Nonmodifiable Risk Factors: Family History ‘Age: >55 years old in women >45 years old in men Gender: men (develops earlier than women) Race: African-American ‘Modifiable Risk Factors: Hyperlipidemi Cigarette smoking Hypertension om Metabolic syndrome Obesity Physical inactivity Injury to the vascular endothelium Monocytes attach to the site of injury (monocyte emigration) and transformed into a macrophage § macrophages ingest lipids & oxidizes lipoprotein molecule gmacrophages become "foam cells” transporting lipids into the arterial wall $ § release biochemical foam cells aggregate on the blood vesecland substances that can futher form fatty streak damage the endothelium ¢ % plaques begin to form; atrracts platelets arteries begin to harden $ {artherosclerosis) initiating clotting & ‘Smooth muscle cells proliferate within the vessel wall & forms a fribrous cap over a core filled with lipids and inflammatory infiltrate § plaques protrude into the lumenee If no apparent obstruction narrowing and in the blood flow ‘obstruction of blood flow § in the coronary artery wall =a ee % 4 ‘Recompanying 5/5 tncrease myocardial If fibrous cap is thick and 508, nausea, fatigue, jemand, decrease Inflammtion Is continuous, anxiety, profuse ‘oxygen supply to the plaque may rupture and np cardium hemorrh sweating, dizziness myo cause ; age \ sweating, dizziness _} Squeezing chest pain blood in the artery radiating to the neck, ‘coagulate and cause Jaw, shoulders, left arm. ‘thrombus formation Lasts usually for 15 gu minutes, relieved by reduced blood flow and nitroglycerine and rest ‘oxygen supply in the myocardium a “ne|e St-elevation Non ST Elevation % \ (+) clinical manifestation 4 u of coronary ischemia (+) einical manifestation partial oclusion in atleast one (+) Cardiac markers: of coronary ischemia Erthe major coronary artery ‘troponin, CKMB. (+) cardiac markers: (+) €CG: with evidence of troponin, CAMB. (+) clinical Mi, presence of (ECG! no evidence of manifestion of pathologic wave mi coronary ischemia () Cardiac markers: a o troponin, cesta () ECG: no evidnece of mi) % —_1—__. ‘Accompanying signs and ‘Chest pain, increasing in) | symptoms: frequency & severity & | | shortness of breath, are not relieved by rest |) nausea, fatigue, anxiety, and nitroglycerine profuse sweating, dizzines