Expertise in Nursing Practice

Abstract
This book helps readers learn the symptoms of coronary artery disease (CAD) and acute coronary syndrome and when someone with CAD would need coronary artery bypass graft surgery. Valve disease may be caused by rheumatic fever, infective endocarditis, calcification, trauma, or connective tissue disorders, such as the Marfan syndrome. Diagnostic testing can determine the type and extent of heart disease and guide treatment strategies. Patients need to understand the reasons for diagnostic tests and what to expect during the test. The book helps readers learn what information is gathered during a cardiac catheterization. Ischemic changes occur in the distribution of the affected coronary artery. New advances in computed tomography (CT) scanning hold promise for evaluation of CAD. Like CT scanning, magnetic resonance imaging (MRI) technology is improving and becoming more versatile. The urgency of cardiac surgery determines how much time is available to prepare the patient. Some cardiac surgeries are performed without cardiopulmonary bypass (CPB), but the majority are performed using CPB. Patients undergo coronary artery bypass grafting (CABG) to decrease anginal symptoms and improve survival. The book also discusses factors that influence the choice of tissue or mechanical valve and postoperative implications of valve surgery. However, mechanical valves are prone to clot formation, so patients will require anticoagulation as long as the valve is in place. Atrial fibrillation, ventricular assist devices, prevention and treatment of common post-op cardiac surgery, administration of medications, and signs and symptoms of stroke are also discussed. The book also includes information on the four phases of cardiac rehabilitation programs and risk factors targeted in secondary prevention programs, including cardiac rehabilitation programs.