This paper provides a clinical overview of coronary heart disease (CHD), examining how plaque buildup in the coronary arteries leads to atherosclerosis, angina, heart attack, arrhythmia, and stroke. It outlines key risk factors, diagnostic procedures, and management strategies ranging from lifestyle changes to surgical intervention. The paper also presents a patient case study drawn from a nursing home interview, comparing the patient's presentation and family history against published literature. A reflective section explores how the experience will inform therapeutic relationships and evidence-based nursing practice, with reference to the Nursing and Midwifery Board of Australia's Registered Nurse standards.
Coronary heart disease (CHD) has been increasing across the globe and, alongside stroke, has been among the top causes of death in many countries, including Australia (Baker Heart and Diabetes Institute, 2017). Because people continue to succumb to complications caused by CHD, it is important for clinicians and nursing practitioners to thoroughly understand the disease, including its causes, effects, and management strategies.
CHD is a disease characterized by the development of a waxy substance called plaque that builds up in the inner walls of the coronary arteries — the arteries responsible for supplying oxygen-rich blood to the heart muscle. The buildup of plaque on the inner arterial walls results in atherosclerosis, a process that can take many years to accumulate to harmful quantities. Over time, the plaque can harden or rupture. Hardened plaque narrows the coronary arteries and significantly reduces the amount of oxygen-rich blood flowing through the heart. If the plaque ruptures or breaks apart, a blood clot can form around it. A large blood clot can partially or completely block blood flow through the artery. Ruptured plaque can also re-harden, further narrowing the coronary artery (American Heart Association, 2014).
When the flow of oxygenated blood to the heart muscle is significantly reduced, heart attack or angina can result. Angina is defined as sharp chest pain or discomfort that may manifest as squeezing or pressure in the chest cavity. The pain can also be felt in the shoulders, neck, back, arms, and jaw, and may even feel like indigestion (Cleveland Clinic, 2017).
A heart attack occurs when oxygen-rich blood is blocked from reaching a section of the heart muscle. In such cases, blood flow must be restored as quickly as possible; if it is not, the heart muscle begins to deteriorate. Delayed treatment can allow a heart attack to escalate into more serious health complications or even death (Mayo Clinic, 2017).
Over a long period of time, CHD can weaken the heart muscle, potentially leading to arrhythmias and heart failure. Heart failure occurs when the heart cannot pump sufficient blood to meet the body's needs for normal functioning. Arrhythmia refers to a complication involving the rhythm or rate of the heartbeat.
It is also worth noting that when a clot blocks blood vessels leading to the brain, the patient may experience an ischemic stroke. If a vessel within the brain bursts due to uncontrolled hypertension, a hemorrhagic stroke may result.
Several risk factors are associated with CHD, including smoking, male gender, diabetes, high blood cholesterol, high blood pressure, physical inactivity, excess weight, unhealthy diet, increasing age, high resting heart rate, kidney disease, depression and stress, and a family history of heart disease (Southern Cross, 2017).
Diagnosis of CHD begins with an assessment of symptoms, risk factors, and medical history. The physician may perform a physical examination and then order diagnostic tests such as an electrocardiogram, echocardiogram, electron beam CT scan, exercise stress test, and cardiac catheterization, among others. These tests allow the doctor to determine how advanced the heart disease is and to identify the most appropriate treatment for each individual case (WebMD, 2017).
"Lifestyle changes, medications, and surgical options"
"Nursing home patient interview and literature alignment"
"Lessons learned and future nursing practice implications"
You’re 47% through this paper. Sign up to read the remaining 3 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.