essay 21 - coronary artery disease - definition, types, pathogenesis

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Last updated 2:31 PM on 6/14/26
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5 Terms

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What is Coronary Artery Disease

  • condition in the coronary arteries become narrowed or blocked, usually due to athersclerosis. This needs to reduce blood flow to myocardium, causing ishemia and potentially myocardial damage. The coronary arteries are the ones that supply oxygen rich blood to the heart muscles

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lsit the types coronary heart diseases

  • acute coronary syndromes

  • chronic ischemic heart disease

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describe chronic ischemic heart disease

  1. stable angina

  • predictable chest pain with exertion or stress

  • caused by fixed narrowing of coronary arteries

  • relived by rets or nitroglycerin

  1. variant angina

  • caused by coronary artery spasm, not necessarily plaque

  • occurs at rest, often at night

  1. silent ischemia

  • ischemia without symptoms

  • common in diabetics and elderly

  • detected via ECG or stress testing

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describe acute ischemic heart disease

  1. unstable angina

  • chest pain at rest or with minimal effort

  • indicates plaque rupture and increased risk of myocardial infarction

  1. Myocardial infarction (NSTEMI/STEMI)

  • complete blockage or severe occlusion of a coronary artery

  • causes death of heart muscle tissue

  • presents with severe chest pain and raised cardiac enzyme (CK-MB)

  1. sudden cardiac death

  • sudden death due to arrythmia, often as a first manifestation of CAD

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pathogenesis of coronary artery disease

  1. endothelial injury - initial event leading to damage to the inner lining or coronary arteries e.g smoking, hypertension, high LDL, diabetes

  2. lipid infiltration = LDL leaks into damaged endothelium and gets oxidised making it more harmful

  3. inflammatory response = macrophages gather to the area and engulf the oxidised LDL forming foam cells

  4. fatty streak formation = foam cells accumulate in artery wall and create a visible fatty streak

  5. plaque formation = smooth muscle cells migrate into area, producing collagen, eventually forming a fibrous cap over a lipid rich core

  6. plaque progression = plaque grows and narrows lumen of arteries

  7. plaque rupture or erosion = fibrous cap may rupture or erode. this triggers platelet aggregation and thrombus formation

  8. acute coronary events = clot partially or completely block the artery. this leads to unstable angina, myocardial infarction or even sudden cardiac death