Adult Medical-Surgical Disorder: Coronary Artery Disease (CAD)
Pathophysiology
Coronary artery disease (CAD) is a condition in which the coronary arteries, which supply blood to the heart, become narrowed or blocked. This can happen due to a buildup of plaque, which is a fatty substance. When the coronary arteries are narrowed or blocked, the heart does not receive enough blood, which can lead to chest pain, heart attack, and other heart problems.
History and Physical Assessment Findings
The most common symptom of CAD is chest pain, also known as angina pectoris. Angina is often described as a feeling of pressure, tightness, or squeezing in the chest. It may also feel like burning, indigestion, or shortness of breath. Angina can be triggered by exertion, stress, or cold weather.
Other symptoms of CAD may include:
- Shortness of breath
- Fatigue
- Dizziness
- Palpitations (feeling like the heart is racing or skipping a beat)
- Sweating
On physical examination, the healthcare provider may find:
- High blood pressure
- High cholesterol
- Abnormal heart sounds
- A weak pulse
Epidemiological Trends
CAD is the leading cause of death in the United States and worldwide. According to the Centers for Disease Control and Prevention (CDC), more than 650,000 people die from CAD in the United States each year. CAD is more common in men than in women, and it is more common in people over the age of 45.
Diagnosis
CAD can be diagnosed with a variety of tests, including:
- Electrocardiogram (EKG): An EKG measures the electrical activity of the heart.
- Echocardiogram: An echocardiogram uses sound waves to create images of the heart.
- Stress test: A stress test measures how the heart responds to exertion.
- Cardiac catheterization: Cardiac catheterization is a procedure in which a thin tube is inserted into an artery in the groin or arm and threaded up to the heart. This procedure can be used to diagnose CAD and to measure the blood pressure and oxygen levels in the heart.
Treatment
The treatment for CAD depends on the severity of the disease and the patient’s overall health. Treatment options may include:
- Lifestyle changes: Lifestyle changes that can help to improve CAD include quitting smoking, eating a healthy diet, exercising regularly, and maintaining a healthy weight.
- Medications: Medications can be used to lower blood pressure, cholesterol, and blood sugar levels. Medications can also be used to prevent blood clots and to control chest pain.
- Surgery: Surgery may be an option for patients with severe CAD. Surgery options include coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), also known as angioplasty and stenting.
Psychosocial Presentation
CAD can have a significant impact on a person’s psychosocial well-being. People with CAD may experience fear, anxiety, depression, and social isolation. They may also worry about their ability to work, exercise, and enjoy life.
It is important for people with CAD to have access to psychosocial support services. These services can help people to cope with the emotional and social challenges of living with CAD.
Conclusion
CAD is a serious medical condition, but it is treatable. With proper treatment and lifestyle changes, most people with CAD can live long and healthy lives.
