Coronary Artery Disease

Running head: CORONARY ARTERY DISEASE
Coronary Artery Disease
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1CORONARY ARTERY DISEASE
Introduction
Coronary Heart Disease (CAD) is also referred to as ischemic heart disease (IHD) and
this disease is associated with the blockage of the blood vessels due to the atherosclerosis.
Due to the blockage in the coronary blood vessels, the blood supply is disrupted to the
cardiac muscles. As result, there is lack of oxygen supply in those region of cardiac muscles.
It is a usually reported that, there are several factors that can promote the risks of CAD
among patients. For example, it can be said that, the patients with high blood pressures,
obesity, diabetes, high level of blood cholesterol, smoking behaviour, family history of CAD,
lack of exercise have the higher chances of developing CAD. Due to restricted blood flow to
the cardiac muscles, the cells of the cardiac muscles may die due to less amount of oxygen
supply (Mack & Gopal, 2016). This condition is generally referred to as myocardial ischemia
or heart attack. Generally CAD takes place only when, the smooth muscles of the coronary
artery develops plaques that may contain deposition of calcium, fatty lipids and a few specific
type of abnormal inflammatory cells in that region. In the treatment of the CAD, beta
blockers, calcium channel blockers, blood thinner, ACE inhibitors can be used (American
Diabetes Association, 2016). In this essay, the overview of the coronary artery disease,
underlying pathophysiology of the disease, pharmacology of CAD along with relevant
clinical practice are discussed in a brief manner.
Overview of Coronary Artery Disease (CAD)
Coronary arteries general supplies blood to the heart, specifically to the cardiac
muscles of the heart. During the normal supply of the blood vessels, adequate amount of
oxygen is supplied to those region of cardiac muscles and this causes continuation of normal
activities of myocardium. Therefore, the local regulatory mechanism of the cardiac muscles
will control the blood flow through the vasodilation and vasoconstriction mechanism. In case

2CORONARY ARTERY DISEASE
of the coronary artery disease (CAD), it is reported that, the both structure and function of the
coronary artery is altered due to the deposition of plaque inside the walls of the coronary
arteries that supplies oxygenated blood to the myocardium. The right and left coronary
arteries of the heart is associated with supplying the blood to heart. The left and right
coronary arteries divides the small and large arteries into arterioles which also can supply
oxygen to myocardium. On the other hand, the left coronary artery supplies blood to the
anterior septum and left ventricle of the heart. The right coronary artery supply blood to the
right ventricle, AV node and myocardial walls of the heart. Hence, any disruption in the
blood supply to those areas can cause serious consequences such as cardiac arrhythmia,
myocardial ischemia. Such problems are due to reduced blood flow in those areas and
simultaneously less amount of oxygen reach in those areas ( Hall, 2015). The due to oxygen
the myocardium become infarcted and promotes the myocardium to die. A specific type of
CAD is STEMI that is ST elevated myocardial ischemia and in this condition, the coronary
artery is completely almost completely blocked by blood clots or plaques. In such cases, it
may happen that, the heart stops to work and leads to the condition refers to heart failure
( Moretti et al., 2015).
Pathophysiology of CAD
The coronary artery disease is associated with the deposition of vessel occluding
lipids inside the blood vessels. The underlying pathophysiology of this CAD starts with the
formation of atherosclerosis inside the blood vessels. The process of atherosclerosis can be
defined as a low grade inflammated condition of the inner lining myocardial cells of the
coronary arteries. These condition can be more serious in case of association of various risk
factors such as high cholesterol, smoking, diabetes, genetics and high blood pressure. In
case of CAD, the slow process of plaque formation inside the walls of coronary arteries
promotes the thickening of the artery walls and that results in gradual narrowness of the