CABG: Severe Coronary Heart Disease

Coronary artery disease (CAD) develops when plaque builds up in the narrow arteries of the heart. The arteries that are affected supply blood to your heart, oxygen, and numerous amounts of nutrients to the heart. The plaque that builds in the arteries is from the amount of cholesterol that is accumulated in the arteries. The plaque that builds within the arteries of the heart decrease the blood flow to the heart often resulting in chest pain (angina), shortness of breath, or other symptoms. This disease is often not diagnosed until the patient has a heart attack. The reason that coronary artery disease goes unnoticed is because this disease develops over decades. “Heart disease is the leading cause of

The following summary is an updated case study of a 47 year old male patient, Jim who was diagnosed with Coronary Artery Disease. The patient did receive information on what CAD is and was informed that test were needed to fully diagnose and be evaluated for underlying conditions (high blood pressure, high blood cholesterol levels, diabetes and blockage. I will discuss the type of test needed for this condition and tests for any underlying conditions that are related to this disease. The type of treatment needed to control and lower his risk factor. I will also give the patient information about complementary and alternative medicine so the patient will be well informed about different types of treatment. The patient will be informed about the prognosis of the disease, and the options that the patient has to succeed in the changes in his lifestyle that are needed.

Coronary artery disease remains number one killer of the western civilization despite 40 years of aggressive drug and surgical interventions (Esselstyn). Usually, pharmaceutical drugs, such as statin, are given to try to slow the progression, but may provide uncomfortable side effects. In fact, the majority of patients discontinue statins within 1 year of treatment initiation (Maningat). Furthermore, surgery is performed to circumvent clogged arteries and literally bypass the symptoms. In the last year, 500,000 coronary bypass procedures were performed (Swaminathan et al). However, these surgeries can have significant risks, including the potential to cause further heart damage, stroke, and brain dysfunction. Thus, it is evident that these way of treatments may not be enough on its own, and that getting to the

The patient's comorbidities include Hypertension, hyperlipidemia, CAD, and GERD. The patient had a CABG operation a few days back from admission day on 4-10-2017. In addition to the CABG surgery, other procedures such as TEE, cardiopulmonary bypass, vein harvest, and a thoracotomy with a chest tube and JP drain. Significant surgical procedures also include angioplasty and left and right knee arthroplasty.

Coronary Artery Disease, also known as CAD, is the most common form of heart disease. (Heart and Stroke Foundation, 2009) Coronary Artery Disease obstructs the blood flow in vessels that provides blood to the heart which is caused by the buildup of plaque on the artery walls. (Rogers, 2011, p.87) (Heart and Stroke Foundation, 2009) Plaque is a yellow substance that consists of fat substances, like cholesterol, and narrows or clogs the arteries which prevents blood flow. (Heart and Stroke Foundation, 2009) Plaque can build up in any artery but usually favors large and medium sized arteries. (Heart and Stroke Foundation, 2009)

Coronary artery disease (CAD) is the commonest heart disease in the United States1. Approximately, 29% of patients with Myocardial Infarction ( MI ) present with ST- elevation Myocardial Infarction ( STEMI )2. STEMI is the result of complete occlusion of a major epicardial coronary artery due to thrombus formation. STEMI from a small coronary artery presenting as substantial EKG abnormalities similar to occlusion of a major artery and hemodynamic instability is a rare entity. The epidemiology, typical clinical presentation, outcomes, and optimal management in this group of patients are not sufficiently known.

The use of coronary CTA is not without risks. The patient safety issues involving coronary CTA are related to radiation exposure, administration of IV contrast material, and ?-blocker and nitrate administration (Weinreb et al., 2005).

It is not unknown for cabg patient’s to develop an atrial fibrillation, bundle branch or atrioventricular heart blocks post operatively. “Although these conditions are more common in older people, young people can also be affected. Heart block may also occur after heart surgery and in this case may be either temporary or permanent.” (“Tripanswers,” n.d.)

Among all patients whose principal procedure was CABG, 39.1 percent of them did not have any comorbid condition. The proportion of patients who had one, two and three or more conditions was 30.7, 15.9, and 14.4 percent respectively. Among all 15,264 CABG cases, 77.5 percent of them underwent multiple CABG procedures for example two vessels CABG and four vessels CABG performed in a single episode of care. Approximately 76.6 percent of hospital admissions included one vessel CABG and 17.5 percent of admissions included four or more vessels CABG. The proportion of CABG procedures performed in emergency settings was 26.1

Coronary Artery Bypass Graft (CABG) is an open-heart surgery where a section of a blood vessel, either a vein or artery, is grafted from the coronary artery to the aorta to bypass a blocked section of the artery to improve blood supply to the myocardium (See appendix A for Physiology) The primary foundation of CABG is to regenerate perfusion to the myocardium. (Diodato & Chedrawy. 2014), The goals of CABG include improving your quality of life, reducing angina allowing you to restart a more active regime, Improving the pumping action of your heart if it has been damaged by a heart attack, lowering the risk of a heart attack, in some patients who have increased risk, like those who have diabetes, Improving

Coronary Heart Disease (CHD) it is also know as Coronary Artery Disease. It happens when the blood vessels delivering to the heart develop blockage or are narrowed by plaque, which reduces the flow of the blood, oxygen and nutrients supplied to the heart. If this happens the person starts to feel chest pain (also known as angina pectoris) and then it lead to the person to have a heart attack. It is known to be the main factor to cause cardiac arrest and it can be fatal unless the heart is restarted in minutes.

“Coronary Artery Bypass Graft (CABG) surgery is a widely used surgical procedure for the relief of symptoms of Coronary Artery Disease” (Bagielia, Connerney, McLaughlin, Shapiro, & Sloan, 2001, p. 1766). Coronary Artery Disease is the narrowing of the blood vessels that supply oxygen and nutrients to the heart muscles. The buildup of fatty material within the walls of the arteries causes cardiac diseases (Coronary Artery Bypass Surgery,, 2010) .To resolve this issue, surgeons take veins and arteries from elsewhere in the patient’s body. Then, surgeons graft the veins and arteries to the coronary arteries to bypass the atherosclerotic narrowing and improve the blood supply to the heart muscles (Coronary Artery Bypass Surgery,, 2010). This procedure increases the blood flow to the heart by giving the blood a new route around the diseased or clogged artery (Bagielia, Connerney, McLaughlin, Shapiro, & Sloan, 2001).

To diagnose a coronary artery disease (CAD) the doctor will use a coronary angiogram procedure to find the percentage of blockage or narrow in arteries, the angiogram results will help the doctor to decide a decision on patient treatment depends on the percentage of blockage on coronary artery, age, weight, and whether patients have other medical conditions, like diabetes . In cases with obstructive average a 50% or slightly more are treated by medications and Balloon angioplasty, but what about the cases with more than one artery completely blockage or the medication and stent do not help them? The doctor will choose a coronary artery bypass grafting surgery (CABG) to restore blood flow in the heart, CABG is a surgery done through replacement

Coronary artery disease Coronary arteries are blood vessels that carry blood to the heart muscle. The coronary artery disease (also called CAD, for its acronym in English) or coronary heart disease is caused by a thickening of the inner walls of the coronary arteries. This thickening is called atherosclerosis. A fatty substance called plaque builds up inside the thickened walls of the arteries and obstructs or delays the flow of blood. If the heart muscle does not receive enough blood to function properly, you may have angina or a heart attack.

Coronary artery disease (CAD) is caused by fatty buildup in the arteries of the heart. Your arteries are made to carry oxygen infused blood to your heart and other parts of your body if it is filled up with plaque, which is the fatty substance that clogs and blocks up the arteries. If it gets clogged enough to where your heart is not receiving fresh oxygen, you could have a heart attack that could cause very serious damage to your body and could even kill you. When you are younger, you can begin to grow plaque in your blood vessels from not eating right and not exercising regularly. When your arteries are being filled up with plaque they become more narrow and harder for blood to get through as easily as it is supposed to be. When you have