Heart 4 Coronary Artery Disorder Flashcards
Coronary artery disease (cad)
Blood vessel disorder
Cad refers to the pathological changes within the coronary artery walls that diminish blood flow through these 3 mechanisms
3 mechanism dimish blood flow
Vascular spasm
Formation of atherosclerosis
Thromboembolism ( complication of atherosclerosis)
Atherosclerosis
Can occur in any artery in the body
Is a progressive, degenerative disease of the arteries that leads to occlusion of the affected vessel/s and subsequent reduces oxygen delivery to tissue
Same disease process
Ischeamic heart disease, coronary heart disease, coronary artery disease, are the terms that are commonly used to describe the same disease process
Pathogensis of atherosclerosis
Chronic endotelial injury
Fatty streak
Fibrous plaque
Complicated lesions
Chronic endothelial injury
Hypertension Tobacco use Hyperlipidaemia Diabetes Toxins
Fatty streak
Lipids accumulate and migrate into smooth muscle cells
Fibrous plaque
Collagen covers the fatty streak
Vessel lumen is narrowed
Blood flow is reduced
Fissures can develop
Complicated lesion
Plaque rupture
Thrombus formation
Further narrowing or total occlusion of vessel
Lipids
To be utilised by the body they must be combine with proteins to become soluble (lipoprotein
Types of lipoprotein
High density lipoproteins
Low density lipoprotein
Very low density lipoprotein
Hdl has
More protein and less lipids than any other lipoprotein
Hdl is higher in women, decreases with age and are low in people with cad
Ldl and vldl
Are higher in cholesterol than protein and vdld contains triglycerides
Elevated cholesterol and triglycerides
In blood greatly increases the chance of myocardial infarction or cerebral vascular accident
Hdl process
Carries lipids away from the arteries to the liver
Liver processes lipids abd partially excretes them
Ldl use
Attracted and attaches to arterial walls
Results in increased risk kf cad
Goal hdl and ldl
More than 1
Less than 1.8 mmol/l
Angina
Chest pain is the mainsign of reversible myocardial ischaemia and results from stable atherosclerosis plaques that cause stenosis of coronary artery
Pain occurs in agina when
Increased demand for oxygen
Decreased supply for oxygen
Precipitating factors of angina
Physical exertion Temperature extremes Strong emotions Consumption of heavy meal Tobacco use Sexual activity Stimulants Circadian rhythm pattern
Acute coronary syndrome
When ischaemia is prolonged and not immediately reversible, acs develops and is an umbrella term that refers to 3 main clinical signs
3 signs if acute coronary syndrome
Unstable angina
Non-st-segment elevation myocardial infarction
St-segment-elevation myocardial infarction
Prevalence of coronary heart disease
Commonly in older age group 75
Indigenous, remote and lowest socioeconomic areas
Risk factors of ca
Modifiable
Non-modifable
Modifiable risk factors of cad
Elevated serum lipids Hypertension Tobacco use Physical inactivity Obesity Diabetes Metabolic syndrome Psychological states C-reactive protein Homocysteine
Non-modifiable factors of cad
Age Gender Ethnicity Genetics Family history of heart disease C-reactive protein Homocysteine
