Coronary artery disease (CAD) refers to the atherosclerotic narrowing of the epicardial coronary arteries. It may manifest insidiously as angina pectoris or as an acute coronary synd...
Pain may be described with a clenched fist over the center of the chest (Levine sign). Episodes of angina are generally of the same character and in the same location as previous epis...
AHA/ACC-recommended BP control goal for most patients with significant CAD: <130/80 mm Hg.
Smoking cessation goal: complete cessation, no exposure to secondhand smoke or e-...
I25.119 Athscl heart disease of native cor art w unsp ang pctrs
I25.118 Athscl heart disease of native cor art w oth ang pctrs
I20.9 Angina pectoris, unspecified
I25.10 Athscl heart disease of...
Maximize antianginal therapy combining β-blockers, CCBs, and nitrates as tolerated, along with high-intensity statin therapy and anti-platelet therapy.
PCI may be considered for those w...
Sign up for a 10-day FREE Trial now and receive full access to all content.
A 24-hour ambulatory electrocardiographic (ECG) recording in a patient with coronary artery disease and episodes of lightheadedness. A: At 10:28:36 p.m., the ECG records ST depression in leads aVF and V5, with ST elevation in lead V1. Over the next 4 minutes, the changes of acute injury progress. B: The rhythm degenerates into polymorphic ventricular tachycardia, from which the patient was resuscitated. This demonstrates the interaction of myocardial ischemia and subsequent ventricular arrh...
A 24-hour ambulatory electrocardiographic (ECG) recording in a patient with coronary artery disease and episodes of lightheadedness. A: At...
Serial images before angioplasty and 6 months after angioplasty. A: Angioscopic appearance of a lesion before angioplasty in a patient with unstable angina discloses a yellow plaque (P) with a superimposed red thrombus (T). B: Angioscopy of the same lesion 6 months after successful angioplasty; angioscopy now discloses a white, smooth, concentric lesion without thrombus.
Serial images before angioplasty and 6 months after angioplasty. A: Angioscopic appearance of a lesion before angioplasty in a patient wit...
<bold>Figure 24-5. Pathophysiology of anginal syndromes. A.</bold> Normal coronary arteries are widely patent, the endothelium functions normally, and platelet aggregation is inhibited. <bold>B.</bold> In stable angina, atherosclerotic plaque and inappropriate vasoconstriction (caused by endothelial damage) reduce the vessel-lumen diameter, and hence decrease coronary blood flow. <bold>C.</bold> In unstable angina, rupture of the plaque triggers platelet aggregation, throm...
<bold>Figure 24-5. Pathophysiology of anginal syndromes. A.</bold> Normal coronary arteries are widely patent, the endothelium...
<bold>Figure 24-7. Pathogenesis of acutecoronary syndromes. A.</bold> A normal coronary artery has an intact endothelium surrounded by smooth muscle cells. <bold>B.</bold> Endothelial cell activation or injury recruits monocytes and T lymphocytes to the site of injury, leading to development of a fatty streak. <bold>C.</bold> Continued oxidative stress within a fatty streak leads to development of an atherosclerotic plaque. <bold>D.</bold> Macrophage apoptosis and co...
<bold>Figure 24-7. Pathogenesis of acutecoronary syndromes. A.</bold> A normal coronary artery has an intact endothelium surro...
Coronary Artery Disease Progression Labeled
Atherosclerotic coronary occlusion. A coronary artery of a patient who died from an acute myocardial infarction shows severe atherosclerosis and a recent thrombus in the narrowed lumen.
Atherosclerotic coronary occlusion. A coronary artery of a patient who died from an acute myocardial infarction shows severe atherosclerosi...