Coronary Artery Disease (CAD)

What is the major cause of CAD Atherosclerosis Atherosclerosis Begins as soft deposits of fat that harden with age Referred to as "hardening of arteries" Atheromas (fatty deposits) prefer coronary arteries Also known as ASHD, CVHD, IHD, CHD Characterized by lipid deposits within intima of artery Platelets may come in and clot to try and repair wall What plays a role in arteriosclerosis Endothelial injury and inflammation Coronary Artery Disease Risk Factors Non- modifiable Age Gender Genetics Coronary Artery Disease Risk Factors Modifiable Diabetes ( keep good control hypertension Lifestyle (smoking) Diet Exercise Coronary Artery Disease Etiology and Pathophysiology C-reactive protein (CRP) Nonspecific marker of inflammation Increased in many patients with CAD Chronic exposure to CRP associated with unstable plaques and oxidation of LDL cholesterol Lab test lets us know that inflammation is occurring Coronary Artery Disease Etiology and Pathophysiology Collateral circulation Arterial anastomoses (or connections) within the coronary circulation Increased with chronic ischemia May be inadequate with rapid-onset CAD In addition to all coronary arteries, as patient gets older, Vessel Occlusion With Collateral Circulation Two risk factors for coronary artery disease that increase the workload of the heart and increase myocardial oxygen demand are A. Obesity and smokeless tobacco use. B. Hypertension and cigarette smoking. C. Elevated serum lipids and diabetes mellitus. D. Physical inactivity and elevated homocysteine levels. B Which patient is most at risk for developing coronary artery disease? A. A hypertensive patient who smokes cigarettes B. An overweight patient who uses smokeless tobacco C. A patient who has diabetes and uses methamphetamines D. A sedentary patient who has elevated homocysteine levels A