Coronary Artery Disease & Myocardial Infarction

CORONARY ARTERY DISEASE

What is CAD?

Most people develop coronary artery disease (CAD) due to atherosclerosis. Atherosclerosis occurs when plaque made up of fat, cholesterol, calcium, and fibrin form inside of our arteries.  High blood pressure, smoking, and cholesterol all can contribute to Atherosclerosis. Our focus is on the arteries that supply the heart muscle.  

What happens with plaque buildup?

When plaque settles inside of the artery it cuts off the important blood supply feeding a specific organ, in the case the heart.   The blood passing through arteries is very crucial to vital organs; it provides this important muscle with oxygen and nutrients.  If this muscle is deprived of oxygen and nutrients it will result in an injury and eventually death.   There is a higher risk of clot formation in these arteries if plaque is present.

cad

Why is CAD so important to understand, prevent, and treat?

 CAD is the most common form of heart disease, leading cause of death in both men and women in the U.S.  CAD can lead to chest pain and a myocardial infarction (heart attack).  Medical management can help prevent or delay further plaque formation. An example of surgical treatment would be a coronary artery catheterization with stent placement, allowing the artery to stay open for adequate blood supply to the cardiac muscle.

(National Heart, Lung and Blood Institute, 2013) & (Texas Heart, 2013).

 

MYOCARDIAL INFARCTION

What is a myocardial infarction?

A myocardial infarction (MI) happens when an artery that supplies oxygenated blood to the heart becomes blocked. The blood is unable to pass through and supply the cardiac muscle properly. The American Heart Association (AHA) estimates that about every 34 seconds an American will have a heart attack.

Causes of a myocardial infarction:

The main cause of a MI is blockage of artery from atherosclerosis with acute clot formation. Spasm of the artery causing occlusion could also occur.  Blood flow can also be decreased during times of shock or severe bleeding ultimately leading to inadequate blood supply to the cardiac muscle.

MI

 

How to prevent a myocardial infarction:

Genetics and family history may cause someone to be at a higher risk for having a MI, but there are also many modifiable risk factors that people can control. These are some of the risk factors that are preventable.

1.     Smoking tobacco products. This includes second hand smoke/exposure to smoke.

2.    High blood cholesterol. The goal is to have more “good” cholesterol, than bad cholesterol. This can be managed through diet.

3.    High blood pressure.This can be reduced with better diet, exercise, stress management, medication.

4.    Uncontrolled Diabetes.Checking glucose frequently and properly taking care of your DM through diet and correct medication regimen.

5.    Physical inactivity.Exercise is important in overall health and can help prevent the risk of a MI.

What to do during a myocardial infarction:

As nurses, our biggest life saver is education and prevention. It is important to teach our patients the signs and symptoms of a heart attack, the importance of quick treatment, and to call 911 if symptoms do not go away after 5 minutes!

Signs and symptoms include:

  • Pressure, burning, tightness in the chest
  • Constant indigestion-like discomfort
  • Uncomfortable pressure in your chest that moves to your shoulders, arms, neck, jaw, or back
  • Lightheadedness, fainting, sweating, or a sick stomach
  • Shortness of breath
  • Anxiety, weakness, nausea or tiredness
  • Irregular heart beat “flutter” feeling

Women may experience slightly different sign and symptoms, these include:

  • Pain or discomfort in the center of the chest
  • Pain or discomfort in other areas of the upper body, including the arms, back, neck, jaw, or stomach
  • Shortness of breath
  • Breaking out in a cold sweat
  • Nausea
  • Light-headedness

If the patient has a nitroglycerin order it’s important to educate them to use them as instructed. If chest pain continues after 5 minutes, remind them to call 911.

If a patient has never experienced this before, educate your patient to chew 1 aspirin or Tylenol and ibuprofen if aspirin is not available until the paramedics arrive.

(Cleveland Clinic, 2013), (National Heart, Lung and Blood Institute, 2013) & (Texas Heart, 2013).

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