Coronary artery disease (CAD), also known as coronary heart disease, is the leading cause of

The plaque restricts blood flow to the heart and deprive the heart of oxygen it needs to function properly. CAD can be chronic, which is narrowing of the coronary artery and limitation of the blood supply to part of the muscle, or it can be acute, which results from a sudden plaque that ruptures. According to Warnica (2013), rupturing of the plaque “exposes collagen and other thrombogenic material, which activates platelets and the coagulation cascade, resulting in an acute thrombus, which interrupts coronary blood flow and causes some degree of myocardial ischemia.” The major risk factors that can lead to atherosclerosis and coronary artery disease are hypertension, dyslipidemia, tobacco smoking, diabetes mellitus, obesity, sedentary lifestyle, and genetic predisposition. The risk factors present in M.T.’s life are history of angina pectoris, history of uncontrolled hypertension due to non-compliance with treatment, obesity, and stress. M.T. is overweight with 289 pounds. M.T.’s cholesterol level is high at 280mg/dl. M.T.’s stress is related to experiencing the death of his best friend and business partner from cancer. Having three teenage children who are constantly in trouble at school and a wife who recently lost her job can be a stress factor in M.T.’s

The development of an atherosclerotic plaque is relatively a very a complicated process where Plaque rupture accounts for about 76% of fatality lead by thrombi. The evolution of atherosclerosis begins with foam cell accumulation where the macrophages accumulate within arterial wall intima, progresses to form fatty streak where further accumulation of intra and extracellular lipids, this is a potentially reversible stage (Greenland p, 2013) further atheroma/fibroatheroma forms where cholesterol and phospholipids accumulate intramurally. This is a vulnerable state as it is predisposed to spontaneous rupture by inflammation and thrombus deposition may occur. Hemodynamic changes during this stage may cause ischemia or silent infarction, if large plaque rupture total occlusion may cause myocardial infarction or sudden cardiac death. Finally a complex lesion can develop where fibro muscular tissue can be seen with repair efforts followed by repeated plaque formation, this may slowly increase in size and produce significant arterial narrowing.

The heart circulates itself by using the major coronary arteries, which are the left circumflex artery, right coronary artery and the left anterior descending artery. In the bloodstream, blood cells that deliver oxygen to the heart muscle, also contain fats, or lipids, which are also known as LDL cholesterol. As the blood passes through the artery, some of the fat accumulates in it, and overtime forms an atherosclerotic plaque. Some plaques are manageable in size and don’t obstruct the blood flow, so a person with asymptomatic CAD (Coronary Artery Disease) might have no myocardial ischemia and no chest pain. Though, if the plaque enlarges, the blood flow gets compromised due to the additional pressure needed to move the blood through that area. In this case, a patient would experience chest pain and would now have myocardial ischemia with exertion, this would be a stable angina case, which isn’t an emergency. But, even then, a patient is still at risk for a life threatening event, because the plaque could rupture and spread through the artery, blocking blood flow. This event is called coronary thrombosis. The myocardial would be injured and this would have to be immediately treated either by dissolving the thrombus, displacing it or completely removing it. To prevent this disease, one exercise, eat a heart healthy diet with more fruits and vegetables, foods that are low in saturated fats and

CAD is when the heart is subjected to a reduction in blood flow that negatively affects its ability to pump (McCance & Huether, 2014). The leading cause of CAD is atherosclerosis (Porter & Kaplan, 2011). Atherosclerosis is when fatty deposits, known as atheromas, deposit between the tunica intima and tunica media of medium and large coronary arteries (Porter & Kaplan, 2011). Macrophages and inflammatory cytokines detect the injury to arterial lining and attempt to protect the body by engulfing it and covering with fibroblasts and collagen (McCance & Huether, 2014). This results in the formation of an atherosclerotic plaque. As time passes the atherosclerotic plaque increases in size and causes complete or partial occlusion of a coronary artery

Cardiovascular disease is conditions that involve narrowed or blocked blood vessels that can lead to stroke, heart attack, and chest pain. Heart disease is the leading cause of death in men and women in the United States (CDC 2015). Numerous problems in the heart lead to atherosclerosis. Atherosclerosis is an active process involving molecular signals that produce altered cellular behavior as well as endothelial dysfunction and a subsequent inflammatory response (Swain 2013). Atherosclerosis is a condition that is developed when plaque builds up in the walls of the arteries. The blood is not able to flow correctly because of the buildup of plaque narrows the arteries. Plaque is a combination of cholesterol, cells, and debris. Atherosclerosis is the most common type of heart disease, killing over 370,000 people annually (CDC 2015). It is the cause of strokes, heart attacks, and peripheral vascular disease. High blood pressure, smoking, or high cholesterol damage the endothelium and it begins atherosclerosis. The damage starts the creation of plaque. LDL enters the wall of artery when it crosses the endothelium, which causes the white blood cells to digest the LDL. There are many ways to prevent and treat atherosclerosis like the change of lifestyle, healthy eating, exercising, and medications.

The complicated lesion contains a fibrous plaque, calcium deposits, and a thrombus formed by haemorrhage into the plaque. It results from continuing cell degeneration due to repeated injury and healing to the site. The lesion’s structure is composed of a lipid, necrotic core and layers of smooth muscle, and connective tissue matrix which form the plaque’s fibrous cap. When the lesion grows larger, it calcifies. The edges of the fibrous cap play an important role because it is the site where most plaques lose their integrity or rupture. The damage is most likely to occur in areas where there is a high amount of stress from the blood flow in the vessel, such as bifurcations and branches. When a plaque ruptures, there is exposure of the underlying thrombogenic core of lipid and necrotic material to the circulating blood within the vessel. This exposure results in platelet adherence, aggregation, and progressive narrowing of the vessel’s lumen.

Coronary artery disease is described by causing the arteries and vessels that provide oxygen and nutrients to the heart to become narrowed or blocked. The accumulation of fatty substances (lipoproteins) on the inner linings of arteries is caused by Atherosclerosis (hardening of the arteries). Cholesterol and Triglycerides are two of those substances (Funk & Wagnalls, 2016). The blood flow to the heart is restricted by the blockage. A heart attack is the outcome of the blood flow to the heart being completely cut off. The leading cause of death in the United States for both women and men is coronary heart disease. Although more than 40,000 lives have been claimed from this disease in the year 2000, the number of deaths from this disease has

Nonmodifiable risk factors associated with coronary artery disease include age, gender, family history, and ethnic background. Modifiable risk factors include smoking, obesity, elevated serum lipid levels, limited physical activity, stress, and hypertension (Ignatavicius & Workman, 2010). M.C’s family history of CAD, hypertension, and hyperlipidemia are leading

Atherosclerosis begins when an accumulation of white blood cells form plaque on the artery wall. These plaques are made up of both live and dead cell, including cholesterol and triglycerides, this can create an inflammatory response in the tissue of the artery wall. These atherosclerosis plaques can be divided into two categories, stable and vulnerable. The stable plaques tend to be asymptomatic and are characterized by smooth muscle cells and have a stronger cell matrix. The second category is vulnerable plaques; these tend to be unstable and have higher levels of macrophages and foam cells. The extracellular matrix creates breaks in the fibrous cap and can lead to ruptures.

Diseases resulting in damage to the heart, coronary blood vessels or peripheral blood vessels are collectively referred to as cardiovascular disease (CVD) which includes coronary heart disease, angina, myocardial infarction, atherosclerosis, stroke etc. CVD is the leading cause of death globally, accounting for 17.3 million or 30% of deaths worldwide in 2008. CVD rates, however, are not proportional across socioeconomic groups as 80% of CVD deaths occur in low and middle income nations. Due to the growing prevalence of diabetes and obesity, CVD is expected to result in 23.3 million deaths by 2030. The underlying cause of most cardiovascular events is Atherosclerosis, a decade long chronic inflammatory disease of large and medium sized arteries,

Coronary Heart Disease initially is an area of athermanous plaque formation due to lipid accumulation under the lining of the coronary artery. The lipid infiltrate which is a foreign substance, prompts white blood cells (macrophages) to engulf the lipids generating a foam cell discharge thereof smooth muscle penetrate and enlarge the area. It is until plaque obstructs more that 50% of the diameter of the coronary artery lumen, that the flow of blood is decreased. However when the subject heart requires more oxygen example during

The main cause of myocardial infarction is the occlusion of the coronary artery, due to the sudden rupture of an atherosclerotic plaque leading to the formation of a blood clot (coronary thrombosis). The formation of plaque is the result of damage to the endothelium layer of cells, caused by high blood pressure, smoking, or high cholesterol. Over time, an accumulation of cholesterol in the artery wall becomes plaque (Beckerman, 2016). This event can also trigger coronary vasospasm, causing constriction of blood vessels, resulting in severe hypertension. If a vessel is fully occluded, an insufficient amount of oxygen results in tissue death. The damaged tissue is comprised of both a necrotic core and a marginal zone consisting of hypoxic tissue that may generate arrhythmias, abnormal heart rhythms. Infarcted tissue can alter ventricular systolic and diastolic function and disrupt electrical activity within the heart. Inevitably, this tissue forms a fibrotic scar. Long-term consequences include ventricular failure, ventricular remodeling of the remaining myocardium, or sudden death (Klabunde, 2007).

The CDC estimates that roughly 610,000 Americans die each year from an acute myocardial infarction and is the number one cause of death amongst men and women.1 Myocardial infarction (MI) stems from the occlusion of one or more coronary arteries, resulting in hypoxia and eventual death of the myocytes downstream.2 As oxygenated blood leaves the left ventricle traveling into the aorta, the left and right coronary arteries branch off almost immediately. These coronary arteries and their branches provide oxygen and nutrients to the epicardium and myocardium.3 Gradual depositions of fatty streaks in the arteries progress to unstable fibrofatty plaques that cause luminal narrowing.2 The etiology of an acute MI occurs when an atherosclerotic plaque breaks free inside a coronary artery, initiating a thrombotic event referred to as atherothrombosis4. This leads to the partial or total occlusion of a coronary artery, and can occur in a proximal or distal segment of the artery5. The location of this occlusion is often evident from patient’s symptoms and is used to determine course of treatment.5

The endothelial layer of the arteries are damaged over time by many disease processes that contribute to the

Coronary heart disease is a condition in which the small blood vessels that supply blood and oxygen to the heart narrows due to the accumulation of fat or scar tissue. These diseases are always stigmatized with elderly people, men especially. But the books shows us that these stigmatisms are extremely wrong, CVDs affect just as much men as it does women, and just as much elderly people, as it does young people. It is the third common reason for death in the world.