Coronary Artery Disease (CAD)

Myocardial Ischemia

Angina Pectoris Myocardial Infarction

Irreversible damage to the myocardium

Scar tissue formation

Cardiac dysfunction

Heart Failure Cardiac Dysrhythmias/Arrest

CORONARY ARTERY DISEASE

• An abnormal condition that may affect the heart’s arteries and produce various pathologic
effects especially reduced flow of oxygen and nutrients to the myocardium.
• Angina Pectoris is the classic symptom of CAD and results from myocardial ischemia.
• Coronary Atherosclesrosis an abnormal accumulation of lipid or fat substances and
fibrous tissue in the lining of arterial blood vessel wall that blocks and narrows the
coronary vessels leading to a reduced blood flow in the myocardium.
Risk Factors:
A. MODIFIABLE B. NON-MODIFIABLE
- Hyperlipidemia - Family History
- Smoking - Increasing Age
- HPN, DM - Gender (men>women)
- Obesity - Race (African American)
- Physical Inactivity
- Lack of estrogen in women
Management:
 Control cholesterol abnormalities
 Diet: LSLF, high fiber
 Smoking cessation
 Managing HPN and DM
 Physical Activity:
a. 30 mins. regular moderate exercise (brisk walking)
b. 5 mins. warm-up and cool down period
c. Instruct to wear loose fitting clothing
d. STOP if chest pain, unusual SOB, dizziness, lightheadedness or nausea occurs
 Medications:
a. Statins (HMG-CoA reductase inhibitors) – blocks cholesterol synthesis, decreases
LDL & triglycerides, increases HDL levels. Eg. Simvastatin, Provastatin
Side Effects: Myopathy, Hepatotoxic
b. Nicotinic Acid (Niacin) – decreases lipoprotein synthesis, decreased LDL &
triglyceride, increased HDL levels.
Side Effects: GI upset, gout, flushing, & Hepatotoxic
c. Fibric Acid/Fibrates – decreased synthesis of cholesterol, decreased triglycerides,
increased HDL levels.
Side Effects: Use cautiously with “statins” can cause Myopathy & ARF, dyspepsia, &
gallstones.
d. Bile Acid Sequestrants/Resins (cholestyramines) – bind cholesterol in the
intestines, increase its breakdown & decrease LDL levels with little effect on HDL’s
and no effect on triglycerides.
Side Effects: GI distention & constipation