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8/13/2019 Presentasi 30 April Fixxxxxx
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THE CARDIOVASCULAR S YSTEM
CORONARY ARTERY DISEASE By : Group 3
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ANATOMY AND PHYSIOLOGI THE
CARDIOVASCULAR SYSTEM
Heart
The heart is greatest in the cardiovascular system.
The heart has 2 sides:Right side & left side
The heart have 4 roows:
right atrium, left atrium,
right ventricle, left ventricle
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BLOOD VESSEL
The blood vessel:
Arteries
arteriolesCapilllaries
Venules
Veins
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CORONARY ARTERY DISEASE
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P ATOPHYSIOLOGI
Pathophysiology disorder as the discussion of
abnormalities in other organs, the discussion of
abnormalities in the arteries is also differentiated by
the underlying process, namely: congenital
abnormalities, inflammatory disorders, degenerativedisorders, immunologic disorders, neoplasms and
other disorders is unclear pathophysiology.
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TYPES AND CLASIFICATION
Acu te Coronary Syndromes
. Advanced Ischem ic Heart Disease
. B i furcat ion B lockage
Heart A ttack (Myocardial Infarct ion ) Microvessel Disease
Stent Restenosis
Total Coronary Occ lusion
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ETIOLOGYCauses Why
Atherosclerosis Fatty plaques deposit and narrow the arteries over time Congenital defects Irregular vessel shapes can cause plaques and other debris
to become trapped narrowing the vessels Coronary artery spasm Creates a temporary vessel blockage
Dissecting aneurysm
An aneurysm creates a bulging out of the vessel wall due to
pressure. This can cause atherosclerotic plaque formation at
the site of the aneurysm, which causes further weakening of the artery wall. A blood clot may form at the site and
dislodge, increasing the chance of stroke Infectious vasculitis Inflammation of the vessels contributes to growth of plaque
in the arteries Syphilis If left untreated, syphilis can cause inflammation of the
vessels, which leads to growth of plaque in the arteries High blood levels of C-reactive
protein (CRP) CRP levels rise when there is protein (CRP) inflammation.
The inflammation process contributes to the growth of plaque in arteries
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Unhealthy blood cholesterol levels. High blood pressure.
Smoking.
Insulin resistance
Diabetes
Family history of early heart disease.
Lack of physical activity
Overweight or obesity.
Age
Unhealthy diet
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CLINICAL APPEARANCES
Signs and symptoms Why
MI The arteries become narrowed due to fatty plaque buildup (atherosclerosis) andnot enough oxygen reaches the heart, causing ischemia
Angina The arteries become narrowed due to fatty plaque buildup (atherosclerosis) and
not enough oxygen reaches the heart, causing ischemia. The ischemia causes
chest pain High blood pressure Atheromas grow, causing narrowing of the arteries and calcium accumulation in
the arteries Decreased peripheral pulses Decreased elasticity of the arteries and the narrowed lumen contribute to
decreased peripheral circulation Nausea and vomiting Angina
Fainting Decreased blood flow prevents oxygenation of the brain Sweating Angina
Cool extremities Decreased peripheral circulation Shortness of breath Decreased cardiac output leads to decreased lung perfusion
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DIAGNOSTIC ASSESMENT
EKG (Electrocardiogram)
Blood Tests Chest X Ray
Ankle/Brachial Index
Echocardiography
Computed Tomography Scan Stress Testing
Angiogram
Electron beam computerized tomography
(EBCT): Magnetic resonance angiography (MRA):
Myocardial perfusion imaging with thallium 201during treadmill exercise
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Risk factor for Coronary Artery Disease includedyslipidemia, smoking,hypertension, male gender
(women are protected untilmenopause), aging, non-white race, family history,obesity, sedimentary
lifestyle, diabetes mellitus,metabolic syndrome,elevated homocysteine, andstress.
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THE THERAPY
blockers, and angiotensin converting enzymeinhibitors) to promote a favorable balance of
oxygen supply and demand.
Antilipid medications to decrease blood
cholesterol and tricglyceride levels in patientswith elevated levels.
Antiplatelet agents to inhibit thrombus
formation.Folic acid and B complex vitamins to reduce
homocysteine levels
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......
Coronary angioplasty , or balloon
angioplasty
Coronary artery bypass graftoperation: Atherectomy , Laser
angioplasty
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NURSING INTERVENTION Monitor blood pressure, apical heart rate, and
respirations every 5 minutes during an anginal
attack. Maintain continuous ECG monitoring or obtain a
12-lead ECG, as directed, monitor for arrhythmiasand ST elevation.
Place patient in comfortable position and administer
oxygen, if prescribed, to enhance myocardialoxygen supply.
Identify specific activities patient may engage inthat are below the level at which anginal painoccurs.
Reinforce the importance of notifying nursing staffwhenever angina pain is experienced.
Encourage supine position for dizziness caused byantianginals.
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Be alert to adverse reaction related to abrupt
discontinuation of beta-adrenergic blocker and
calcium channel blocker therapy. These drug must
be tapered to prevent a “rebound phenomenon”;tachycardia, increase in chest pain, and
hypertension.
Explain to the patient the importance of anxiety
reduction to assist to control angina. Teach the patient relaxation techniques.
Review specific factors that affect CAD
development and progression; highlight those risk
factors that can be modified and controlled toreduce the risk.
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TERIM K SIH T PERH TI NY