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Angina: A coronary artery must be at least 70% blocked for symptoms to occur.

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Information collected

• Health history
• Symptoms (length, type, trigger)
• Current medications
• Risk factors

ER Procedures

• ECG and telemetry
• Chest xray
• Lab work
• Blood pressure
• Medications administered (oxygen, nitrates, pain medication, etc.)

Cardiac Catheterization


Uses dyes and x-ray scans to determine where blockages are in coronary arteries and how extensive they are.
There may be one blockage or several.
A coronary artery is about 70% blocked before it produces angina symptoms.

There are several treatments available for blocked coronary arteries.

But no matter what the treatment is, the goal is to restore blood flow in the heart.

Sometimes, medications are all that's needed:

• Nitrates (increase blood flow)
• Beta blockers (reduce cardiac workload)
• ACE inhibitors (reduce blood pressure)
• Diuretics
• Anti-arrhythmic (control heart rhythm)
• Anti-platelet (prevent clotting)

Other times invasive procedures are used to restore blood flow to the blocked coronary artery(s). These procedures are performed by a surgeon or cardiologist.

Angioplasty: A catheter with a balloon is inserted through the femoral artery. When the catheter reaches the blocked coronary artery, the balloon is inflated to break up the blockage and restore blood flow. The artery can become re-occluded, so results are not guaranteed.

Stent: A wire mesh that is inserted via a catheter. Like angioplasty, stents are opened up at the sight of the blocked coronary artery. Many have medication in them that help them stay open longer. It is not uncommon for someone to have more than 1 stent.

Coronary artery bypass graft (CABG):
Surgeon uses saphenous veins or mammary arteries to bypass blockages in coronary arteries. Requires cutting the sternum. Heart is stopped and heart /lung machine keeps blood circulating. High success rate, but bypasses can become blocked again over time.

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CABG requires cutting the sternum (sternotomy) to open the chest. It can take up to 12 weeks for the sternum to heal completely.

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Phase 1 cardiac rehab

Phase 1

• Physician referred
• Goals: early mobilization
• Monitor exercise response
• Identify activity limits
• Symptom limited

Phase 1

• Frequency: 2-4 x /day
• Intensity: Resting HR (RHR) + 20 bpm for MI; RHR + 30 bpm for CABG; No higher than 120 bpm
• Time: 3-5 minutes as tolerated
• Type: walking

Going home

Restrictions for CABG

Post MI

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Phase 2 cardiac rehab

Phase 2

Stress test

Resistance Training

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Return to work

• Stress
• Physical demands
• Hours
• Driving

FITT

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Unmodifiable Risk Factors

• Family history
• Gender
• Age
• Ethnicity

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Smoking

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