Coronary Atherosclerosis CAD🫀

The most common cause of cardiovascular disease in the US is?

atherosclerosis

What is atherosclerosis?

an abnormal accumulation of lipid or fatty substances and fibrous tissue in the lining of the arterial blood vessel walls

The inflammatory response involved with the development of atherosclerosis begins with injury to the?

Vascular endothelium

injury to the endothelium can be caused by?

Smoking, HTN, Hyperlipidemia, and other factors

The endothelium undergoes changes and stops producing what two things?

Normal anti-thrombotic and vasodilating agents

Atheromas are?

plaques that narrow or obstruct blood flow

Nonmodifiable risk factors for CAD

1. Family history

2. increasing age

3. gender

4. race

5. history of premature menopause

6. preeclampsia

7. primary hypercholesterolemia

Modifiable risk factors for CAD

1. Hyperlipidemia

2. tobacco use

3. hypertension

4. diabetes

5. metabolic syndrome

6. obesity

7. physical inactivity

8. chronic inflammatory conditions

9. chronic kidney disease

clinical manifestations of CAD- Ischemia

Impeachment of blood flow is usually progressive, causing an inadequate blood supply that deprives the cardiac muscle cells of oxygen needed for their survival

clinical manifestations of CAD- angina pectoris

Chest pain from a MI, usually caused by significant coronary atherosclerosis

risk factors: elevated LDL

Normal: less than 100mg/dl

Abnormal: More than 100mg/dl

what is LDL?

Low density lipoprotein

bad cholesterol

risk factors for CAD-Elevated HDL

1. Normal MEN: less than 40

2. Normal WOMEN: less than 50

Abnormal: more than 40 for men and 50 for women

people at highest risk for a Cardiac event are

1. Metabolic Syndrome

2. Diabetics

3. PAD

4. abdominal aortic aneurysm

5. CAD

6. smoking

7. hypertension

8. abnormal, cholesterol levels

9. bad diet age

10. gender

For patients higher at risk for a cardiac event what should their LDL be?

less than 70mg/dl

prevention: control cholesterol

Fasting labs (LDL,HDL, Total cholesterol, Triglycerides) nothing to eat or drink after midnight

prevention: dietary measures and healthy diet

Low sodium equals heart healthy diet

increase fresh fruits + vegetables

increase red meat

lower cholesterol

low fat diet

other prevention methods

physical activity

medications

promote smoking sensation

stop drinking alcohol

Medication: atorvastatin

reducing LDL and triglycerides

Diagnosis

Physical examination

EKG

Blood Tests

Stress tests

Coronary angiography

CT angiography (calcium scoring)