When the blood supply to the heart is blocked by the accumulation of fatty substances in the arteries supplying blood to the heat muscle, it results in what is known as Coronary heart disease. This can lead to the artery walls becoming clogged with fatty deposits. For some people, the first sign of coronary heart disease may be a heart attack which may be fatal.
Associated Anatomy of Coronary Heart Disease
It affects the coronary arteries and therefore heart muscle.
Causes of Coronary Heart Disease
When the blood supply to the heart is affected by the accumulation of fatty substances in the coronary arteries, it can lead to coronary heart disease. The coronary artery gets obstructed with fatty deposits and calcium (atherosclerosis). Lifestyle factors such as lack of exercise, smoking, excessive alcohol consumption, as well as high cholesterol, hypertension, diabetes, and insulin resistance can put you at risk for atherosclerosis. Family history of heart disease also is a very important risk factor.
Signs or Symptoms of Coronary Heart Disease
Symptoms of coronary heart disease are -
- Chest pain or angina: Exhibits pressure or tightness in your chest, usually in the middle or left side of the chest, specially on exertion.
- Heart attack: This is caused by a completely blocked coronary artery. Symptoms include crushing pressure in the chest and pain in the shoulder or arm. May be associated with profuse cold sweat.
- Shortness of breath: The reason for this is your heart can no longer pump enough blood to meet your body's needs.
- Pain throughout the body
- Feeling of light-headedness
- Nausea/vomiting.
Possible Treatment for Coronary Heart Disease
Treatment for coronary heart disease involves -
This includes quitting smoking, eating healthy, exercising regularly, avoiding drugs and excessive amounts of alcohol, and reducing stress.
The condition is treated with drugs such as cholesterol-modifying medications, aspirin (to reduce the tendency of the blood to clot), beta-blockers (to slow heart rate), calcium channel blockers (if beta-blockers alone aren't effective), and ACE inhibitors (to decrease blood pressure).
Coronary artery stent, angioplasty, and coronary bypass surgery help to restore and improve blood flow to heart muscle.
Risk Factor of Coronary Heart Disease
Risk factors for coronary heart disease include -
- Age: Advancing age increases the risk of damaged and narrowed arteries.
- Sex: Men are generally at greater risk of coronary heart disease. In the case of women, the risk increases after menopause.
- Family history: This is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. The risk is highest if a person’s father or brother was diagnosed before age 55 or if their mother or sister developed Coronary heart disease younger than 65.
- Smoking: This significantly increases the risk of heart disease. Breathing in second-hand smoke also increases risk.
- Hypertension: Uncontrolled high blood pressure can result in the hardening, narrowing, and thickening of arteries. High blood cholesterol: This can increase the risk of plaque formation and atherosclerosis.
- Diabetes: Type 2 diabetes increase risk of coronary heart disease share similar risk factors, such as obesity and hypertension.
- Obesity: Excess weight typically worsens other risk factors and itself increases risk.
- Sedentary lifestyle: Lack of exercise is associated with coronary heart disease.
- High stress: Unrelieved stress may damage arteries.
- Unhealthy diet: High amounts of saturated fat, trans fat, salt, and sugar can increase the risk of coronary heart disease.
- Sleep apnea: Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure, possibly leading to coronary heart disease.
- Alcohol use: Heavy consumption can lead to heart muscle damage.
- Autoimmune diseases: Inflammatory conditions such as rheumatoid arthritis and lupus may increase the risk of atherosclerosis.
- High-sensitivity C-reactive protein: This protein appears in higher-than-normal amounts when there's inflammation in the body.
- Triglycerides: High levels of this lipid may raise the risk of coronary heart disease, especially for women.
- Homocysteine: High levels of this amino acid may increase the risk of coronary heart disease.
- Preeclampsia: This condition, which sometimes develops in women during pregnancy, causes high blood pressure leading to a higher risk of heart disease later in life.
Coronary Heart Disease Stages
The various stages of coronary heart disease are as follows:
Stage A:
Hypertension, coronary artery disease, diabetes, and metabolic syndrome may contribute to the development of this stage. Chances are also higher for those with a history of alcohol abuse, inflammations such as rheumatic fever, certain forms of cardiotoxic drug intervention, or cardiomyopathy (a hereditary heart disease).
Stage B:
This is when there is a dysfunction in the left chamber or ventricle of the heart. Those who have had valve disease, a heart attack, or been diagnosed with cardiomyopathy may enter this stage.
Stage C:
Systolic heart failure is exhibited at this stage, accompanied by tiredness and difficulty breathing.
Stage D:
Here, the left ventricle may not be able to contract properly, resulting in heart failure.
Typical Tests for Coronary Heart Disease
First, the doctor will do a risk assessment, where you will be asked about your medical and family history. Blood pressure and cholesterol are checked through blood tests. You will also be asked about lifestyle, exercise, and whether you smoke.
Other tests include -
- Electrocardiogram to reveal evidence of a previous heart attack or one that is in progress
- Echocardiogram to determine whether all parts of the heart wall are contributing normally to your heart's pumping activity
- X-rays to detect the presence of calcium in the heart or blood vessel
- Exercise stress tests, where you will be asked to walk on a treadmill
- Nuclear stress test to measure blood flow to the heart
- Cardiac catheterization and angiogram to determine blockages
- Cardiac CT scan to examine if there are calcium deposits in the arteries
- CT coronary angiogram to produce detailed images of the heart arteries
Primary Prevention of Coronary Heart Disease
The same lifestyle habits used to help treat coronary artery disease can also help prevent it. They include -
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Quitting smoking
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Maintaining a healthy weight
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Exercising regularly
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Controlling conditions such as hypertension, high cholesterol, and diabetes
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Staying physically active
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Eating a balanced, low-fat, low-salt diet rich in fruits, vegetables, and whole grains
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Reducing stress levels
Secondary Prevention of Coronary Heart Disease
Maintaining a healthy lifestyle that includes a low-fat, low-salt diet rich in vegetables, fruits, and whole grains, exercising regularly, managing stress, and quitting smoking are some ways to prevent coronary heart disease. Secondary prevention includes medical therapy, cardiac rehabilitation, surgical intervention in the form of coronary artery bypass grafting, and drug treatment.
Alternate Name for Coronary Heart Disease
Coronary heart disease is sometimes known as ischemic heart disease.
Coronary Heart Disease Epidemiology
It is estimated that coronary heart disease affects around 126 million individuals or 1.72% of the world’s population. Men are usually more commonly impacted than women.
Expected Prognosis of Coronary Heart Disease
Coronary heart disease is treatable, but there is no cure. Timely diagnosis and treatment provided excellent quality of life, Survival advantage and event-free survival and very good progress.
Natural Progression of Coronary Heart Disease
Although atherosclerosis is believed to progress over many years, in some patients it can progress over a few months to two years. But healthy lifestyle habits can help to halt the progress of heart disease.
Pathophysiology of Coronary Heart Disease
Atherosclerosis is the pathologic process of lipid accumulation, scarring, and inflammation in the vascular wall, leading to thickening, calcification, and in some cases, thrombosis.
Possible Complications of Coronary Heart Disease
Coronary heart disease can lead to:
- Chest pain or angina occurs when coronary arteries narrow.
- Heart attack: Complete blockage of the heart artery may trigger a heart attack.
- Arrhythmia: Abnormal heart rhythm occurs when there is an inadequate blood supply to the heart.
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