Pathophysiology

Pathophysiology Study Guide

©2018 of 131 Coronary Artery Disease Coronary artery disease is the condition when plaque, caused due to atherosclerosis, accumulates in the coronary arteries in the heart. Due to this, the coronary arteries that supply oxygen and nutrient- rich oxygen to the heart become narrow, which reduces the flow of blood to the heart. This also leads to the formation of blood clots in the arteries and can block the flow of blood partially or completely. Risk factors for coronary artery disease are smoking, high cholesterol levels, obesity, lack of physical activity, diabetes, and high blood pressure. Symptoms of coronary artery atherosclerosis are chest pain, shortness of breath, swelling in legs, weakness, fatigue, a reduction in the capacity of exertion, palpitation, gain of weight, diaphoresis, stable angina pectoris, change in blood pressure, heart murmurs, leg edema, syncope, tachycardia, tachypnea, rales, and intermittent claudication. Angina Angina is described as a feeling of discomfort, and is usually when a person complains of chest pain. The main reason for this pain and discomfort is the inadequate supply of blood in some area of the muscles of the heart. The individual feels pressure in the chest area or a squeeze-like sensation. It may also be possible that pain occurs in surrounding areas like the shoulders, arms, neck, jawline and back. It is not a disease, but is one of the crucial symptoms of coronary heart disease. There are different types of angina: stable, unstable, variant, and micro-vascular. The most common type is stable angina, and is characterized by a higher workload by the heart. The pain from stable angina can be relieved with rest or medicine. It acts as a warning signal for the occurrence of a heart attack in the near future. There is a specific pattern of a stable angina and one can predict the occurrence of pain. There is no certain pattern of an unstable angina. The frequency is higher and the pain is generally more severe in the case of unstable angina. It may occur even if the person is not exerting, and thus, will not provide any relief by resting or medicine. It shows that heart attack is likely to occur soon and the person needs emergency treatment. Variant angina is also known as Prinzmetal's angina. This is very rare and is caused by a spasm forming in the coronary artery. It generally occurs when the individual is in a state of rest but the pain is severe. The timing for this angina is between midnight and early morning, and can be relieved by taking medication. The most severe kind of angina pain is micro-vascular. The pain is most severe and it lasts for a longer duration of time. Medication does not ease the pain, and thus, requires emergency treatment. In this case, the small arteries narrow and a reduced supply of oxygen and nutrient rich blood restricts the heart. It may not affect the large arteries of the coronary. Causes of angina are uncontrolled high blood pressure, aortic stenosis, cardiomyopathy, anemia and poisoning, atrial fibrillation, uncontrolled atrial flutter, fever, hyperthyroidism, stress, major infection, and trauma. Rare causes include abnormalities with the coronary arteries, like scarring due to radiation; inflammation in arteries due to systemic lupus erythematous or Kawasaki's disease; and congenital abnormalities. Achieve Page 54