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Cardiovascular Diseases Coronary Artery Disease Atherosclerosis most common cause of CADAbnormal accumulation of lipid or fatty substancesstreaks and fibrous tissue in the lining of arterial blood vessel wallsCreate blockages and narrow the coronary vesselsreduce blood flowRepetitious inflammatory response macrophages to injury of vascular endothelium o Injury may be initiated by smoking hypertension etc o Macrophages ingest lipidsturn into foam cells and release biochemical substances that further damage endotheliumattract plateletso Smooth muscle cells proliferate and form fibrous cap atheromasplaquesStable or unstable plaques depending on inflammation and thickness if thin lipid core may grow rupture and hemorrhage into plaquethrombus Clinical ManifestationsIschemiainadequate blood supply that deprives cardiac muscle cells of O2Angina Pectoris chest pain brought about by myocardial ischemia caused by significant atherosclerosiso If decrease blood supply great enough long enough MI may occurMyocardial damage may result in low CO cant meet body needsheart failurechest painmany patients asymptomaticSOBwomen atypical symptoms dyspnea nausea weakness Risk FactorsElevated blood lipid levels LDL Smoking Hypertension Diabetes Obesity Family history PADMetabolic syndrome need 3 of the following o insulin resistance 55 fasting glucose o abdominal obesity 89women 102men o Dyslipidemia triglycerides 285 HDL 129women 103men o Hypertension o Proinflammatory state high Creactive protein o Prothrombotic state high fibrinogen Primary preventionprevent CAD Secondary Preventionprevent progression of CAD
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