PathophysiologyBMS 243

Lecture vCoronary Artery Disease

Dr. Aya M. Serry

2015/2016

Coronary Artery Disease (CAD)

Coronary artery disease (also called CAD) is the most common type of heart disease. It is also a leading cause of death for both men and women

The coronary arteries wrap around the heart and supply it with blood and oxygen.

It occurs when fatty deposits called plaque build up inside the coronary arteries. When plaque builds up, it narrows the arteries and reduces the amount of blood that gets to your heart.

Plaque also can crack, which causes blood cells called platelets to clump together and form blood clots at the site of the cracks. This narrows the arteries more and worsens angina or causes a heart attack

Coronary Artery Disease

When arteries become filled with plaque and the arteries narrow, atherosclerosis occurs.

When atherosclerosis happens in the coronary arteries, it is called coronary artery disease. When this happens, the heart cannot get enough oxygen to function properly

Coronary Artery Disease

Coronary Artery Disease

Hypertension

Angina; Angina is chest pain that occurs when your

heart is not getting enough blood

CHF; it means that your heart is failing to pump blood

the way that it should

Myocardial Infarction; Death of heart cells due to lack

of oxygen

Death

Complications of CAD

Uncontrollable

• Sex

• Hereditary

• Race

• Age

Controllable

• High blood pressure

• High blood cholesterol

• Smoking

• Physical activity

• Obesity

• Diabetes

• Stress and anger

CAD Risk Factors

Findings may be normal during asymptomatic period

Chest pain - due to lack of oxygen

Palpitations

Dyspnea

Syncope

Excessive fatigue

CAD Signs and Symptoms

1. Cholesterol-lowering medications

2. Anticoagulants : prevent clots from forming in your arteries and blocking blood

flow

3. ACE inhibitors : lower blood pressure and reduce the strain on your heart. They

also may reduce the risk for a future heart attack and heart failure.

4. Beta-blockers: slow the heart rate and lower the blood pressure to decrease

the workload on your heart.

CAD Treatment

5. Nitroglycerin: to prevent or relieve chest pain.

6. Thrombolytic : Dissolve the clots that can occur during heart attacks.

CAD Treatment

• Many people are able to manage coronary artery disease with lifestyle changes and medications (Prevention and Treatment)

• Other people with severe coronary artery disease may need surgery, such as:

1) Stenting

2) Angioplasty

CAD Surgical Treatment

3) Bypass surgery

• healthy blood vessel is removed from leg, arm or chest• This blood vessel is used to create new blood flow path in your heart

around (bypassing) the blocked portion of the diseased artery

CAD Surgical Treatment