Pathophysiology BMS 243 Lecture v Coronary Artery Disease

Pathophysiology BMS 243 Lecture v Coronary Artery Disease Dr. Aya M. Serry 2016

Coronary Artery Disease (CAD)

Coronary Artery Disease Ø Coronary artery disease (also called CAD) is the most common type of heart disease. It is also a leading cause of death for both men and women ØThe coronary arteries wrap around the heart and supply it with blood and oxygen. ØIt occurs when fatty deposits called plaque build up inside the coronary arteries. When plaque builds up, it narrows the arteries and reduces the amount of blood that gets to your heart. Ø Plaque also can crack, which causes blood cells called platelets to clump together and form blood clots at the site of the cracks. This narrows the arteries more and worsens angina or causes a heart attack

Coronary Artery Disease Ø When arteries become filled with plaque and the arteries narrow, atherosclerosis occurs. ØWhen atherosclerosis happens in the coronary arteries, it is called coronary artery disease. When this happens, the heart cannot get enough oxygen to function properly

Coronary Artery Disease

Complications of CAD Ø Hypertension Ø Angina; Angina is chest pain that occurs when your heart is not getting enough blood Ø CHF; it means that your heart is failing to pump blood the way that it should Ø Myocardial Infarction; Death of heart cells due to lack of oxygen Ø Death

CAD Risk Factors Uncontrollable Controllable • Sex • High blood pressure • Hereditary • High blood cholesterol • Race • Smoking • Age • Physical activity • Obesity • Diabetes • Stress and anger

CAD Signs and Symptoms ØFindings may be normal during asymptomatic period ØChest pain - due to lack of oxygen ØPalpitations ØDyspnea ØSyncope ØExcessive fatigue

CAD Treatment 1. Cholesterol-lowering medications 2. Anticoagulants : prevent clots from forming in your arteries and blocking blood flow 3. ACE inhibitors : lower blood pressure and reduce the strain on your heart. They also may reduce the risk for a future heart attack and heart failure. 4. Beta-blockers: slow the heart rate and lower the blood pressure to decrease the workload on your heart.

CAD Treatment 5. Nitroglycerin: to prevent or relieve chest pain. 6. Thrombolytic : Dissolve the clots that can occur during heart attacks.

CAD Diagnosis • ECG (Electrocardiogram) • Stress Testing - During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to raise your heart rate. - A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity • Coronary Angiography and Cardiac Catheterization https: //www. youtube. com/watch? v=Je. H 4 z. Pz. Qg. Rc

CAD Surgical Treatment • Many people are able to manage coronary artery disease with lifestyle changes and medications (Prevention and Treatment) • Other people with severe coronary artery disease may need surgery, such as: 1) Stenting 2) Angioplasty

CAD Surgical Treatment 3) Bypass surgery • healthy blood vessel is removed from leg, arm or chest • This blood vessel is used to create new blood flow path in your heart around (bypassing) the blocked portion of the diseased artery