Coronary Artery Disease (CAD) & Acute Coronary Syndrome (ACS) Review

This set of flashcards covers key concepts from the 'Coronary Artery Disease (CAD) & Acute Coronary Syndrome (ACS)' lecture notes, including definitions, pathophysiology, risk factors, clinical manifestations, diagnostic tests, nursing interventions, pharmacological management, and patient education.

What is Coronary Artery Disease (CAD)?

A progressive disease of the coronary arteries caused by atherosclerosis, leading to lipid deposits and endothelial dysfunction.

What are the major outcomes of CAD?

Angina, myocardial infarction, and heart failure.

What is the first step in the pathophysiology of CAD?

Endothelial injury, often caused by smoking, hypertension, or hyperlipidemia.

What is the final step in the pathophysiology of CAD that leads to myocardial ischemia?

Plaque rupture leading to thrombus formation and occlusion.

Name three non-modifiable risk factors for CAD.

Age, gender (higher in males), family history, or genetic predisposition.

Name three modifiable risk factors for CAD.

Hypertension, smoking, diabetes mellitus, obesity, physical inactivity, hyperlipidemia, or unhealthy diet.

Describe stable angina.

Chest pain that is predictable, occurs with exertion, and is relieved by rest or nitroglycerin.

What are the clinical manifestations of a myocardial infarction?

Severe, unrelieved chest pain, nausea, diaphoresis, and dyspnea.

What three conditions are included in Acute Coronary Syndrome (ACS)?

Unstable Angina, Non-ST Elevation Myocardial Infarction (NSTEMI), and ST-Elevation Myocardial Infarction (STEMI).

What is the key difference on an ECG between STEMI and NSTEMI?

STEMI shows ST elevation on ECG due to complete occlusion, while NSTEMI has no ST elevation (though troponins are positive) due to partial occlusion.

What initial nursing interventions are critical for acute care of ACS?

Assess chest pain (PQRST method), administer oxygen, initiate MONA (Morphine, Oxygen, Nitroglycerin, Aspirin), monitor ECG, and cardiac enzymes.

What is the key difference between CAD and ACS?

CAD is a chronic, progressive narrowing of arteries, while ACS is an acute, sudden reduction of blood flow that requires emergency intervention.

What is considered the 'gold standard' diagnostic test for CAD assessment?

Coronary angiography.

What blood test identifies ischemic changes in the heart?

Electrocardiogram (ECG).

When managing ACS, why might an elevated White Blood Cell (WBC) count be relevant?

Elevated WBCs suggest inflammation, which may be present in ACS.

Name two types of antiplatelet therapies used in pharmacological management of CAD/ACS.

Aspirin and Clopidogrel.

What is the purpose of statins in pharmacological management of CAD/ACS?

To lower cholesterol.

What are key patient education strategies for CAD prevention?

Smoking cessation, healthy diet, regular exercise, blood pressure and cholesterol control, medication compliance, and recognizing early signs of chest pain.

Define myocardial ischemia.

A temporary, reversible lack of oxygen to the heart muscle.

What ECG finding is associated with myocardial injury (STEMI)?

ST elevation.

What ECG finding indicates an old myocardial infarction?

Pathologic Q waves.

What is a Percutaneous Coronary Intervention (PCI)?

A minimally invasive procedure to open blocked arteries, including balloon angioplasty and stent placement.

What is Coronary Artery Bypass Graft (CABG)?

A surgical procedure that reroutes blood flow using grafts, indicated for multiple or severe blockages.

What is a crucial pre-procedure nursing consideration for PCI involving contrast dye?

Assess for allergies to contrast dye or iodine.

What are important post-PCI nursing interventions?

Monitor for bleeding at the insertion site, assess distal pulses and perfusion, and watch for chest pain (possible re-occlusion).