Causes of Coronary Artery Disease| Pathophysiology/Med-Surg | Lecturio Nursing
Aug 18, 2023
Causes of Coronary Artery Disease| Pathophysiology/Med-Surg | Lecturio Nursing
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Content
0.109 -> Hi, welcome to our video series.
2.406 -> In this one, we're going to look at coronary
artery disease and specifically atherosclerosis.
8.165 -> Okay, that one's a mouthful but I want to
walk you through this simple steps of the changes
13.398 -> that happened in someone's
body with coronary artery disease.
17.16 -> So we always we start with the definition, it's a
great kind of of solid foundation point to start on.
22.374 -> So coronary artery disease you'll see us shorten it to CAD,
it's caused by atherosclerosis so that's how they're aided.
31.052 -> so the atherosclerosis is actually
the most common type of heart disease
35.437 -> so most people as they age
develop some level of this atherosclerosis.
41.105 -> Now what the problem is is we have
arteries that supplies blood to the heart.
45.617 -> That part's not the problem but in coronary artery
disease, you start to have some issues with narrowing,
52.558 -> the vessels become hard or even blocked to the
point that the oxygen-rich blood flow is compromised.
59.166 -> When I say that, that means there's not enough
blood that's got the oxygen the heart muscle needs
65.094 -> getting to that heart muscle,
that's when we have a problem.
69.419 -> So let's take a look at that.
70.825 -> We've given you a good graphic there I
love this picture to help you kind of peek inside
75.291 -> what's going on the artery.
77.171 -> So take a look at the picture on the left.
79.736 -> You see that we've got the long piece of
the artery there, but then we've sliced it in half
85.062 -> so you can see the endothelium.
87.519 -> Okay now, around the endothelium
we've got the smooth muscle.
91.839 -> Look at it in both pictures.
93.496 -> See that, it's right in the walls of the vessels.
96.839 -> So here we've got a long section there, we've got
a slice like a little carrot-sized slice of your vessel,
102.705 -> so see where there's smooth
muscle right in the wall,
105.846 -> and hardening and narrowing of these arteries
is what causes the problem of your patient.
111.659 -> Now you have this hardening, the
narrowing because you got a buildup of plaque.
117.207 -> Now plaque is that kind of the
yellowy stuff that you see there.
121.298 -> So in the very early part of that
long piece, you see it looks really clear
126.086 -> but as you move down toward the end closest
to us, you see that we've got lipids and calcium
131.644 -> and all kinds of cellular debris there.
133.953 -> That's what gets really hard and stiff eventually.
137.469 -> You can tell how it narrows the
space that the blood has to flow through.
141.633 -> Look at the drawing on the right.
143.175 -> That atherosclerosis, has almost
cut that vessel's capacity in half
149.317 -> and that's one of the reasons why atherosclerosis
can be so difficult for a patient's body to adjust to.
156.082 -> So how do we end up in this state?
What happens?
159.457 -> Well I want to walk you through step-by-step
what happens over relatively long period of time
165.857 -> but we're just going to speed it up.
167.945 -> Now look at the heart there, you
see that we got kind of that black area?
172.176 -> That's to remind you that that's an area where an
occlusion happened, where it's been completely blocked off
177.624 -> and the surrounding muscle tissue is damaged.
180.64 -> The reason it's damaged is because it
blocked off the hearts supply to the muscle.
185.457 -> So start at the top in our vessels.
187.268 -> You have a normal artery, then it has kind of an
early injury, start to have the atherosclerosis build-up,
193.664 -> and the bottom one is a complete blockage.
196.863 -> That's what leads to that
damaged or infarcted tissue.
200.716 -> Well at the first three vessels we see normal, early
injury and then you see the atherosclerosis building up.
207.99 -> What happened in the bottom one?
209.939 -> Some type of clot broke off, floated to the
system and it got to a narrowed part of the artery
215.779 -> because of atherosclerosis and
completely blocked off the blood supply.
220.989 -> So that's how we fast forwarded through that,
now let's break down some of the teaching points.
225.972 -> so we know that atherosclerosis member sclerosis
means "the hardening", athero- refers to the vessels
234.135 -> So kind of file that away in your medical
vocabulary to help you sort through other words
238.805 -> when they appear with those
same suffixes or the beginning parts.
243.382 -> So hardening and narrowing of the
arteries is caused by a build up of plaque,
247.727 -> and you saw how that happened from normal artery,
then first having early injury then you have the response
253.469 -> and then it becomes hardened and that's when we
have the partial blockage which could lead to complete.
258.67 -> So it's a chronic inflammatory
process, that's what happens.
263.355 -> So you got the normal, now you see the early injury.
267.002 -> Write in there, chronic inflammation.
269.765 -> So I want you to have that in your mind that
that's one of the things we really try to combat
273.92 -> in all patients so we to try to minimize inflammation.
277.885 -> Now we'll talk about the processes
that we use to do that later.
280.938 -> but I want you to have established in your mind it's
a chronic, meaning it happens over a period of time
287.085 -> and start with damage to the endothelium.
289.892 -> Now a complete blockage could be sudden, right?
292.987 -> but it's because the damage has been done to those
vessels over a period of time - that's the chronic part
299.04 -> that you can end up in a high-risk event like
complete blockage or myocardial infarction.
305.504 -> Now here's what happens, here's what gathers there:
309.197 -> You've already guessed that in your
mind, you know it's an inflammatory process,
312.314 -> but the LDLs - now in case that word's not
familiar to you, that's a form of cholesterol -
318.17 -> The LDLs crossed the damaged
endothelium into the wall of the artery.
323.706 -> So we've got it to just shortcut for you over
there, talk about early injury and then atherosclerosis.
328.896 -> Breaking that down for you what
happens after that early injury.
332.54 -> So these LDLs cross the damaged
endothelium into the wall of the artery.
338.134 -> Now what happens is over time, this
cholesterol becomes part of the plaque.
343.333 -> So you have increased circulation?
345.664 -> No.
346.689 -> The circulation can become compromised
because these LDLs that have crossed over there,
351.482 -> they become part of the plaque -
thats what narrowed the arteries.
355.173 -> So these patients have a higher risk of a cardiovascular
event, an MI - a myocardial infarction, or a stroke.
362.894 -> Now we've been very careful to lay these concepts
down because you need to understand these concepts
368.617 -> when your patient start showing new symptoms.
371.155 -> Knowledge of understanding how atherosclerosis
happens will help you when you're diagnosing how severe,
377.974 -> the type of pain and symptoms
your patient's experiencing.
Source: https://www.youtube.com/watch?v=6d_idNFw44w
