Heart and cardiovascular diseases
Coronary Heart Disease
What is Coronary Heart Disease?
Coronary Heart Disease (CHD)is a condition when coronary arteries are clogged and hardened by cholesterol and fatty buildup know as plaque causing restriction in the blood flow to the heart muscle. Process of building plaque in arteries occurs over decades and the condition is called atherosclerosis.
The plaque buildup causes the arteries to get narrow resulting less blood flow to the heart which can slow down or stop the heart. Sometime an area of plaque even can rupture and in the process of healingthe arteries, blood will clot over the surface of plaque. If the plaque is big enough it can also block the blood flow completely. When the blood supply is entirely cut off, it can cause a heart attack.
Coronary heart disease is also known by coronary artery disease or ischemic heart disease.
Causes of Coronary Heart Disease
Through research it is assumed that coronary heart disease begins when certain factors damages or injure the inner layer of a coronary artery. When the body starts the healing process the plaque buildup starts. There are various factors which can cause damage, some of them are:
- Smoking
- High blood pressure
- Diabetes (high blood sugar)
- High level of fats and cholesterol
Symptoms of Coronary Heart Disease
When the arteries are clogged by plaque buildup, they become narrow and prevent the supply of oxygen rich blood to the heart. It can cause chest pain andit especially occurs when the person is physically active. In some case people who have coronary heart disease do not have any sign and symptom. Hence it is called as silent coronary heart disease. Also sometime when coronary heart disease lead to cause serious health conditions like heart attack, heart failure, or an arrhythmia then the diseased is diagnosed. Some of the coronary heart disease symptoms include:
- Chest pain (Angina): Chest pain is the most common symptom of coronary heart disease. It’s a kind of chest pain or discomfort which may feel like a pressure of tightness in the chest as if someone is standing on the chest, this squeezing pain also refer as Angina. Sometime the pain in women is sharp and brief in abdomen, shoulders, arms, neck, jaw or back of the body and also may feel like indigestion. The pain may get worse while being physically active and feeds away when being rested. Angina can be triggered by emotional stress.
Shortness of Breath: when the heart cannot pump enough blood to meet the body’s need, people can develop extreme fatigue with exertion or shortness of breath.
Coronary heart disease is the most common trigger to cause arrhythmia because it produces scare tissue in the heart and these scare tissues disrupt the transmission of signals which control the heart rhythm.
If the buildup of plaque has completely blocked the coronary arteries, it can cause heart attack. And the sign and symptom of heart attack is almost like angina. However in most heart attacks the center or left side of the chest pain often lasts for more than a few minutes or the pain goes away and comes back where in angina chest pain goes away after a awhile when it is rested .
Coronary heart disease damages the heart causing heart failure, and it is a condition in which the heart can’t pump enough blood to meet the body’s needs and the fluid built up in the lungs cause it hard to breath and people will fill shortness of breath.
Who is at the risk of Coronary Heart Disease?
Coronary heart disease death in Azerbaijan has reached 30.35% of total deaths and rank Azerbaijan #15 in the world.
There are various risk factors which can lead to cause coronary heart disease. Some risk factors are nonmodifiable which cannot be changed and some risk factors are modifiable which can be controlled. The more the risk factor the more possibility emerges to develop the disease. However if the risk factors are been controlled then coronary heart disease can be prevented or delayed.
Nonmodifiable Risk Factors:
There are certain factors which cannot be controlled or changed such as:
Ageing: Getting older increases the risk of damaging and narrowing the arteries.
Gender: Men tend to have more risk of heart attack than women. However women’s risk of cardiovascular disease increases after menopause.
Family history: A family history of cardiovascular disease increases with a higher risk of coronary artery disease, especially if a close relative such as father or a brother was diagnosed with heart disease before age 55, or mother or a sister developed it before age 65.
Modifiable Risk Factors:
There are certain factors which can be changed, controlled or treated such as:
Quit smoking: Smoking is the most preventable risk factor for cardiovascular disease and stroke. Nicotineconstricts the blood vessels. Also when cigarette is smoked the carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. The incidence of heart attack in women who smoke at least 20 cigarettes a day is six times that of women who have never smoked. For men who smoke, the incidence is triple that of nonsmokers.
Maintain the cholesterol level: Excessive amount of low-density lipoprotein (LDL), known as “bad” cholesterolcan increase the risk of plaque buildup. High-density lipoprotein (HDL), known as “good” cholesteroltakes the LDL cholesterol away from the arteries and back to the liver where it can be passed out of the body. High levels of HDL seem to protect against cardiovascular disease however a low level of HDL can promote atherosclerosis.
Control high blood pressure: Uncontrolled high blood pressure for long time can increase the workload of heart alsoharden and thicken the arteries, narrowing the channel through which blood can flow. This increases the risk of heart attack, heart failure, stroke and kidney diseases.
Control diabetes: diabetes is a condition when the pancreas is not able to produce insulin or the body is not able to use the insulin. This elevates the level of blood sugar. Diabetes especially in women have a higher risk of promoting cardiovascular diseases as it increase other risk factors.
Maintain a healthy weight: excess weight raises blood cholesterol, triglycerides and blood pressure. Also research has shown that being overweight contributes to the onset of cardiovascular disease.
Be physically active: Being physically activity helps to reduce so many other risk factors such as it lowers the blood pressure, lower the high cholesterol, reduce the stress, achieve and maintain a healthy body weight. Lack of exercise, lead to the risk of having coronary artery disease.
Follow a healthy diet: There are four major risk factor related with diet which are high blood pressure, high blood cholesterol, diabetes and obesity.Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other risk factors for coronary heart diseases.
Contributing Risk Factors:
There are certain factors which not considered traditional risk factors but they contribute to overall risk for cardiovascular disease,such as:
Stress: Stress can be managed by practicing relaxation techniques rather than smoking and drinking. Unrelieved stress in may damage arteries as well as worsen other risk factors for coronary artery disease.
Alcoholism:Consumption of excess amount of alcohol can increase blood pressure, irregular heartbeats and lead to heart failure and stroke.
Diagnosis of Coronary Heart Disease
The doctor will diagnose coronary heart disease based on the medical and family histories, the risk factors, a physical examination and the results from medical tests and procedures.
Medical and Family Histories
The doctor may ask series of question regarding the symptoms of coronary heart disease also may ask if patience is suffering from other health problems which can lead to coronary heart disease. Also may ask if the patience smoke or use alcohol or drugs, has stress and etc.
Further the doctor may ask regarding the background of patience’s family if any of the sibling or parents had a history of coronary heart disease, diabetes, high blood pressure etc.
Physical Examination
The doctor will listen to the heart and check the pulse to find out the rhythm and rate. Also listen to find if there is any murmur or clicks sound during heartbeat.
Tests and Procedures
Some of the tests and procedures will be prescribed.
Laboratory Tests
- Blood Tests
- C - reactive protein Testing
- Enzymes & Protein Blood Tests
- Lipid Blood Tests
Imaging Tests
- Echocardiogram(ECHO)
- Electrocardiogram (ECG or EKG)
- Stress Test
- Nuclear Imaging - Heart
- Radiographic Tests - Heart
- Electron-Beam Computed Tomography
Invasive Testing
- Coronary Angiography
- Cardiac Catheterization
- Intravascular Ultrasound
Treatments of Coronary Heart Disease
Treatment for coronary heart disease usually involves lifestyle changes and, if necessary, medicine and certain medical procedures.
Lifestyle Changes
There are some lifestyle factors which can cause coronary heart disease. Changing these lifestyles can even prevent, prolong or treat coronary heart disease. These factors include:
- Quitting smoking or tobacco using
- Follow a healthy diet
- Maintain a healthy weight
- Be physically active
- Manage the stress
Medicines
There are various medicines which can be used to treat coronary artery disease, including:
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensinreceptor blockers (ARBs)
- Aspirin or other blood thinner
- Beta blockers
- Cholesterol-modifying medications
- Nitroglycerin
- Calcium channel blockers
These medicines can help in:
- To relive symptoms of coronary heart disease
- To reduce the workload of heart
- To prevent the blood clots from forming
- To lower the cholesterol level
- To decrease the blood pressure
- To relax the muscles that surrounds the coronary arteries
- To reduce chest pain by opening up the coronary arteries and reducing the heart’s demand for blood
- To delay or reduce the risk of further heart attacks
- To prevent progression of coronary heart disease
Medical Procedures
- Angioplasty
- Cardiac catheterization and coronary interventional procedures
Surgical Procedures
- Minimally invasive bypass surgery
- Coronary artery bypass grafting