Introduction
Coronary artery disease (CAD) is caused by reduced blood flow in the coronary arteries. This subsequently leads to reduced oxygenation to the myocardium, resulting in transient ischemia or angina. CAD may cause permanent damage to myocardial cells or infarction. The left ventricle of the heart is most susceptible to CAD.
The causes of CAD include atherosclerosis, congenital defects, coronary artery spasm, dissecting aneurysm, infectious vasculitis and syphilis. Atherosclerosis and vasospasm are the most prevalent causes of CAD, with atherosclerosis being the most common.
Pathophysiology
Atherosclerosis
Atherosclerosis is the hardening of the arteries. It occurs when fat, cholesterol and other substances build up in the walls of the arteries and form plaques. It primarily affects the intima of the arterial wall. The process of atherosclerosis begins when the body attempts to heal any irritation, damage or injury to the endothelial lining. CAD progresses though three developments, which are, the fatty streak, the fibrous plaque, and the complicated lesion.
(1) The Fatty Streak
Fatty streaks contain atherogenic lipoproteins and macrophage foam cells. The streak is caused by the development of fatty, lipid-rich lesions that result from macrophages adhering to the vessel’s intact endothelial surface. The streaks usually form between the endothelium and internal elastic lamina of the vessel. The macrophages engulf the lipids, produce a fibrous tissue and stimulate calcium deposition, leading to a thickening of the intimal layer. The smooth muscle cells then migrate to the intima and become lipid laden. Lesions at this stage do no obstruct the artery. However, the continuous cycle results in the transformation of the fat...
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...as the other end is attached to the coronary artery distal to the arterial stenosis. On the other hand, LIMA is carefully dissected away from the chest wall. The distal end of the LIMA is anastamosed to the left anterior descending artery (LAD) whereas the proximal end remains attached to the left subclavian artery. Most CABG procedures use LIMA to bypass the LAD because it has a greater long-term patency than an SVG. The use of LIMA is also associated with a greater rate of long-term survival. At the end of the procedure, the heart is restarted and the sternum is closed and held together with wires.
After the procedure, patients will typically need 1 to several days of intensive care unit management and then up to a week more of further care. Patients with poor exercise capacity before the procedure usually take longer to recover and recover good functional status.
Cardiomyopathy, by definition, means the weakening of the heart muscle. The heart is operated by a striated muscle that relies on the autonomic nervous system to function. Cardiomyopathy is diagnosed in four different ways based on what caused the illness and exactly what part of the heart is weakened. The four main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular dysplasia. One other category of cardiomyopathy that is diagnosed is “unclassified cardiomyopathy.” Unclassified cardiomyopathy is the weakening of the heart that does not fit into the main four categories.
An artery is an elastic blood vessel that transports blood away from the heart. There are two main types of arteries: pulmonary arteries and systemic arteries.
Atherosclerosis begins when the inner wall of the artery becomes damaged and cholesterol and fatty plaques begin to lodge in the arteries. Damage to the endothelial wall inside the artery can be caused by hypertension, hyperlipidemia, and hyperglycemia (“Subclinical Atherosclerosis..” 443). When this happens, the immune system responds by sending monocytes to the damaged area. The monocytes turn into macrophages; their job is to eat up the excess cholesterol and unblock the artery. The macrophages are unable to digest all of the cholesterol, and as a result turn in to foam cells. When many macrophages are turned into foam cells, plaque results, and protrudes into the arterial wall, restricting blood flow and raising blood pressure (“Atherosclerosis Growth Process.” 8). If the plaque becomes too large it may break, releasing plaque into the blood. This can cause a great reduction in blood flow or a clot, resulting in stroke or myocardial infarction (“Stroke Risk.” 3).
Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
Coronary heart disease is defined by the hardening of the epicardial coronary arteries. The buildup of plaque in the arteries slowly narrows the coronary artery lumen. In order to better understand the physiology of the disease, it is important to first know the basic anatomy of the human heart. The aorta, located in the superior region of the heart, branches off into two main coronary blood vessels, otherwise known as arteries. The arteries are located on the left and right side of the heart and span its surface. They subsequently branch off into smaller arteries which supply oxygen-rich blood to the entire heart (Texas Heart Institute, 2013). Therefore, the narrowing of these arteries due to plaque buildup significantly impairs blood flow throughout the heart.
Cardiovascular Disease is defined by the American Heart Association as “Heart and blood vessel disease”. Atherosclerosis of the arteries, can lead to hypertension, heart failure, arrhythmias, heart valve problems, myocardial infarctions or a stroke (AHA, 2016). In this paper, all of heart and vessel diseases aforementioned, will be considered cardiovascular disease (CVD). According to
CHD is primarily due to atherosclerosis, which is the blockage of blood flow in the arteries due to the accumulation of fats, cholesterol, calcium and other substances found in the blood. Atherosclerosis takes place over many years, but when the blood flow becomes so limited due to the build up of plaque in the arteries, there becomes a serious problem. “When...
Coronary heart disease or coronary artery disease affects 16.8 million people in the United States and causes more than 607,000 deaths annually (Lemone, chap.30). It is caused by atherosclerosis which is the accumulation of fatty deposits in the arteries causing impaired blood flow to the myocardium. CAD or coronary artery syndrome is usually without symptoms but may induce heart attack, angina and acute coronary syndrome if not properly treated. There are many risk factors associated with CAD like obesity, high cholesterol diet, hereditary, physical inactivity, just to name a few. Patients with CAD may be unable to identify and manage their risks factors. It is imperative for nurses to educate the patient about CAD and measures to enhance their health.
Heart disease kills over 600,000 men and women in the United States every year. That translates to one out of every five deaths are caused by heart disease. Heart disease has several factors, but they all contribute to difficulty in blood flow from the heart. It is most often caused by an unhealthy lifestyle such as a poor diet, little exercise, being overweight and smoking. People die from heart disease several ways including heart attack or stroke.
What is coronary heart disease (CHD)? It is a disease when plaque gets built up in the coronary arteries; and the job of the arteries are to provide rich-oxygenated blood to the heart muscle. Built plaque in the arteries leads to atherosclerosis and the plaque that is built can result from over the years. Throughout the years, the plaque tends to get hard or can rupture. If hardened, the arteries are now narrow and have weakened the flow of blood that travels to the heart. Blood clots can form from the plaque rupturing which can cause a great chance for the blood flow to be mostly blocked or blocked altogether. There are other names for coronary heart disease such as coronary artery disease, atherosclerosis, ischemic heart disease, etc.
Cardiovascular disease is developed by a build-up of fatty deposits on the inner walls of the blood vessels, which typically takes years to accrue (World Health Organization). The development of the fatty-acid deposits can occur due to an unhealthy diet, physical inactivity, tobacco use, and a harmful intake of alcohol. The behavioral risk factors listed above account for about 80% of cardiovascular disease, with the other 20% being cause by fixed risk factors (age, gender, race).
(Slide 2) What is Cardiomyopathy? If we break down the word we can see “Cardio” which means of the heart, “myo” which means muscle, and “pathy” which means disease, therefore cardiomyopathies are diseases of the heart muscle. (Slide 3) There are 3 main types of cardiomyopathies; hypertrophic, dilated, and restrictive. I will only be discussing dilated cardiomyopathy, which is characterized by the enlargement of the hearts chambers with impaired systolic function. It is estimated that as many as 1 of 500 adults may have this condition. Dilated cardiomyopathy is more common in blacks than in whites and in males than in females. It is the most common form of cardiomyopathy in children and it can occur at any age (CDC).
of fatty substances on the inside wall of the arteries). It is not caused by
Oxygen was first admitted to the client with chest pain over 100 years ago (Metcalfe, 2011). Chest pain is a large bracket that can contain many different conditions, but for the purpose of this analysis it is focused manly upon a myocardial infarction. A myocardial infarction is mainly referred to as a heart attack, and occurs when one or more coronary arteries leading to the heart reduce or completely stop blood flow (Tuipulotu, 2013 ). Administering high concentrations of oxygen to patients with chest pain is now embedded in guidelines, protocols and care pathways, even with a lack of clear supporting evidence (Nicholson, 2004 ). High concentration of oxygen means that up to 60% is administered (Knott, 2012). More recent research has suggested that the use of oxygen in this scenario is unnecessary and can lead to unwanted side effects, especially in normoxic cardiac patients (Moradkham & Sinoway, 2010 ). The aim of this comparative analysis is to dismantle and understand both the benefits and risks of the commonly known practice of administration of oxygen to the client with chest pain. Through completing this analysis using recent and appropriate evidence a more improved practice can be given and understood.
Heart disease describes a range of conditions that affect your heart. Diseases under the heart disease umbrella include blood vessel diseases, heart rhythm problems, and heart defects. The major cause of this is a build-up of fatty plaques in the arteries. Plaque build-up thickens and stiffens the vessel walls, which can inhibit blood flow through the arteries to organs and tissues.