VIII.

PATHOPHYSIOLOGY
Major Risk Factors:

Complications: System Involved: - Unhealthy blood cholesterol levels

- High blood pressure
- Smoking
- Heart attack / myocardial CARDIOVASCULAR SYSTEM - Insulin resistance
infarction - Diabetes
- Overweight / obesity
- Heart failure - Metabolic syndrome
- Unstable angina - Lack of physical activity
- Age
- Sudden death
- Family history of early heart disease
- Race
- Gender

Etiology/Cause: Emerging Risk Factors:

Atheromas - High levels of CRP (C-reactive protein)

- High levels of triglycerides
(in the coronary arteries)
Other Factors:

- Sleep apnea
- Stress
- Alcohol
Molecular/Cellular Changes: - Contraceptive pills

4th: fatty streaks of lipids are deposited in the intima of the

arterial wall Gross/Anatomical Physical Changes:
5th: activated macrophages release biochemical substances
1st: nonspecific injury to the vascular endothelium
that can further damage the endothelium, attracting platelets
2nd: desquamation of endothelial lining
and initiating clotting
6th: plaques begin to form foam cells within the endothelium

Physiologic Manifestations on Effect on Bodily Function:

3rd: increased permeability / adhesion molecules

7th: lipids are engulfed by the cells and smooth muscle cells develop
8th: plaques protrude into the lumen, narrowing it and obstructing blood flow
9th: decreased coronary tissue perfusion
Laboratory Findings:

- Decreased RBC count

- Increased HgbA1c
- Increased Troponin I

Clinical Manifestations:

 Chest pain: angina pectoris (may not be noted if ECG interpretation:

patient is older, diabetic or has heart failure)
- Sinus rhythm with isolated premature
 Atypical symptoms of myocardial ischemia
ventricular depolarization
(shortness of breath, nausea, and
- Left ventricular hypertrophy
unusual fatigue) - Left atrial enlargement
 ECG changes, ventricular aneurysms
 Dysrhythmias
Roentgenographic report shows:

- Heart is enlarged

Final Diagnosis:

CORONARY ARTERY DISEASE