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Coronary Artery Disease PowerPoint Presentation

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Description : Check out this medical presentation on Angina, which is titled "Coronary Artery Disease", to know about coronary artery disease, pathophysiology, signs and symptoms of coronary artery disease, diagnostic features of coronary artery disease, and, the management of coronary artery disease.

Tags : Angina, Coronary Artery Disease, pathophysiology, signs, symptoms

Published on : May 25, 2021 | Views : 4557 | Downloads : 7

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CORONARY ARTERY DISEASE
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LEARNING OBJECTIVES At the end of class the learner will be able to Define coronary artery disease Elaborate on pathophysiology, signs and symptoms of coronary artery disease List down diagnostic features of coronary artery disease Understand the management of coronary artery disease 5/27/2021 1:14 PM (NAME) 2
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Coronary Artery Disease 5/27/2021 Definition: CAD is a term that refers to the effect of the accumulation of atherosclerosis plaque in the coronary arteries that obstructs blood flow to the myocardium
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Contd…… Conditions result from CAD 1. Angina Pectoris 2. Myocardial Infarction
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Angina Pectoris Definition: Angina: Choking or suffocation. Pectoris: Chest. Angina pectoris, is the medical term used to describe acute chest pain or discomfort. Angina occurs when the heart’s need for oxygen increases beyond the level of oxygen available from the blood nourishing the heart. It has 3 types Stable Angina Un stable angina & Variant Angina (Prinzmetal’s or resting angina) :
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Cont. Types of Angina Stable angina: People with stable angina have episodes of chest discomfort that are usually predictable. That occur on exertion or under mental or emotional stress. Normally the chest discomfort is relieved with rest, nitroglycerin (GTN) or both. It has a stable pattern of onset, duration and intensity of symptoms.
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Cont. Unstable angina: It is triggered by an un predictable degree of exertion or emotion. (progressive), more severe than stable. Characterized by increasing frequency & severity. Provoked by less than usual effort, occurring at rest & interferes with pt lifestyle.
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Cont. Variant Angina (Prinzmetal’s or resting angina) occur spontaneously with no relationship to activity. Occurs at rest due to spasm. Pt discomfort that occurs rest usually of longer duration. Appears to by cyclic & often occurs at about the same time each day (usually at night). Thought to be caused by coronary artery spasm
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Mechanism Of Angina 5/27/2021 www.health-nurses-doctors.blogspot.com
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Causes Coronary atherosclerosis (atheroma ) Factors increasing preload : Hyperthyroidism Exercise Anemia Factors increasing after load: Hypertension Aortic stenosis Obstructive cardio myopathy Coronary artery spasm
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Clinical Manifestations Characteristics: Squeezing, burning, pressing, choking, or bursting pressure. Onset: Quickly or slowly Location: Chest, right or left arms, shoulder, or neck, jaw. Duration: Less then 5 minutes. Associated: Dyspnea, Sweating, faintness, palpitation, dizziness ect. Relieving: GTN and rest. Aggravating: exertion, exercise, heavy meal, emotional upset, and anger.
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Investigations Electrocardiogram ( ECG) Coronary angiography Exercise Electrocardiogram (Stress test). Complications Myocardial infarction Cardiac Arrhythmias
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Myocardium Infarction Myo means muscle, “Cardiac” heart, infarction means “death of tissues due to lack of blood supply”. It is also called heart attack. It occurs when coronary arteries become blocked and the part of myocardial muscles become dead due to prolonged lack of oxygen supply to the muscle cells.
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PATHOPHYSIOLOGY Coronary artery cannot supply enough blood to the heart in response to the demand due to CAD Within 10 seconds myocardial cells experience ischemia Ischemic cells cannot get enough oxygen or glucose Ischemic myocardial cells may have decreased electrical & muscular function Cells convert to anaerobic metabolism. Cells produce lactic acid as waste Pain develops from lactic acid accumulation Pt feels anginal symptoms until receiving demand increase 02 requirements of myocardial cells
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ECG changes in Angina & MI Zone of Ischemia: T wave inversion Zone of Injury: ST elevation Zone of Necrosis: Abnormal Q wave
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Sign and Symptom Classic symptom of heart attack are chest pain radiating to neck, jaws, back of shoulder, or left arm The pain can be felt like: Squeezing or heavy pressure A tight band on the chest An elephant sitting on the chest
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Cont Other symptoms include: Shortness of breath (SOB) Weakness and tiredness Anxiety Lightheadedness Dizziness Nausea vomiting Sweating, which may be profuse
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Collaborative Management Assessment History Clinical manifestation Cardiovascular assessment Laboratory assessment Troponin T & I CK-MB
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Radiographic Assessment ECG Stress Test Myocardial perfusion imaging MRI Cardiac Catheterization
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IMPORTANT INFORMATION TO REMEMBER Increase supply of Oxygen Decreasing the demand of Oxygen: Stop activity and lie down (CBR) Take Tab. Angisid sublingually and wait till it dissolves. If pain continues take up to 03 Tab. Angisid one every five minutes. If pain is not relieved yet take another tab. and rush to EMERGENCY services.
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IMMEDIATE MANAGEMENT OF MI: GOALS To prolong life. Minimize infarct size. Reverse ischemia. Reduce cardiac work. Prevent and treat complications. A) INITIAL TREATMENT Rapid triage. OMI (oxygen, monitor and I/V line). Check vital signs and O2 saturation. ECG within 10 minutes and repeat ECG. Blood samples for enzymes, CBC, electrolytes, and lipid profile.
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Intervention Medication: Morphine Sulphate Nitrates (GTN) Beta blockers Calcium Channel Blocker Anti platelets / Anti coagulant Thrombolytic therapy 5/27/2021
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Surgical management PTCA (Percutaneous Transluminal Coronary Angioplasty 5/27/2021
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Coronary Artery Bypass Graft surgery (CABG) 5/27/2021
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Prevention Recognize the symptoms Reduce your risk factors: Lose weight Quit Smoking Keep your cholesterol at a normal level. Keep your blood pressure under control. Use techniques to ease stress. Control blood sugar level. Eat Right REGULER EXERCISE 5/27/2021
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COMPLICATIONS OF MI: Arrhythmias Atrial arrhythmias. Ventricular arrhythmias. Bradycardia and heart block. Asystol. Hypertension. LV failure. Cardiogenic shock.
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FOLLOW UP
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Nursing Diagnosis Acute pain R/T imbalance between myocardial oxygen supply and demand Ineffective tissue perfusion R/T interruption of arterial blood flow Ineffective coping R/T effects of acute illness and major changes in life style Impaired gas exchange related to ineffective breathing pattern and decreased systemic tissue perfusion. Anxiety related to present status and unknown future, possible lifestyle changes, pain, and perceived threat of death. Activity intolerance related to fatigue 5/27/2021
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Evaluation Define coronary artery disease? Explain in detail pathophysiology and management of a patient with coronary artery disease? 5/27/2021 1:14 PM (NAME) 30
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BIBLIOGRAPHY Smeltzer C, Bare Brenda. Brunner and Suddarth’s textbook of medical surgical nursing, 10th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. Black MJ, Jacobs EM. Luckmann & Sorensen’s medical surgical nursing, 4th ed. Philadelphia: Saunders;1993. Basavanthapa BT. Medical surgical nursing, 1st ed. New Delhi: Jaypee; 2003. Lewis SM, Heitkemper MM. Textbook of medical surgical nursing, 6th ed. Missouri: Mosby; 2004. Phipps, Monahan, Sands. Medical surgical nursing, 7th ed. Missouri: Mosby; 2004. www.wikipedia/myocardial infarction.com 5/27/2021 1:14 PM Gireesh G.R 31
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5/27/2021 1:14 PM (NAME) 32