MS1 (#7) - CORONARY ARTERY DISEASE AND ANGINA PECTORIS

Coronary Artery Disease (CAD)

A condition in which plaque builds up inside the coronary arteries.

Coronary Arteries

Arteries that supply the heart muscle with oxygen

Plaque

A buildup of fat, cholesterol, calcium, and other substances found in the blood.

Pathophysiology of CAD

Plaque narrows coronary arteries, reduces blood flow, promotes clot formation, and may lead to angina or heart attack.

Angina

The most common symptom of CAD; chest discomfort caused by reduced blood flow to the heart.

Chest Pain

A common symptom of CAD that may be described as heaviness, tightness, pressure, aching, burning, numbness, fullness, or squeezing.

Shortness of Breath

Difficulty breathing caused by inadequate oxygen supply to the heart.

Heart Palpitations

Irregular heartbeats, skipped beats, or a flip

Tachycardia

A faster-than-normal heartbeat.

Dizziness

A feeling of lightheadedness caused by reduced cardiac output.

Nausea

A possible symptom of CAD due to reduced blood flow.

Extreme Weakness

A symptom that may occur due to decreased oxygen delivery.

Diaphoresis

Excessive sweating often associated with cardiac events.

Atherosclerosis

A chronic inflammatory disease characterized by hardening and narrowing of arteries due to plaque buildup.

Risk Factors for Atherosclerosis

High LDL cholesterol, smoking, and hypertension.

Lipid Panel

A blood test measuring total cholesterol, HDL, and LDL levels.

Electrocardiogram (ECG)

A diagnostic test that records the electrical activity of the heart.

T-Wave Inversion

An ECG finding that indicates myocardial ischemia.

ST-Segment Depression

An ECG finding that indicates myocardial injury

Modifiable Risk Factors for CAD

Cholesterol abnormalities, tobacco use, hypertension, and diabetes mellitus.

Dietary Management of CAD

Lower sodium, lower cholesterol and fat, lower calorie intake, and increased dietary fiber.

Aspirin

A medication used to reduce clot formation.

Beta-Blockers

Drugs that reduce the workload and oxygen demand of the heart.

Calcium Channel Blockers

Drugs that lower blood pressure and heart rate.

Nitrates

Medications that improve blood flow and relieve chest pain.

Platelet Inhibitors

Medications that reduce the formation of blood clots.

Statins (HMG-CoA Reductase Inhibitors)

Drugs used to lower cholesterol levels.

Vital Signs Monitoring

Nursing intervention to detect hypertension and abnormal heart rate.

Liver Function Monitoring

Required for patients taking statins due to potential liver effects.

Myalgia

Muscle aches that may occur as a side effect of statin therapy.

Smoking Cessation

An important lifestyle modification for CAD patients.

Alcohol Reduction

Recommended to decrease cardiovascular risk.

Weight Reduction

Helps lower cardiac workload and reduce risk factors.

Angina Pectoris

A clinical syndrome characterized by episodes of chest pain or pressure caused by insufficient coronary blood flow.

Cause of Angina

Decreased oxygen supply to the myocardium during increased oxygen demand.

Stable Angina

Predictable chest pain triggered by exertion and relieved by rest or nitroglycerin.

Unstable Angina

Chest pain that increases in frequency and severity and may not be relieved by rest or nitroglycerin.

Intractable (Refractory) Angina

Severe chest pain that persists despite optimal medical treatment.

Variant Angina

Chest pain at rest caused by coronary artery vasospasm and associated with reversible ST

Silent Ischemia

Evidence of myocardial ischemia without chest pain.

Pathophysiology of Angina

Coronary artery obstruction prevents adequate blood flow, resulting in myocardial ischemia.

Myocardial Ischemia

Reduced blood supply to the heart muscle causing oxygen deprivation.

Myocardial Infarction

Death of heart muscle tissue resulting from prolonged ischemia.

Physical Exertion

A common trigger for angina attacks.

Exposure to Cold

A factor that can precipitate angina.

Heavy Meals

Can trigger angina by diverting blood flow to the digestive system.

Stress

Causes catecholamine release, increasing heart rate, blood pressure, and myocardial workload.

Pain usually felt behind the sternum and may radiate to the neck, jaw, and shoulders.

Chest Pain in Angina

Numbness in Angina

Weakness or numbness that may occur in the arms, wrists, and hands.

Pallor

Pale skin resulting from inadequate blood supply to peripheral tissues.

Oxygen Therapy

Treatment used during angina episodes to increase oxygen delivery to the myocardium.

Nitroglycerin (NTG)

A fast-acting nitrate used to treat and prevent acute angina attacks

Usually provides relief within about 3 minutes.

Nitroglycerin Onset

Venodilation

The primary effect of nitroglycerin, reducing venous return and cardiac workload.

Coronary Vasodilation

Widening of coronary arteries to improve blood flow to the heart muscle.

Antiplatelet Medications

Drugs that prevent platelet aggregation and clot formation.

Anticoagulants

Medications that prevent thrombus formation.

Semi-Fowler's Position

Recommended position during an angina attack to promote comfort and reduce cardiac workload.

Sublingual Nitroglycerin

Nitroglycerin administered under the tongue for rapid absorption.

Pain Prevention

Nursing strategy of identifying activities that trigger angina and planning accordingly.

Balancing Activity and Rest

An important nursing measure to decrease myocardial oxygen demand.