CORONARY

ARTERY DISEASE

PRESENTED BY
NEHA KATOCH
ANATOMY OF CORONARY ARTERIES
 TWO MAIN CORONARY ARTERIES

LEFT MAIN RIGHT

CORONARY CORONARY
ARTERY ARTERY

 Circumflex Artery
branches : supplies Supplies blood to the
blood to outer side right ventricle , the
and back of the heart right atrium , SA node,
 Left Anterior and AV nodes, which
Descending Artery : regulate the heart
supplies blood to the rhythm
front of the left side of
the heart .
DEFINITION

• Narrowing of the coronary arteries

preventing adequate blood supply to the
heart muscle is referred to as coronary artery
disease.
• Usually caused by atherosclerosis, it may
progress to the point where the heart muscle
is damaged due to lack of blood supply. Such
damage may result in infarction, arrhythmias,
and heart failure.
 CORONARY ARTERY DISEASE IS ALSO KNOWN AS

• ATHEROSCLEROTIC HEART DISEASE

• CORONARY ATHEROSCLEROSIS
• CORONARY HEART DISEASE
 RISK FACTORS /ETIOLOGY

MODIFIABLE NON
FACTORS -MODIFIABLE
FACTORS

• High blood cholesterol level

• Cigarette smoking, tobacco
use • Family history

• Hypertension • Increasing age

• Diabetes mellitus • Gender(male)

• Lack of estrogen in women

• Physical activity
• Obesity
 S I O LO G Y
PATHOPY
 DUE TO ETIOLOGICAL FACTORS

INJURY TO THE ENDOTHELIAL CELL THAT LINING THE

ARTERY  INFLAMMATION AND IMMUNE REACTIONS

ACCUMULATION OF LIPIDS IN THE INTIMA OF ARTERIAL

WALL

T LYMPHOCYTES AND MONOCYTES THAT BECOMES AS

MACROPHAGES INFILTRATE

PROLIFERATION OF SMOOTH MUSCLE CELLS WITH IN

THE VESSEL 
 FORMATION OF FIBROUS CAP OVER DEAD FATTY
CORE (ATHEROMA)

PROTRUSION OF ATHEROMA IN TO THE LUMEN OF

VESSEL

NARROWING AND OBSTRUCTION

HEMORRHAGE INTO PLAQUE ALLOWING

THROMBUS TO DEVOLOP

THROMBUS AND OBSTRUCT  AND OBSTRUCTION IN

CORONARY ARTERY
 AI ON
EST
ANIF
L M
CA
INI
CL
 CHEST PAIN

SHORTNESS OF
BREATH

HEART ATTACK
 Diaphoresis

Fatigue

Hypertension
 Bradycardia

ECG changes

Pulmonary Edema
DIAGNOSTIC EVALUATION

L L EC TION
IS TO RY CO
H

PHYS
EXAM ICAL
INATI
ON
 A PH
G R
DI O
A R ANGIOGRAPHY
C OC
E

CARDIAC ENZYMES
troponin T 
creatine phosphokinase
(CPK)
T Myoglobin
T ES
E SS
R
ST
 EN T
A G EM
MA N
 PHARMACOLOGICAL MANAGEMENT

 Vasodilators : Act as a blood vessel dilator

 Nitrates

 Beta Blockers : Decrease work load in heart

 Propranolol

 Calcium Channel Blocker : Improve the coronary blood flow

 Nifedipine

 Anticoagulant Drugs
 Heparin

 Analgesic

 Thrombolytic drugs

 Antihypertensive drugs
 ANGIOPLASTY /
STENTS

SURGICAL
INTERVENTION

CABG PTCA
 NURSING DIAGNOSIS

• Altered breathing pattern related to imbalance between myocardial

oxygen supply and demand as evidenced by an increase in respiratory
rate.
• Altered comfort (chest pain) related to inflammatory response of the
arteries as evidenced by patient rubbing the chest.
• Activity intolerance related to dyspnea as evidenced by inability to
perform some of daily living activity
Weight control Smoking cessation

Lifestyle
changes

Exercise
Healthy diet
 COMPLICATIONS

• Heart failure

• Pericarditis

• Cardiogenic Shock

• Ischemic Cardiomapathy.