Coronary Artery Disease

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					Coronary Artery Disease

   By Nabeel Sharaf, Franz Garay,
          Michael Javier
       Anatomy and Physiology
1. The Heart
• The Blood will circulate through the heart
• The right atrium receives de-oxygenated
   blood and the left atrium receives
   oxygenated blood
• The ventricles pump blood to the
   appropriate part of the body
       Anatomy and Physiology
2. Coronary Arteries
• The coronary arteries provide oxygenated
  blood to the heart muscle
• Right coronary artery- supplies blood to the
  right ventricle
• Left coronary artery- supplies blood to the left
• Posterior circumflex artery- supplies blood to
  the posterior aspect of both ventricles
            Anatomy and Physiology
1. Cardiac Conduction System
• The heart has a system in which the electrical impulse stimulates the muscle
   fibers in the heart to contract
• The electrical impulse originates at the sinoatrial (SA) node, which is located
   in the wall of the right atrium.
    – The SA node is the heart's natural pacemaker: it regulates the heart rate.
• The impulse proceeds through the atria, stimulating them to contract.
• After the atria are stimulated to contract, the atrioventricular (AV) node
   slows the electrical impulse before it proceeds to the ventricles. This pause
   allows the ventricles to fill with blood before they contract.
    – The AV node is located between the atria and the ventricles.
• After the pause, the impulse then proceeds through the ventricles,
   stimulating them to contract.
Coronary Artery Disease Basic Info
• The most common type of heart disease
• The most common cause of death in the
  United States in both men and women
• About half of all deaths related to
  cardiovascular disease result from coronary
  artery disease
•   Rank Countries Amount
•    # 1 Ireland:324 deaths per 100,000 people
•   # 2 Austria:297 deaths per 100,000 people
•   # 3 Germany:292 deaths per 100,000 people
•   # 4 Finland:284 deaths per 100,000 people
•   = 5 United Kingdom:265 deaths per 100,000 people
•   = 5 United States:265 deaths per 100,000 people
•   # 7 Sweden:260 deaths per 100,000 people
•   # 8 Norway:258 deaths per 100,000 people
•   # 9 Denmark:251 deaths per 100,000 people
•   # 10 New Zealand:247 deaths per 100,000 people
•   # 11 Belgium:246 deaths per 100,000 people
•   # 12 Italy:243 deaths per 100,000 people
•   # 13 Netherlands:230 deaths per 100,000 people
•   # 14 Canada:219 deaths per 100,000 people
•   # 15 Switzerland:218 deaths per 100,000 people
•   # 16 Australia:214 deaths per 100,000 people
•   # 17 France:168 deaths per 100,000 people
•   # 18 Japan:151 deaths per 100,000 people
•   Total:4,432 deaths per 100,000 people Weighted average:246.2 deaths per
    100,000 people
How does it start? Why does it start?
The build up of plaque, cholesterol and other fatty
  materials, in the inner walls of the arteries

When the plaque hardens it causes arteries to be
 narrowed which in turn causes the blood flow to

An imbalance between oxygen demand and oxygen
  supply, causes the myocardium to be hypoxic
This causes blood to be blocked from the heart that provides oxygen and
nutrients to the myocardium (heart tissue)
• Due to Atherosclerosis, the heart cannot receive
  the needed oxygen from the blood.
• This lead to angina, chest pain that occurs when
  the heart does not get enough oxygen.
• Can also leave permanent damage to the heart
  when the blood supply is cut off. A person can
  have a heart attack.
• The heart is eventually weakened and pump less
  blood to the body, heart failure.
• The normal beating pattern of the heart can also
  change called Arrhythmias.
• Men have a greater chance of having a heart
  attack than men and they also have heart
  attacks earlier, equalizes after the age of 70
• More likely to occur with age
• Greater risk if parents were diagnosed with a
  heart disease
• The risk of heart disease is higher among
  Mexican Americans, American Indians, native
  Hawaiians and African Americans due to
  higher blood pressures and diabetes in the
Factors that increase the chance of
•   Smoking
•   High blood cholesterol and high triglycerides
•   High blood pressure
•   Physical Inactivity
•   Overweight
• Pain or discomfort in other areas of the upper body
  including the arms, left shoulder, back, neck, jaw, or
• Difficulty breathing or shortness of breath
• Sweating or “cold sweat”
• Fullness, indigestion, or choking feeling (may feel like
• Nausea or vomiting
• Light-headedness, dizziness, extreme weakness or
• Rapid or irregular heart beats
• Ischemia
•   EKG
•   Stress Testing
•   Echocardiography
•   Chest X-ray
•   Blood Test
•   Family History Check
• Some patients need a stent, a small mesh
  tube, to be implanted in the artery to restore
  blood flow.
• Coronary bypass surgery
• Reduce the oxygen demand of the heart with
  antianginal drugs, reduce myocardium hypoxia
• In less severe cases, a healthier diet
Coronary Bypass
            Future Treatment
• Predicting if a person will have CAD may be
  helped by new genetic markers. People with
  diabetes or type 2 diabetes have shorter
  telemeres 1, this is and indicator if a person
  may develop CAD.
• Using folic acid to treat Atherosclerosis

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