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CORONARY HEART DISEASE (CHD) - Coggle Diagram
CORONARY HEART DISEASE (CHD)
TREATMENTS
SURGERY
(2) HEART TRANSPLANT
Removes a damaged or diseased heart and replaces it with a healthy one that comes from a donor who has died.
The last resort for people with heart failure when all other treatments have failed
(1) CORONARY BYPASS SURGERY
Redirects blood around a section of a blocked or partially blocked artery in the heart by taking a healthy blood vessel from the leg, arm, or chest and connecting it below and above the blocked arteries in the heart
(3) ANGIOPLASTY
Deflated balloon is threaded up to the coronary arteries where the balloon will inflated to widen the blocked areas
MEDICATION
(5) PROPRANOLOL
: ß-adrenergic blocker that competitively blocks ß1 and ß2-receptors resulting in decreased heart rate, myocardial contractility, BP and myocardial oxygen demand.
(2) ISOSORBIDE MONONITRATE:
Exogenous source of nitric oxide which causes vascular smooth muscle relaxation and consequent dilation of peripheral arteries and veins
(4) ANTI PLATELETS (ASPIRIN)
: Inhibit platelet activation and aggregation
(1) ATOVASTATIN
: Inhibits HMG-CoA reductase that will increase the expression of LDL receptors and stimulation of LDL catabolism.
(3) CALCIUM CHANNEL BLOCKER (FELODIPINE)
: Inhibit Ca ion influx into cardiac & smooth muscle that will relax coronary vascular smooth muscle and reduce peripheral vascular resistance
DIAGNOSTICS AND BIOCHEMICAL TESTS
DIAGNOSTIC AND BIOCHEMICAL TESTS
Blood test: Measure the amount of these proteins in the bloodstream. Higher than normal levels of these proteins suggest a heart attack.
ECG: Test that checks how heart is functioning by measuring the electrical activity of the heart
How electrical impulse generated?
By the sinus node (also called the sinoatrial node, or SA node)
SA nodes = a small mass of specialized tissue located in the right upper chamber (atria) of the heart
The sinus node generates an electrical stimulus regularly, 60 to 100 times per minute under normal conditions
Normal ECG
The diagnosis of the normal electrocardiogram is made by excluding any recognized abnormality.
PR interval: 120 – 200 ms, QRS: 120 ms. QT: 440 ms
In each ECG, every P waves is followed by QRS waves.
Chest x-ray: To see if the heart is enlarged and if the lungs are congested with fluid
Cardiac enzyme: To determine if someone is having or has already had a heart attack by checking the level of the enzyme that is released by the heart muscle when it is injured such as during a heart attack
Angiogram: Diagnostic test that uses x-rays to take pictures of the blood vessels.
Echocardiogram: A type of echo called Doppler ultrasound shows how well blood flows through your heart's chambers and valves and it can detect possible blood clots inside the heart
Exercise stress test: An electrocardiogram (ECG) done while exercise
CARDIAC BIOMARKERS
Creatinine kinase: Chemical waste product in the blood that passes through the kidneys to be filtered and eliminated in urine. The chemical waste is a by-product of normal muscle function.
Myoglobin: Small protein that stores oxygen
Cardiac troponin: measure the level of cardiac-specific troponin in the blood to help detect heart injury (the most commonly used)
RISK FACTORS
AGE:
Getting older increases the risk of damaged and narrowed arteries. Blood vessels become less flexible,** making it harder for blood to move through them easily
STRESS
: High levels of cortisol from long-term stress can increase blood cholesterol, triglycerides, blood sugar, and blood pressure
FAMILY HISTORY
: A family history of coronary heart disease (CHD) is associated with an approximately 1.5- to 2.0-fold higher risk of CHD independent of conventional risk factors
OBESITY OR OVERWEIGHT
: Obese individuals tend to have greater amounts of blood, which makes the heart pump harder and can lead to heart failure over time
DIABETES
: Over time, high blood sugar can damage blood vessels and the nerves that control the heart.
HIGH BLOOD PRESSURE
: High blood pressure puts added force against the artery walls. Over time, this extra pressure can damage the arteries, making them more vulnerable to the narrowing and plaque buildup associated with atherosclerosis
SYMPTOMS
SHORTNESS OF BREATH
NAUSEA OR FEELING OF INDIGESTION
COLD SWEATS
FATIGUE
ANGINA
Stable Angina: When a person has brief episodes of pain, squeezing, pressure, or tightness in the chest during moderate physical activity or when you are pushing yourself physically.
Unstable Angina: When a person get angina symptoms while doing very little or resting.
CRUSHING PAIN IN SHOULDER OR ARM
CHD = WHEN THE CORONARY ARTERIES BECOME NARROWED BY A GRADUAL BUILD-UP OF FATTY MATERIAL WITHIN THE WALLS.
PREMATURE CHD
: One that occurs before age 55 in a man or before age 65 in a woman.
TRIGGER 2
Diagnosed with Angina
Have insulin resistance and mild dyslipidemia
Have high BP and normal pulse at rest
Due to progressive angina, surgery was performed.
TRIGGER 1
Experienced heavy in the chest after walking incline + shortness of breath
He has a history of smoking and family history of CHD.
BP-151/99 mmHg, pulse-97 beats/minute (bpm), respirations-20/minute, temperature-36.6 °C oxygen saturation-98%
obese stature, weighing 126 kg and 183 cm tall (BMI 39.7)
21 years old, caucasian, male student
