Coronary heart disease
By: Dr.Weka Gunawan, MPH
We heard about
heart attack almost every day. We found out that the disease is very common in
our community. Is there any help can reduce the attack? What should to do to
minimize the risk? As family health specialist, I write you about the heart disease
from some sources. I wish this article can give you all some useful information.
Insya ALLAH.
The Definition of Coronary artery disease;
Arteriosclerotic heart disease; CHD; CAD
Coronary heart disease
(CHD) is a narrowing of the small blood vessels that supply blood which is
contains oxygen to the heart. CHD is also called coronary artery disease.
The Causes,
incidence, and risk factors
Coronary heart disease
(CHD) is the leading cause of death in developed countries for men and women.
Coronary heart disease is
caused by the clogs in the arteries to your heart.
- Fatty material and other substances form a
clog on the walls of your coronary arteries. The coronary arteries bring
blood and oxygen to your heart.
- This build up causes the arteries to get
narrow.
- As a result, blood flow to the heart can slow
down or stop at all.
A risk factor for heart
disease is something that increases your chance of getting it. You cannot
change some risk factors for heart disease, but others you can change.
The risk factors for heart disease that you CANNOT change are:
- Your age. The risk of heart disease increases
with age.
- Your gender. Men have a higher risk of getting
heart disease than women who are still getting their menstrual period.
After menopause, the risk for women is closer to the risk for men.
- Your genes. If your parents or other close
relatives had heart disease, you are at higher risk.
- Your race. African Americans, Mexican
Americans, American Indians, Hawaiians, and some Asian Americans also have
a higher risk for heart problems.
Many things increase your risk for heart disease/ Predisposing factors:
- Diabetes is a strong risk
factor for heart disease.
- High blood pressure
increases your risks of heart disease and heart failure.
- Extra cholesterol in your blood builds up
inside the walls of your heart's arteries (blood vessels).
- Smokers
have a much higher risk of heart disease.
- Chronic kidney disease can increase your risk.
- People with narrowed arteries in another part
of the body (examples are stroke and poor blood
flow to the legs) are more likely to have heart disease.
- Substance abuse (such as cocaine)
- Being overweight
- Not getting enough exercise, and feeling
depressed or having excess stress are other risk factors.
Symptoms
Symptoms may be very
noticeable, but sometimes you can have the disease and not have any symptoms.
Chest pain or discomfort (angina) is the most common
symptom. You feel this pain when the heart is not getting enough blood or
oxygen. How bad the pain is varies from person to person.
- It may feel heavy or like someone is squeezing
your heart. You feel it under your breast bone (sternum), but also in your
neck, arms, stomach, or upper back.
- The pain usually occurs with activity or
emotion, and goes away with rest or a medicine called nitroglycerin.
- Other symptoms include shortness of breath and
fatigue with activity (exertion).
Women, elderly people, and
people with diabetes are more likely to have symptoms other than chest pain,
such as:
- Fatigue
- Shortness of breath
- Weakness
Signs and
tests
Many tests help diagnose
CHD. Usually, your doctor will order more than one test before making a diagnosis.
Tests may include:
- Coronary
angiography/arteriography -- an invasive test that evaluates
the heart arteries under x-ray
- CT angiography -- a noninvasive way to perform
coronary angiography
- Echocardiogram
- Electrocardiogram (ECG)
- Electron-beam computed tomography (EBCT) to look
for calcium in the lining of the arteries -- the more calcium, the higher
your chance for CHD
- Exercise stress test
- Heart CT scan
- Magnetic resonance angiography
- Nuclear stress test
Treatment
You may be asked to take
one or more medicines to treat blood pressure, diabetes, or high cholesterol
levels. Follow your doctor's directions closely to help prevent coronary artery
disease from getting worse.
Goals for treating these
conditions in people who have coronary artery disease:
- Blood pressure less than or equal to 140/90
(even lower for some patients with diabetes, kidney disease, or heart
failure)
- Glycosylated hemoglobin (HbA1c) levels less
than or equal to 7% for people with diabetes
- LDL cholesterol level less than or equal to
100 mg/dL (even lower for some patients)
Treatment depends on your
symptoms and how severe the disease is. Your doctor may give you one or more medicines
to treat CHD, including:
- ACE inhibitors to lower blood pressure and
protect your heart and kidneys
- Aspirin, with or without clopidogrel (Plavix)
or prasugrel (Effient) to help prevent blood clots from forming in your
arteries
- Beta-blockers to lower heart rate, blood
pressure, and oxygen use by the heart
- Calcium channel blockers to relax arteries,
lower blood pressure, and reduce strain on the heart
- Diuretics ("water pills") to lower
blood pressure and treat heart failure
- Nitrates (such as nitroglycerin) to stop chest
pain and improve blood flow to the heart
- Statins to lower cholesterol
NEVER
ABRUPTLY STOP TAKING ANY OF THESE DRUGS. Always talk to your doctor first. Stopping these drugs suddenly can
make your angina worse or cause a heart attack.
Your doctor may refer you
to a cardiac rehabilitation program to help improve your heart's fitness.
Procedures and surgeries used to treat CHD include:
- Angioplasty and stent placement, called percutaneous
coronary interventions (PCIs)
- Coronary artery bypass surgery
- Minimally invasive heart surgery
LIVE A HEALTHY LIFESTYLE
Some of the risks for heart
disease that you CAN change are:
- Do not smoke or use tobacco.
- Get plenty of exercises, at least 30 minutes a
day on at least 5 days a week (talk to your doctor first).
- Maintain a healthy weight. Men and women
should aim for a body mass index (BMI) between 18.5 and 24.9.
- Get checked and treated for depression.
- Women who are at high risk for heart disease
should take omega-3 fatty acid supplements.
- If you drink alcohol, limit yourself to no
more than one drink per day for women, and no more than two drinks per day
for men.
Nutrition is important to your heart health, and it will help control some of your heart disease
risk factors.
- Choose a diet rich in fruits, vegetables, and
whole grains.
- Choose lean proteins, such as chicken, fish,
beans, and legumes.
- Eat low-fat dairy products, such as 1% milk
and low-fat yogurt.
- Avoid sodium (salt) and fats found in fried
foods, processed foods, and baked goods.
- Eat fewer animal products that contain cheese,
cream, or eggs.
- Read labels, and stay away from
"saturated fat" and anything that contains
"partially-hydrogenated" or "hydrogenated" fats. These
products are usually loaded with unhealthy fats.
Expectations/Prognosis
the Disease
Everyone recovers
differently. Some people can maintain a healthy life by changing their diet,
stopping smoking, and taking medications exactly as the doctor prescribes.
Others may need medical procedures such as angioplasty or surgery.
Although everyone is
different, early detection of CHD generally results in a better outcome.
Calling your
health care provider
If you have any risk
factors for CHD, contact your doctor to discuss prevention and possible
treatment.
Immediately contact your
health care provider or go to the emergency room if you have:
- Angina or chest pain
- Shortness of breath
- Symptoms of a heart attack
Thankyou for reading this article. You can leave some comments below to enrich the article. Thankyou. (Dr.Weka)
