CORONARY ARTERY DISEASE PATHOPHYSIOLOGY

Non Modifiable Factors Age Gender Family History Modifiable factors Smoking Lack of exercise Stress Diet high in fat Hypertension Elevated Serum cholesterol levels Alcohol consumption Diabetes Mellitus

Non-specific injury to arterial wall (Endothelial Injury)

Desquamation of endothelial lining Increased Permeability or Adhesion of Molecules Lipids (LDL) and Platelets Assimilate in the Area Oxydized LDL attracts Plaques begin to form from monocytes and macrophages to the site cells which imbibed into the endothelium

Lipids are engulfted by the cells (foam cells) and Smooth Muscle Cells Develop

Disruption of Plaque Continuous aggregation of platelets Thrombus Formation Rapid increase in size of the thrombus in Coronary Artery Wall

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Coronary Atherosclerotic Heart Disease/CAD

Reduction of blood flow Decreased Blood Supply to the Myocardium Decreased Myocardial Oxygen Supply Myocardial Ischemia Anaerobic metabolism More Lactic Acid Production Myocardial Cell Necrosis Inflammatory response Increase WBC Chest Pain Acidosis Myocardial cells are sensitive to changes in pH and become less functional Released of endogenous pyrogens Pyrogens will stimulate the release of prostaglandins Prostaglandins

Conduction System Disorder will reset the Hypothalamic thermostat to high temperature Decreased myocardial contractility Fever/Hyperthermia Decreased Cardiac Output circulation

Decreased systemic

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Hypotension Sympathetic receptors are stimulated

Redirection of blood away from the skin to the major organs

Inadequate Pallor cerebral Increase in heart rate/ pumping action as a compensatory mechanism Fatigue Weakness Tachycardia

Decreased perfusion of

oxygenated blood to perfusion other organs

Loss of Consciousness Dyspnea, /Dizziness and Body

Deterioration of hearts ability to pump Moderate left ventricular failure Decreased arterial pressure Right side of the heart continuously propel blood to the lungs Left eject Peripheral Vasoconstriction ventricle is unable to fully

Stimulation of Baroreceptors

the returning blood to systemic circulation Pulmonary

Congestion Hypertension Dyspnea sounds Adventitious breath

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