vaccines
- Identify stressors and effective coping strategies
