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CORONARY ARTERY DISEASE
M.SC.NURSING FINAL YEAR
Coronary artery disease is the narrowing or blockage of the coronary
arteries, usually caused by atherosclerosis.
Cardiovascular diseases, especially coronary heart disease (CHD),
are epidemic in India. The Registrar General of India reported
that CHD led to 17% of total deaths and 26% of adult deaths in 2001-
2003, which increased to 23% of total and 32% of adult deaths in
MODIFIABLE RISK FACTORS:
High blood cholesterol or triglyceride levels
Lack of exercise
NONMODIFIABLE RISK FACTORS:
Family history of heart disease
High blood pressure
Development of atherosclerosis;
Coronary artery disease is thought to begin with damage or injury to
the inner layer of a coronary artery, sometimes as early as childhood.
The damage may be caused by various factors, including:
High blood pressure
Diabetes or insulin resistance
Control conditions such as high blood pressure, high cholesterol
Stay physically active
Eat a low-fat, low-salt diet that's rich in fruits, vegetables and
Maintain a healthy weight
Reduce and manage stress
Various drugs can be used to treat coronary artery disease, including:
Vasodilators (These drugs acts as blood vessel dilator):
Beta-Blockers (Decrease work load in heart):
• Propranolol 20-40 mg
Calcium channel blocker (They improve coronary blood flow):
Methydopa- This medication is used alone or with other medications
to treat high blood pressure (hypertension). Lowering high blood
pressure helps prevent strokes, heart attacks, and kidney problems.
Methyldopa works by relaxing blood vessels so blood can flow more
Sodium nitroprusside- It is used for lowering the blood pressure.
Amlodipine- Amlodipine is used with or without other medications
to treat high blood pressure. Lowering high blood pressure helps
prevent strokes, heart attacks, and kidney problems. Dose-10 mg,20
Instruct the client regarding the purpose of diagnostic medical &
surgical procedures and the pre- & post procedure expectations.
Assist the client to identify risk factors that can be modified, and set
goals that will promote change in lifestyle to reduce the impact of risk
Instruct client regarding a low-calorie, low-sodium, low-cholesterol,
low-fat diet with a increase in dietary fiber. Stress that dietary changes
are not temporary and must be maintained for life.
Provide community resources to client regarding exercise, smoking
cessation and stress reduction.
Impaired gas exchange related to decreased blood flow as evidenced by
Acute pain related to disease condition as evidenced by patient
Impaired physical mobility related to weakness as evidenced by patient
is unable to perform daily activity.
Imbalanced nutrition less than body requirement related to less intake of
food as evidenced by weight loss
A new study has found that the heart’s small left ventricle with thick
walls, can be the strongest predictor of morphologic remodeling, which is
most likely to be considered a first step towards heart failure in patients
with ischemic heart disease. According to study coordinators Frank
Rademakers and Jan D’Hooge, the results of the DOPPLER-CIP
(Determining Optimal non-invasive Parameters for the Prediction of Left
ventricular morphologic and functional Remodeling in Chronic Ischemic
Drug-eluting stents — a less-invasive alternative to bypass surgery — are as
effective as surgery for many patients with a blockage in the left main
coronary artery, a study has found. Coronary artery bypass graft (CABG)
surgery has long been considered the definitive treatment for patients with
left main coronary artery disease (LMCAD), in which the artery that supplies
oxygen-rich blood to most of the heart muscles is clogged with
atherosclerotic plaque. However, stents, which are placed into the diseased
artery via a catheter that is inserted through a small opening in a blood vessel
in the groin, arm, or neck, are a less-invasive treatment option for many
people with coronary artery disease.
Difference BETWEEN angiography and angioplasty
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