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Coronary Artery Disease (CAD)

Etiology

  • Obstruction of blood flow in a coronary artery lumen, most commonly due to coronary artery atherosclerosis

Major RF: HLD, HTN, Smoking, DM, FH, Age >45M or 55F

  • Premature CAD: 1st degree male relative diagnosed age <50 y/o or female <60 y/o
  • SLE is a known risk factor for accelerated atherosclerosis and premature CHD

Symptoms

  • Subclinical or Asymptomatic CAD
    • Evidence of CAD w/o symptoms

Complications

  • Heart Failure
    • IHD/CAD = 60-75% of cases in developing world
  • Cardiac Ischemia
    • Unstable Angina: Mural thrombus
    • Acute MI: Results from acute thromboses after plaque disruption
    • SCD: Usually from fatal arrhythmia
    • Chronic Stable Angina

Management

  • Give all CAD patients Statins
    • Reduced risk of death by 24%, reduced risk of stroke by 31%, and reduction in need for CABG or Coronary Angioplasty by 27%
  • Aspirin for secondary prevention
    • Increased risk of Thromboembolic events if stopped, 70% occur within 7-10 days