CORONARY

ARTERY DISEASE
Minerva A. Cobus RN, CCN
 CORONARY ARTERY
DISEASE
1. Refers to variety of pathologic conditions that
causes narrowing or obstruction of the coronary
arteries, resulting in decreases blood supply to the
myocardium.
2. Occurs most often between ages 30 and 50; men
affected more than women, prevalent in whites.
3. May lead to Angina pectoris and MI
 RISK FACTORS
1. Family history of CAD
2. Gender
3. Age
4. Race -risk appears higher in African-Americans
5. Hypertension -widened QRS complex (bundle branch
block)
6. Serum lipoproteins
7. Obesity
8. Lifestyle
9. Elevated serum uric acid levels
10. Hyperlipidemia: increased total cholesterol; increased LDL
(high: 130 to 150 mg/dL; very high: 160 mg/dL or more);
increased ratio of total cholesterol or LDL to HDL
 PATHOPHYSIOLOGY
Cholesterol, lipids deposit in the arterial
wall

Atherosclerosis

May develop to angina, MI, CHF, and death

 SIGNS AND SYMPTOMS
1. May be asymptomatic
2. Palpitations
3. Dyspnea
4. Excessive fatigue
5. ECG changes -may reveal ischemia (inverted T
wave, elevated ST segment) or evidence of MI
(presence of Q wave); a Holter monitor may be
used to detect changes associated with activities of
daily living (ADLs)
6. Angina
7. Myocardial Infarction
 SIGNS AND SYMPTOMS
1. Retrosternal chest pain that may radiate to arms, jaw,
neck, shoulder, or back; pain described as “pressure,”
“crushing,” or “viselike”; palpitations, apprehension,
feeling of dread/impending doom, dyspnea, nausea,
vomiting; pain of angina can be associated with activity
and generally subsides with rest; asymptomatic with silent
ischemia
 NURSING MANAGEMENT
1. Assess/Monitor v/s
2. Assist client with identification of modifiable risk
factors
3. Provide emotional support and encouragement
4. Refer to available community resources.
 MEDICAL/SURGICAL
INTERVENTION
• Lifestyle modification
• Coronary Artery Bypass Graft (CABG)
• Percutaneous Transluminal Coronary Angioplasty
(PTCA)
• Intracoronary stent
CORONARY ARTERY
BYPASS GRAFT
CORONARY ARTERY
BYPASS GRAFT
PERCUTANEOUS TRANSLUMINAL
CORONARY ANGIOPLASTY
• (4066) Coronary Angioplasty (Femoral Access) –
YouTube

• (4066) Angioplasty Procedure Animation Video. -

YouTube