Coronary Heart Disease - Symptom, Causes, Treatment of Coronary Heart Disease

Coronary Heart Disease is mainlt the blockage or narrowing of the coronary arteries that supply blood to the heart musde, with the result that the blood supplyto an or part of the heart musde is cut off or inadequate. Blockage is usually caused by a clot, or occasionally by foreign matter, obstructing the blood flow through an already nar royved artery, and leads to a heart attack. Coronary artery disease is atherosclerosis of the coronary arteries .

Coronary disease appears to be a lifelong process in some people, beginning at an early age and progressing slowly until the vessels become so clogged that the heart muscle no longer gets adequate nourishment. Most coronary artery narrowing is caused by atheroma (fatty deposits in the lining of arteries). Whenthe blood supply to the heart is reduced the condition is known as coronary insufficiency, which causes angina pectoris (severe chest pain) and may lead to heart failure.

The heart has 3 major coronary arteries.

• Two of these arteries arise from a common stem, called the left main coronary artery.
• The left main coronary artery supplies the left side of the heart.
• Its left anterior descending (LAD) branch supplies the front part of the heart.
• The left circumflex (LCX) branch supplies the left lateral and back side of the heart.
• Finally, the right coronary artery (RCA) is separate and supplies the right and the bottom parts of the heart.

Diagnosis of Coronary Heart Disease

The only certain way to diagnose and measure the extent of coronary heart disease is through the use of coronary angiography.  Since the extent of Coronary Heart Disease does not always match the duration and severity of chest discomfort, it is important for anyone who has chest pain to see a doctor. Once the diagnosis and extent of your Coronary Heart Disease is determined, your doctor can give you specific guidelines for managing chest pain. Your doctor can tell if you have coronary artery disease by:

• Talking to you about your symptoms, medical history and risk factors.
• Performing a physical exam.
• Performing diagnostic tests, including an electrocardiogram (ECG or EKG), exercise stress tests, electron beam (ultrafast) CT scans, cardiac catheterization and others.

Symptoms of Coronary Heart Disease

While the symptoms and signs of coronary heart disease are noted in the advanced state of disease, most individuals with coronary heart disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a "sudden" heart attack, finally arise. More common symptoms of coronary heart disease include the following. No one person usually has all of these symptoms.

• Chest pain on exertion (angina pectoris), which may be relieved by rest
• Shortness of breath on exertion
• Jaw pain, back pain, or arm pain, especially on left side, either during exertion or at rest
• Palpitations (a sensation of rapid or very strong heart beats in your chest)
• Dizziness, light-headedness, or fainting
• Weakness on exertion or at rest
• Irregular heartbeat

Causes of Coronary Heart Disease

The cause of coronary heart disease is related to multiple risk factors. The tendency to develop heart disease can be genetic. However, certain lifestyle factors such as diet, smoking, and stress make a big difference in whether or not a person will develop heart disease. The following are the most common:

• Heredity: Coronary heart disease runs in the family.
• High cholesterol: Levels of cholesterol in the blood are above healthy levels.
• Tobacco abuse: This includes not only smoking any form of tobacco (cigarettes, cigars, pipes), but also chewing tobacco.
• Obesity
• High blood pressure (hypertension)
• Diabetes
• Lack of regular exercise
• High-fat diet
• Emotional stress
• Type A personality (impatient, aggressive, competitive)

Treatment of Coronary Heart Disease

Surgical options include:

1. Coronary angioplasty. Often called balloon angioplasty or percutaneous transluminal coronary angioplasty (PTCA), this procedure involves placing a catheter in the diseased coronary artery. Once the catheter is in place, a tiny balloon is repeatedly inflated and deflated to stretch or break open the blocked area. By opening the affected coronary arteries, blood and oxygen flow to the heart muscle can be improved. Stents are usually left in the artery to help maintain potency.
   
2. Coronary artery bypass surgery. Often referred to as CABG, this major operation involves opening the chest wall and inserting a graft (usually taken from a vein in the leg) into the coronary artery that is blocked. By placing a graft in the diseased artery, blood can then bypass the obstruction. If more than one coronary artery is blocked, multiple grafts can be inserted.

Some Prevention Tips:

• Quit smoking.
• Maintain a normal blood pressure.
• Keep your cholesterol levels within normal range.
• Exercise regularly. Check with your doctor to see which type of exercise is best for you.
• Maintain as near normal body weight as possible.
• If you have diabetes, keep blood sugar as tightly controlled as possible.
• Reduce the amount of stress in your life.

Risk Factors of Coronary Heart Disease

Coronary heart disease has been a common reason for premature death among Australian men. Recently death rates from this cause have fallen because of advances in angioplasty, coronary artery bypass and measures to reduce blood fats. Vasodilator drugs (which dilate arteries) are used to treat angina pectoris, and high blood pressure and high blood fats can also be treated if necessary. High levels of blood fats, hypertension, diabetes mellitus, heavy cigarette smoking, stress andobesity increase the risk of coronary heart disease. Heredity is another factor.

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