Coronary Heart Disease

Coronary heart disease:

Coronary artery disease is alternatively called Arteriosclerotic heart disease Incidence of Coronary artery disease (CAD) the commonest. It is the most important cause of death in the United States in both men and women.

Heart is the main pumping station of blood in the body. From aorta the oxygenated blood is pumped all over the body via arteries. Arteries enter into respective organs break into capillaries, where exchange of gases through permeable walls of capillaries is facilitated. Later after delivering oxygen the deoxygenated blood returns to the heart through vena cava. From heart blood goes to lungs through pulmonary vein for oxygenation. So heart is a muscular organ which is just concerned with circulation of blood all over the body.

For its regular functioning heart also needs a constant and an uninterrupted blood supply. Coronary arteries supply blood to the heart. During coronary heart diseases the coronary arteries lose their flexibility due to accumulation of cholesterol and other material, called plaque, on their inner walls. Due to this the lumen of the arteries becomes narrow; they become hard, leading to a condition called arthrosclerosis. As this deposition builds up it offers an obstruction in the amount of blood thereby oxygen reaching the heart. Due to this heart becomes in want of oxygen leading to a chest pain or angina. And in more acute conditions when plaque depositions become too tough they hamper the blood supply all the more causing thrombosis of blood at the site. Thrombosis or the blood clot formation suddenly cuts off the heart's blood supply, causing permanent heart damage apparent as a heart attack.

Heart failure and arrhythmias occurs due to CAD which deteriorates the heart muscle the long run. Heart failure means the heart can't pump blood to the rest of the body leading to the dysfunction of the other organs as well .While arrhythmias is related to the changes in the rhythmical movements of heart.
Primarily coronary heart disease is caused by the deposition of plaque in the arteries supplying the heart, commonly called hardening of arteries. Fatty material like cholesterol and low density lipids constituting plaque cut down on the flow of blood. There are a variety of risk factors, some that can be altered others that cannot be, which make one prone to the ailment.

Certain risk factors like age, gender, genetic set up and race cannot be altered. The risk of heart diseases shoots up with aeging. On the sexual category front, males are at a bigger risk than females and have been reported to have a higher incidence of the ailment. However, after menopause the risk in females is closer to the risk for men.Genetically , the ailment is passed down to the progeny therefore if parents or close relatives have the ailment one be at bigger risk to fall prey to it. On racial grounds, African Americans, Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk for heart problems.
Yet, there are many others which can be monitored like level of sugar should be kept in check. High blood sugar levels can be a very potential risk factor, leading to a heart disease. High blood pressure also magnifies the risk of a heart disease. Watching what we eat, i.e. monitoring diet can check the amassing of cholesterol in the arteries. Addiction to nicotine and other illicit drugs, being overweight, not following an exercise regime all these factorts are threatening and may lead to a coronary disease.

The ailment is marked in form of an array of symptoms in some while others may remain asymptomatic unless the ailment becomes acute. The commonest symptom which is evident is a discomfort or a pain in the thoracic region identified as chest pain or angina. This occurs when heat does not get sufficient amount of oxygen. People may also experience a heavy pressure and a squeezing sensation below the sternum (breast bone) which later radiates to the other parts like neck, arms, stomach, or upper back. Usually pain occurs in response to a physical activity or some sort of emotional excitement and generally fades out with the intake of nitroglycerin. Shortness of breath, excessive fatigue, unexplained constant weight gain, lingering weakness are some other symptoms associated with the coronary heart disease.

Treatment follows diagnosis which is made by performing a series of tests. The tests like Coronary angiography, an invasive test during which a catheter is introduced in an artery present in the groin or the arm region and a contrast dye is injected into it. As the dye travels through the arteries, X-ray pictures are taken to trace the blockages. CT angiography, a non invasive way to perform coronary angiography is also used to diagnose the blockages. Electro cardiogram (ECG) is conducted with a person wearing an ECG monitor while the person is walking on the treadmill.ECG patterns obtained during the test confirm the presence of CAD. Echocardiograph test is also employed for detecting CAD it makes use of the sound waves to spot the ailment. Nuclear stress test which involves the use of a radioisotope is also performed to detect CAD. Other tests performed in this respect include Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries -- the more calcium, the higher your chance for CHD, Magnetic resonance angiography, and heart CT scan.

Treatment revolves around resolving and preventing problems pertaining to CAD. Drugs are administered to keep blood pressure, diabetes and high cholesterol in control. Blood tests are constantly performed to keep a watch on the lipid profile and the blood sugar level in the body. Depending on the degree of severity the medication is prescribed by the practioner. The drugs used to cure CAD include ACE inhibitors which lower the blood pressure and thereby protect heart and kidneys. Aspirin a wonder drug prevents the thickening of blood and prevents clotting. Beta blockers lower heart rate, blood pressure while Calcium channel blockers relax arteries, lower blood pressure, and reduce tension on the heart. Diuretics popularly called water pills lower the blood pressure and prevent heart from failure. Nitrates especially nitroglycerin ceases chest pain and statins impose a check on the cholesterol count of the body.

Certain lifestyle and behavioural changes if made also help in fighting the ailment. Quitting smoking, exercising regularly ,maintaining a healthy weight, being in a relaxed mental state, consuming a balanced and a healthy diet especially rich in fibres and low in fats, giving up on alcohol and other drugs helps overcome the problem to a great extent.

However, in severe cases surgeries like Angioplasty and stent placement, Coronary artery bypass surgery, Minimally invasive heart surgery are also recommended.

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