CORONARY ARTERY DISEASE

ATHEROSCLEROSIS ANGINA PECTORIS MYOCARDIAL INFARCTION

ATHEROSCLEROSIS

DEFINITION

Hardening & narrowing of arteries from cholesterol plaque formation

CAUSES & RISK FACTORS

High BP, cholesterol Smoking DM Age Family hx BP Cholesterol DM Obesity Smoking

SYMPTOMS HEART angina BRAIN weakness of arms & legs, slurred speech, drooping muscles in face ARTERIES intermittent claudication

COMPLICATION

CAD PAD Aneurysms

DIAGNOSIS
PE
weak/absent pulse, low BP on affected limb, bruits, aneurysms, poor wound healing

Blood tests FBS Doppler UTZ Ankle-brachial index ECG Stress test Imaging

MANAGEMENT
Medications
Cholesterol-lowering meds Antiplatelet drugs Beta-blockers ACE inhibitors Ca channel blockers Diuretics Others

Angioplasty & stent placement Endarterectomy Thrombolytic therapy Bypass surgery

Angioplasty & Stent Placement

Endarterectomy

Thrombolytic Therapy

Bypass Surgery

ANGINA PECTORIS

DEFINITION

Pain or pressure in middle of chest, L neck/shoulder/arm/jaw/back Relieved by nitroglycerin Reduced blood flow to heart

SYMPTOMS
Chest pain (pressure, squeezing, fullness in center of chest; vise-like) Radiating pain Nausea Fatigue SOB Sweating

TYPES
STABLE
Develops when heart works harder Predictable Pain same w/ previous episodes Lasts <5mins Disappears w/ meds/rest

TYPES
UNSTABLE
Occurs even at rest Change in usual pattern; unexpected More severe Lasts >30mins Not relieved by meds/rest

TYPES VARIANT
Resting Severe Relieved w/ meds

CAUSES STABLE physical activity UNSTABLE plaques/blood clots VARIANT - spasms

RISK FACTORS
Smoking DM High BP Cholesterol Lifestyle (obesity, smoking, stress) Age

COMPLICATIONS

DIAGNOSIS
ECG Stress test Echocardiogram Nuclear stress test Imaging Coronary angiography Blood tests

MANAGEMENT
Medications
Nitrates Aspirin Antiplatelet Beta-blockers Statins Ca channel blockers Ranolazine

Surgery
Angioplasty & stenting CABG

MYOCARDIAL INFARCTION

DEFINITION

partial interruption of blood supply to a part of the heart muscle, causing the heart cells to be damaged or die

CAUSE/S & RISK FACTORS

Ventricular fibrillation Clots

Age Smoking High BP, chol, trigly DM Family hx Sedentary lifestyle Illegal drugs Hx of preeclampsia

COMPLICATIONS

Arrhythmia Heart failure Rupture Valve probs

DIAGNOSIS
ECG Blood tests CXR Echocardiogram Coronary catheterization Cardiac stress test Imaging CRP test

MANAGEMENT
Medications
Aspirin Thrombolytics Superaspirins Anticoagulants Analgesics Nitroglycerin Beta blockers ACE inhibitors Cholesterol-lowering meds

Surgery
same

ACUTE CORONARY SYNDROME

DEFINITION

Sudden reduced blood flow to heart Same with heart attack or unstable angina st 1 sign: cardiac arrest

CAUSE/S & RISK FACTORS

Atherosclerosis Same with MI Same with MI

SYMPTOMS
SAME W/ HEART ATTACK

abdominal pain, pain like pyrosis,

restlessness, clammy skin, lightheadedness, unexplained fatigue

MANAGEMENT Aspirin Thrombolytics Nitroglycerin Beta blockers ACE inhibitors ARBs Ca channel blockers Cholesterollowering drugs Antiplatelet