CAD

CORONA-RY ARTERY DISEASE

1. PRESENTED BY Monika Devi M.S.c ( N) HCN, SRHU Coronary Artery Disease

2. CORONARY ARTERY DISEASE PLAGUE FORMATION

3. CORONARY ARTERY DISEASE Definition CAD refers to narrowing of the coronary artery The blood vessels that supply oxygen and blood to the heart it is also known as CAD. it is a major cause of illness and death.

4. CAUSES Is a combination o f genetic and lifestyle factors. These are called risk factor. NON modifiable causes. Age Gender more than 55 years. Males and in female are more after menopause have high risk of CAD. Heredity. Ethnicity :People of African or Asian are of high risk.

5. CONT… Modifiable factor Smoking Diabetes Excess body weight, especially around waist High blood pressure Abnormal blood cholestrol levels Lack of regular exercise Excessive stress level Depression

6. Sign And Symptoms CAD usually have no symptoms for severals years during its early stages, eventually the disease progresses untill the symptoms of angina or heart attack occur. These symptoms can be experience during activity or rest. Chest pain, or a feeling of heaviness in the chest Pain in arm , neck or jaw

7. CONT… Shortness of breath Sweating Nausea Heart palpitations (irregular heart beat) Loss of consciousness In women early sign include :- fatigue Sleep disturbance SOB Indigestion Chest discomfort anxiety

8. Diagnosis ECG :- Tto identify problem with heart rhythm or sign of a heart attack. TMT (treadmill test) :- To measure how will the heart functions when challenged to work harder(during exercise) then normal. Nuclear perfusion imaging :- To identify the area of the heart that are receiving less blood.

9. CONT… Echocardiogram :- to determined volume of blood pumped by heart CT coronary angiography:- to identify the blockage in the arteries in the heart Cardiac catheterization :- to identify the blocked or restricted arterie s Blood test complete hemogram :- increase TLC count suggestive of infection Cardiac marker :- tropinin I , CPK-MB

10. MANAGEMENT Management I ncludes medical procedure and medication, life style modification , diet , and exercise regularly. Medication Include Statins :- lipid lowering agents decrease the cause of developing cardiovascular disease Beta blockers :- To reduce blood pressure and heart rate.

11. CONT… Nitroglycerine patches, sprays, tablets :- To control chest pain by reducing the heart’s demand for blood by widening the coronary arteries. Angiotensin - converting enzymes ACE inhibitors :- To lower the blood pressure and help to slow or stop the progression of CHD.

12. CONT.. Calcium Channel Blockers :- To widen the coronary arteries, allowing greater blood flow to the heart and reduce hypertension.

13. Surgical management Surgery can be open or replaced arteries it the blood vessels become very narrow or if symptoms are not responding to medications. Laser surgery :- this involves making several tiny holes in the heart muscles which encourage the formation of new blood vessels

14. CONT.. Coronary bypass surgery :- The surgeon use a blood vessels from another part of the body to create a graft that can bypass the blocked artery. The graft may come from the leg or an inner chest wall artery.

15. CONT… Angioplasty and stent placement :- A catheter is inserted into the narrowed part of the artery. A deflated ballon is passed through the catheter to The affected area. When the ballon is inflated it compresses the fatty deposits against the artery walls. A stent or mess tube , may be left in the artery help to keep it open.

16. Nursing management Nursing assessment Heath history : Assess for chest pain, focus on the location, severity, intensity, duration and onset. Precepitating factor : exercise stress and smoking. Measure attempted to control pain for examples lying down, eating and drinking , using of antacids. Assess for other symptoms : in digestion , heartburn, nausea, abdominal pain

17. CONT… Physical examination Assessing for the following Posture indicating chest pain examples rubbing chest, leaning forward. Changes in vital sign Dyspnea , crackles, dysrhythmias . Level of conciousness vommiting

18. Nursing diagnosis 1 . Altered breathing pattern related to imbalance between myocardial oxygen supply and demand as evidence by an increase in respiratory rate . Goal The patient will have normal respirations. Nursing intervention Assess the pattern and rhythm of breathing Check spo2 level Place the patient in semi fowler position Administer oxygen therapy Give medication as prescribed

19. CONT… 2. Chest pain related to inflammatory response of the arteries as evidence by patient rubbing the chest. Goal To relieve pain Intervention Place the patient in a position which he / she feeling comfortable Administer prescribed analgesics

20. CONT… 3. Activity intolerance related to dyspnea as evidence by inability to perform some activity of daily living. Goal patient will tolerate gradually with increasing levels of activities Interventions Promote, encourage and provide activities of daily living.

21. Prevention Controlling blood cholesterol levels , reduce the risk of CHD. Restricted alcohol intake Avoiding tobacco Being physically active Consuming health diet ( avoid fast food, food with added preservatives) Limiting sugar and salt.

22. Complication of CAD Heart failure Dysarrthymia Pericarditis Cardiogenic shock Cardiomegaly

23. THANKS