Coronary Artery Disease

Definition - What is it?

• decreased supply of blood and oxygen to myocardium caused by occlusion to 1 or more coronary arteries

• usually occludes left anterior descending, right coronary artery, left circumflex artery in that order

• occlusion secondary to atherosclerotic plaque

What is atherosclerosis?

a chronic arterial disease characterised by teh progressive accumulation of lipids, inflammation and thickening of vessel walls, primarily in the subendothelial space and emerges as a significant contributor to coronary artery disease

Pathophysiology of Atherosclerosis

1) plaque build-up begins when endothelial cells lining the arteries are damaged by smoking, high BP, and other causes

2) in response to damage, platelets and other types of cells collect at the sit and a fibrous cap forms, isolating the plaque within the artery walls. an early stage plaque is called a fatty streak

3) chemicals released by cells cause further inflammation and build-up of an advanced plaque

4) the narrow artery is vulnerable to blockage by clots. the risk of blockage and heart attack rises if the fibrous cap cracks

Risk Factors of Atherosclerosis

• hypercholesterolaemia

• hypertension

• smoking

• diabetes

• obesity

• gender

• age

• FHx

Symptoms

• numbness or weakness in arms or legs

• chest discomfort during exercise

• dizziness

• SOB with light movement

Medications

antiplatelets:

• clopidogrel

• aspirin