Atherosclerosis (plaque buildup in coronary arteries)

Hypertension (HTN)

Hyperlipidemia (high LDL, low HDL)

Diabetes Mellitus

Smoking

Obesity

Sedentary lifestyle

Family history of CAD

Stress

Atherosclerosis → Narrowing of coronary arteries

Reduced blood flow → Ischemia (angina)

Plaque rupture + Thrombus formation → Complete blockage

Myocardial Infarction (MI) → Myocardial cell death (necrosis)

Complications → Heart failure, arrhythmias, cardiogenic shock

Stable Angina: Chest pain relieved by rest or nitroglycerin

Unstable Angina: Chest pain at rest, unpredictable

Myocardial Infarction (MI):

• Severe, crushing chest pain (radiates to arm, jaw, back)

• Diaphoresis (sweating)

• Dyspnea

• Nausea/vomiting

• Pallor, cool clammy skin

• Anxiety, feeling of impending doom

ECG: ST-elevation (STEMI) or ST-depression (NSTEMI)

Cardiac Biomarkers:

• Troponin I & T (most specific)

• CK-MB (creatine kinase-muscle/brain)

• Myoglobin

Echocardiogram: Assess heart function

Coronary Angiography: Identify blockages

Stress Test: Evaluate ischemia

Acute MI Treatment (MONA-B):

• Morphine – Pain relief

• Oxygen – If hypoxic

• Nitroglycerin – Vasodilation

• Aspirin – Prevent clot formation

• Beta-blockers – Reduce myocardial workload

Reperfusion Therapy:

• Thrombolytics (tPA, streptokinase) – If PCI is unavailable

• Percutaneous Coronary Intervention (PCI): Stent placement

• Coronary Artery Bypass Graft (CABG): Severe blockages

Monitor vital signs, ECG changes, and pain level

Administer oxygen, medications as prescribed

Educate on risk factor modification (diet, exercise, smoking cessation)

Encourage cardiac rehabilitation

Monitor for complications (heart failure, arrhythmias)

Heart failure

Cardiogenic shock

Arrhythmias (ventricular fibrillation, atrial fibrillation)

Pericarditis

Recurrent MI

Decreased Cardiac output related to reduced myocardial contractility due to ischemia as evidenced by decreased cardiac output.

Acute paint related to decreased myocardial oxygen supply leading to ischemia as evidenced by chest pain and anxiety and restlessness

Ineffective Cardiac tissue perfusion related to coronary artery occlusion and decreased blood flow to the heart as evidenced by weak pulses ad cool, clammy skin

PAD:

• Atherosclerosis (plaque buildup in arteries)

• Smoking

• Diabetes Mellitus

• Hypertension

• Hyperlipidemia

• Obesity

• Sedentary lifestyle

HTN:

• High sodium intake

• Chronic stress

• Genetics

• Renal disease

• Endocrine disorders (Cushing’s, Hyperaldosteronism)

PAD:

• Atherosclerosis → Narrowing of arteries → ↓ Blood flow to extremities → Ischemia

HTN:

• Increased systemic vascular resistance → ↑ Cardiac workload → Vascular damage

PAD:

• Intermittent claudication (pain in legs when walking)

• Cold, pale extremities

• Weak or absent pulses

• Delayed wound healing

• Dependent rubor (redness when dangling)

HTN:

• Often asymptomatic

• Headaches, dizziness

• Blurred vision

• Chest pain, palpitations

• Epistaxis (nosebleeds)

PAD:

• Ankle-Brachial Index (ABI)

• Doppler ultrasound

• Angiography

HTN:

• Blood pressure measurements (≥140/90 mmHg)

• Electrocardiogram (ECG)

• Lipid profile

PAD Treatment:

• Medications: Antiplatelets (Aspirin, Clopidogrel), Statins, Vasodilators

• Surgical Interventions: Angioplasty, Bypass Surgery

• Lifestyle Changes: Smoking cessation, exercise, low-fat diet

HTN Treatment:

• Medications:

  • Diuretics (Hydrochlorothiazide)

  • ACE Inhibitors (Lisinopril)

  • Beta-blockers (Metoprolol)

  • Calcium Channel Blockers (Amlodipine)

• Lifestyle Changes:

  • Low-sodium diet

  • Exercise

  • Stress reduction

Monitor blood pressure, pulses, and circulation

Assess for complications (stroke, MI, gangrene, aneurysms)

Encourage smoking cessation and weight management

Teach foot care for PAD patients (avoid injury, wear proper footwear)

Educate on medication adherence and lifestyle modifications

PAD: Critical limb ischemia, ulcers, amputation

HTN: Stroke, MI, kidney disease, heart failure

Ineffective Peripheral Tissue Perfusion related to decreased arterial blood flow secondary to atherosclerosis as evidenced by intermittent claudication.

Risk for Decreased Cardiac Output related to increased afterload and myocardial workload due to hypertension as evidenced by Elevated blood pressure readings (≥140/90 mmHg).

Acute pain related to decreased oxygenation to tissues from PAD as evidenced by relief by dangling legs.