Description of coronary heart disease
The coronary arteries carry oxygen-rich blood to the heart muscle. Coronary artery disease (CHD) It leads to blockage of the arteries. If the lock It is complete, may be damaged portions of the heart muscle. In severe cases, the heart muscle dies. This can lead to a heart attack, также известному как инфаркт миокарда (THEIR).
Coronary heart disease is the most common form of heart disease. It is the leading cause of death worldwide.
Causes of ischemic heart disease
Causes include:
- Thickening of the walls of the arteries, supplying the heart muscle;
- Accumulation of fatty plaques in the coronary arteries;
- A sudden spasm of the coronary arteries;
- Narrowing of the coronary arteries;
- The inflammation in the coronary arteries;
- The development of blood clots in the coronary arteries, that blocks blood flow.
Risk factors for coronary heart disease
Factors, which increase the risk of coronary heart disease:
- Paul: male (Men have a higher risk of heart attack, than women);
- Age: 45 and older men, 55 years and older women;
- Heredity: family history of heart disease;
- Obesity and overweight;
- Smoking;
- High blood pressure;
- A sedentary lifestyle can also increase the risk of coronary heart disease and premature death;
- High cholesterol (in particular, High LDL cholesterol, and low levels of HDL cholesterol);
- Diabetes;
- Metabolic syndrome (the combination of high blood pressure, obesity and insulin resistance).
Other risk factors include:
- Stress;
- Excessive alcohol consumption;
- Depression;
- A diet high in saturated fat, trans fats, cholesterol and / or high-calorie foods. Constant consumption of carbonated sugary drinks can increase the risk of coronary heart disease.
Ишемическая болезнь сердца – симптомы
Most coronary artery disease may progress without any symptoms.
Стенокардия – иногда появляющаяся боль в грудной клетке – один из первых признаков ИБС. Pain in the shoulder can give (and), hand (and), or jaw. Angina usually lasts for about 2-10 minutes. She often goes away after a short rest. Angina may cause:
- Physical activity or strenuous activity;
- Emotional stress;
- Cold weather;
- Large meal.
Chest pain may indicate a serious unstable angina or a heart attack symptoms, if there:
- Pain, that does not go after a rest or nitroglycerin;
- Severe angina;
- Angina, which begins at rest (No Activity);
- Angina, that lasts more than 15 minutes.
Accompanying symptoms may include:
- Breathlessness;
- Sweating;
- Nausea;
- Weakness.
In unstable angina needs immediate medical care. CAD in women may develop without chest pain, and only cause shortness of breath and fatigue.
Diagnosis of coronary heart disease
If you go to the emergency room with chest pain, Some tests will be done at once. They will determine the presence of angina or a heart attack. If there is a stable angina, They can be assigned to other tests, to determine the severity of the disease.
The doctor will ask about your symptoms and medical history. Examine physically.
Tests may include:
- Blood tests, to find specific substance in the blood (troponynы), that help the doctor determine whether a heart attack;
- Электрокардиограмма – записывает деятельность сердца путем измерения электрического тока через сердечную мышцу, and can detect the presence of past heart attacks, acute heart attacks, as well as problems of heart rate;
- Эхокардиограмма – использует высокочастотные звуковые волны (ultrasound), to examine the size, the shape and motion of the heart, It gives information about the structure and function of the heart;
- Стресс-тест – запись электрической активности сердца при повышенной физической активности;
- Ядерный стресс-тест – сердце наблюдается при введении радиоактивных материалов в кровоток, that helps to find problem areas;
- Коронарная оценка кальция – тип рентгеновской томографии, which uses computer, to find the calcium deposits in the arteries of the heart;
- Коронарная ангиография – проводится рентген сосудов после введения контрастного красителя в артерии. It allows the doctor to find abnormalities in the arteries.
Treatment of coronary heart disease
Treatment may include:
Nitroglycerin
This drug is usually taken during an attack of angina pectoris. It may be provided in the form of capsules, which dissolve under the tongue or as a spray. Dosage forms with prolonged action type (tablets, patch or ointment) They may be used, to prevent angina before vigorous activity.
Blood-thinning drugs
A small daily dose of aspirin, It has been shown, reduces the risk of heart attack. Talk to your doctor, before taking aspirin daily.
Other blood-thinning medicines include:
- Warfarin;
- Ticlopidine;
- Clopidogrel;
- Prasugrel.
Beta Blockers, calcium channel blockers and ACE inhibitors
Supplementation may help prevent angina. In some cases, they may reduce the risk of heart attack.
Drugs to lower cholesterol
Drugs, such as statins, often prescribed to people, that patients with CHD. Statynы (eg, atorvastatin) lower cholesterol, that can help prevent coronary heart disease attack.
Revaskulyarizatsiya
Patients with severe blockages in the coronary arteries is recommended to undergo the procedure, which will quickly improve the blood flow to the heart muscle:
- Percutaneous coronary intervention (CHKV), eg, ballonnaя angioplasty. В некоторых случаях устанавливается стент, to keep the artery open;
- Coronary artery bypass grafting (AKS) – сегменты сосудов отбираются из других областей тела и вшиваются в артерии сердца, to redirect blood flow around clogged arteries.
Some studies have shown, that CABG may be more effective, than PCI. Lifestyle changes and intensive care may also be just as effective, as a PCI.
Options for treatment of refractory angina
Patient, who underwent revascularization, but after a while angina reappeared, despite medication, There are the following options for treatment:
- Enhanced external counterpulsation (UNCP) – подушки с воздухом надуваются вокруг ног в такт с сердечными сокращениями. The patient receives 5 hour treatments per week for seven weeks. As shown, procedure reduces the symptoms of angina;
- Transmyocardial revascularization (TMR) – оперативное вмешательство с помощью лазера позволяет уменьшить боли в груди.
Researchers are also studying the possibility of gene therapy as a possible treatment option CHD.
Prevention of coronary heart disease
To reduce the risk of coronary artery disease:
- Maintain a healthy weight;
- Eat foods low in saturated fat, red meat and meat products, as well as increase the number of products in the diet of whole grains, fruits and vegetables;
- Do the exercises in accordance with the doctor's recommendations;
- Quit smoking;
- Treat high blood pressure and / or diabetes;
- Take drugs to lower cholesterol or triglycerides;
- Ask your doctor about receiving low-dose aspirin every day;
- For some patients, it is recommended to take rosuvastatin. We need to ask your doctor about it.