Please enable JavaScript.
Coggle requires JavaScript to display documents.
Complaints of erectile dysfunction after CABG RARA KHAIRANIA MAYFA …
Complaints of erectile dysfunction after CABG
RARA KHAIRANIA MAYFA
1908260065
CABG
Definitions
Coronary Artery Bypass Graft (CABG) is performed to create a new route around narrowed or blocked arteries so that blood flows smoothly so that the heart muscle still gets enough oxygen and nutrients.
CABG is a catheter-based technology, like angioplasty and stenting, and it works.
Coronary artery bypass grafting (CABG) is a major surgical operation where atheromatous blockages in a patient’s coronary arteries are bypassed with harvested venous or arterial conduits.
Procedures
In general, on-pump and off-pump are the 2 types of CABG surgical procedures with the difference being the use of a cardiopulmonary bypass circuit and an arrested heart to operate during an on-pump CABG.
The conduits used as bypass grafts are routinely the left internal mammary artery (LIMA) and the saphenous vein grafts (SVG) out of the lower extremities.
Other conduits that may be grafted include the right internal mammary artery (RIMA), the radial artery, and the gastroepiploic artery.
Typically, the LIMA is grafted to the left anterior descending (LAD) artery, and the other conduits are used for the other occluded arteries.
Indications
CABG is generally recommended when there are high-grade blockages in any of the major coronary arteries and/or percutaneous coronary intervention (PCI) has failed to clear the blockages.
Contraindications
Contraindications to CABG include patient refusal, coronary arteries incompatible with grafting, and the absence of viable myocardium to graft.
Erectile dysfunction post CABG
Definitions
Sexual dysfunction may be categorized into four types: loss of libido, erectile dysfunction (ED), ejaculatory insufficiency, and anorgasmic states.
ED, also known as impotence, is the inability to achieve and/or maintain a penile erection sufficient enough to participate in satisfactory sexual activity.
Sexual dysfunction is one of the most common complications following on-pump CABG surgery and an important cause of reduction in quality of life among patients
Etiology
Psychological
Sexual assessment and counseling are being recommended globally, yet it is an overlooked aspect of cardiac rehabilitation after CABG surgery.
Organic
Organic due to hormonal changes. sex hormone levels especially estradiol in men less than 70 years old.
Specific surgical and clinical
Specific surgical and clinical variables are predictors for sexual dysfunctions among CABG patients.
Risk Factors
Age & Gender
Male sexual dysfunction affects about 10-
25% of middle-aged and elderly men.
Multiple Comorbidities
Atherosclerosis, hypertension, dyslipidemia, diabetes mellitus.
Other
Smoking, obesity and sedentary lifestyle.
Heart Failure
Definitions
Heart failure is a complex clinical syndrome in which the heart cannot pump enough blood to meet the body's requirements.
Patients usually present with fatigue and dyspnea, reduced exercise tolerance, and fluid retention (pulmonary and peripheral edema).
Heart failure happens when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is a serious condition, but it does not mean that the heart has stopped beating.
Etiology
Structural Abnormalities
Structural causes of congestive heart failure (CHF) include hypertension,
valvular heart disease, uncontrolled arrhythmia, myocarditis, and congenital heart disease. Coronary artery disease and diabetes mellitus have become the predominant predisposing factors for heart failure.
Functional Abnormalities
Diastolic heart failure with impaired ventricular filling can be caused by restrictive cardiomyopathies and constrictive pericarditis.
Other triggering factors
Inappropriate drug treatment, dietary sodium restriction, and decreased physical activity.
Classification
HFrEF
Has varied among different studies and guidelines but is generally defined as an ejection fraction (EF) of less than 40%
HFpEF
Is generally defined as heart failure with an EF of greater than 50%.
HFmrEF
Is defined as heart failure with an EF of 40% to 50%
Combination
The latter may consist of mixed left ventricular dysfunction
(a combination of systolic and diastolic heart failure).
Risk Factors
Medical Conditions
Coronary artery disease (CAD) (the most common type of heart disease)
heart attacks
Diabetes
High blood pressure
Obesity
Other Conditions Related to Heart Disease
Valvular Heart Disease
Unhealthy Behaviors
Smoking tobacco
Eating foods high in fat, cholesterol, and sodium
Not getting enough physical activity
Excessive alcohol intake
Score
(FITT + 2P)
Frequency
The number of physical exercise sessions, for example how many days a week, 4-7 days a week is recommended (most days of the week).
Intensity
Given load
Parameter VO2max, HRmax, HRR, RPE
Time
Length of practice.
Warming up & cooling down 5-10 minutes.
Conditioning 20-60 minutes.
Type
Type of exercise, is individual.
Brisk.
jogging.
Run.
Bicycle.
Swimming.
Cardiac rehabilitation
6 Core Components
Patient assessment
Education and counseling
Risk factor control
Post-illness physical activity and occupational counseling
Heart exercise test (Exercise Stress Test)
Create a physical exercise program
Cardiac rehabilitation phase
Phase I (inpatient phase):
Phase II (outpatient phase)
Phase III (maintenance)
Practice test
