Care of patient with coronaery haert diseases

Management & Nursing Care
of Patient with Coronary Artery Diseases
Dr. Fakhria Jaber
Adult Nursing
Outlines
• Anatomic& physiologic overview of cardiovascular system
• Coronary a
• therosclerosis
• Angina
• Myocardial infarction
• Congestive heart failure

Anatomic& physiologic overview of cardiovascular system
Introduction
• Vascular system( the blood vessels)
• Blood circulation
• Introduction

• The cardiovascular/circulatory system transports food, hormones, metabolic wastes, and gases (oxygen, carbon dioxide) to and from cells.
• Components of the circulatory system
• Blood: consisting of liquid plasma and cells
• Blood vessels: (vascular system): the "channels" (arteries, veins, capillaries) which carry blood to/from all tissues. Arteries carry blood away from the heart. Veins return blood to the heart. Capillaries are thin-walled blood vessels in which gas/ nutrient/ waste exchange occurs.
• Heart: a muscular pump to move the blood
Vascular System - the Blood Vessels
• Arteries, veins, and capillaries comprise the vascular system. Arteries and veins run parallel throughout the body with a web-like network of capillaries connecting them.
•

Blood circulation
Coronary Atherosclerosis
• Diseases of the coronary arteries is almost always due to plaque and its complications , particularly thrombosis.
• Atherosclerosis is a progressive inflammatory disorder of arterial wall that is characterized by focal lipid rich deposits of atheroma that remain clinically silent until they become large enough to impair tissue perfusion
Risk factors for developing atherosclerosis
• Age and sex
• Family history for ( hypertension, hyperlipidemia, diabetes mellitus)
• Smoking
• Hypertension
• Hypercholesterolemia
• DM
• Haemostatic factors, platelets activation and high levels of fibrinogen are associated with an increased risk of coronary thrombosis
• Physical activity
• Obesity
• Alcohol
• Personality type
Coronary heart disease: clinical manifestations and pathology
• Clinical problem Stable angina , Unstable angina Myocardial infarction
• Ischemia due to fixed atheromatous stenosis of one or more coronary arteries
• Ischemia caused by dynamic obstruction of a coronary artery due to plaque rupture or erosion with imposed thrombosis
• Myocardial necrosis caused by acute occlusion of a coronary artery due to plaque rupture or erosion with imposed thrombosis

• Myocardial dysfunction due to ischemia or infarction
• Altered conduction due to ischemia or infarction
Prevention of atherosclerosis
• primary prevention (control of risk factors)
• Do not smoke
• Take regular exercise ( minimum of 20 min 3 times a week)
• Maintain ideal body weight
• Eat a mixed diet rich in fresh fruit and vegetables
• Aim to get no more than 10% of energy intake from saturated fat
• Primary prevention in patients without evidence of coronary disease but with high serum cholesterol concentration, cholesterol- lowering with statin prevent coronary events e.g. (angina, MI)
• Secondary prevention in patients with established coronary disease (MI or angina), statin therapy is safely.