Coronary Artery Disease

Megan McClintock

Coronary Artery Disease

• Definition

• Etiology/Pathophysiology

• Risk Factors– Unmodifiable– Modifiable

• Signs & symptoms– Angina pectoris– Acute coronary syndrome– Sudden cardiac death

Angina

• Types• Etiology/Pathophysiology• Diagnostic studies• Drug therapy

– Aspirin– Nitrates– Beta-adrenergic blockers– Calcium channel blockers

• Surgical therapy– PCI– Stent placement– Atherectomy– Laser Angioplasty– Myocardial revascularization

Angina Interventions

• Health promotion– Management of risk factors– Nutrition therapy– Drug therapy for hyperlipidemia

• Acute– Administer oxygen– Vital signs– ECG– Nitrate followed by narcotic– Heart sounds– Comfortable positioning

• Ambulatory/Home Care– Prevention– Proper use of nitroglycerin

Myocardial Infarction

• Etiology/Pathophysiology• Signs & symptoms

– Angina– Pain– Nausea/vomiting– Sympathetic nervous system stimulation– Fever– CV manifestations

• Complications– Arrhythmias– CHF– Cardiogenic shock– Papillary muscle dysfunction– Ventricular aneurysm– Pericarditis– Dressler syndrome– Pulmonary embolism

Myocardial Infarction

• Diagnostic studies– ECG findings– Serum cardiac markers

• Treatment– IV– Morphine sulfate– Oxygen– Reperfusion therapy

• Fibrinolytics• Cardiac catheterization• PCI

– Drug therapy• Nitroglycerin• Antiarrhythmics• Morphine• Beta-adrenergic blockers• ACE inhibitors• Stool softeners

– Nutrition therapy

MI Interventions

• Nursing care plan (pg ______)• Acute

– Pain assessment– Morphine– Monitoring– Rest– Anxiety– Denial

• Ambulatory/Home Care– Cardiac rehabilitation– Teaching– Exercise– Resumption of sexual activity

Sudden Cardiac Death

• Definition

• Etiology/Pathophysiology

• Risk factors

• Interventions– Diagnostic workup– Antiarrhythmics– ICD

Congestive Heart Failure

• Definition• Etiology/Pathophysiology• Types

– Left-sided failure– Right-sided failure

• Signs & symptoms– Acute

• Pulmonary edema– Chronic

• Fatigue• Dyspnea• Tachycardia• Edema• Nocturia• Skin changes• Behavioral changes• Chest pain• Weight changes

Congestive Heart Failure

• Complications• Diagnostic studies• Treatment

– Decreasing intravascular volume– Decreasing venous return– Decreasing afterload– Improving gas exchange and oxygenation– Improving cardiac function– Reducing anxiety– Biventricular pacing– Cardiac transplantation

Congestive Heart Failure

• Drug therapy– ACE inhibitors– Diuretics– Inotropic drugs– Beta-adrenergic agonists– Phosphodiesterase inhibitors– Calcium sensitizers– Vasodilators– Beta-adrenergic blockers

• Nutritional therapy– Sodium restriction– Fluid restriction– Weight reduction

CHF Interventions

• Nursing care plan (pg _______)

• Health Promotion

• Acute

• Ambulatory/Home Care– Drug instructions– Symptoms of hypokalemia– Energy saving behaviors

Cardiomyopathy

• Definition• Types

– Dilated• Etiology/pathophysiology• Signs & symptoms• Treatment

– Hypertrophic• Etiology/pathophysiology• Signs & symptoms• Treatment

– Restrictive• Etiology/pathophysiology• Signs & symptoms• Treatment

Cardiac Transplantation

• Indication

• Surgery

• Post operative care