PEDRO A.

IBIAS III

IV-TEMPERANCE

What Is Coronary Heart Disease?

Coronary heart disease (CHD), also called coronary artery disease, is a condition in which plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). The buildup of plaque occurs over many years

Types of Coronary Artery Disease

Acute Coronary Syndromes
Three types of heart attack occur because of sudden rupture of plaque inside the coronary artery. These depend on the location of blockage, amount of time blood flow is blocked, and damage that occurs. Emergency medical care is critical for these life-threatening conditions.

Advanced Ischemic Heart Disease

Patients with aggressive heart conditions are at risk for heart failure and arrhythmias. They may have already had at least one coronary artery bypass surgery, multiple stents or angioplasty procedures, or still suffer from chest pain even after receiving optimum treatment.

Bifurcation Blockage
Fatty build-up is more likely to occur in the Y-junction where vessels branch off from the main coronary artery because of changes in blood flow. Narrowing in this region is called bifurcation blockage, and it is treated using special techniques to prop up the vessel.

Heart Attack (Myocardial Infarction)

Myo means muscle and cardial refers to the heart. Infarction means death of tissue due to lack of blood supply. Heart attack is myocardial infarction, and it causes permanent damage to the heart muscle.

Microvessel Disease
This type of cardiovascular disease occurs when tiny blood vessels narrow when they should widen. This starves the heart muscle of oxygen and causes chest pain that can impact quality of life. This disease affects women and can be treated by medications to ease pain and lifestyle changes.

Stent Restenosis
When an artery or large blood vessel is treated with a stent to prop open the vessel and allow for healthy blood flow, it can collapse and require medical attention again. An experienced cardiac suggest interventional procedures that will remedy the situation.

Total Coronary Occlusion

A complete blockage in a coronary artery can lead to heart attack because of restricted blood flow to the heart muscle. When the blockage is more than three months old, it is called a chronic coronary occlusion.

CAUSES
Coronary artery disease typically begins when the inside walls of the coronary arteries are damaged because of another health problem, such as:

High cholesterol. High blood pressure. Diabetes. Smoking.

RISK FACTORS
Risk factors you may be able to change include:

Smoking. High blood pressure. High cholesterol. Diabetes. Obesity. Lack of exercise. Using birth control pills Using hormone therapy after menopause. This risk is higher for some women than others.

Risk factors that you can't change include:

Family history . You're more at risk if one or more of your close relatives have or had early CAD. Being male. Men generally develop heart disease 10 years earlier than women do. But women who have diabetes may develop heart disease at a younger age. By age 60, heart disease is one of the leading causes of death in both sexes. Age.

SIGN AND SYMPTOMS

The most common symptoms of coronary artery disease are:

Chest pain or discomfort, also called angina. Shortness of breath

Other symptoms include:

A fast heartbeat. Weakness dizziness nausea Increased sweating

DIAGNOSIS EXAMINATIONS

Electrocardiograph tests use the electrocardiogram to evaluate the electrical activity generated by the heart at rest and with activity. Nuclear imaging is a method of producing images by detecting radiation from different parts of the body after the administration of a radioactive tracer material. Ultrasound tests use ultrasound, or high frequency sound waves, to create graphic images of the heart's structures, pumping action and direction of blood flow. Radiographic tests use x-ray machines or very high-tech machines (CT, MRI) to create pictures of the internal structures of the chest. Invasive testing involves inserting catheters into the blood vessels of the heart to get a closer look at the coronary arteries, or to stimulate and test the electrical system of the heart. Laboratory tests include a number of blood tests used to diagnose and monitor treatment for heart disease. Procedures include procedures used to treat heart disease.

Medical Management
Thrombolytic Therapy A type of medicine given in the hospital through the veins (intravenous) to break up blood clots. Heart attack (caused by a blood clot in a coronary artery) and ischemic stroke (caused by a blood clot in an artery in the brain) are the two main conditions for which thrombolytic medications may be prescribed. Statin Therapy A first line treatment to lower high cholesterol in patients with or at risk for coronary artery disease, statins also provide additional benefits to the blood vessels that result in a decrease incidence in cardiovascular events. Aspirin Therapy in Heart Disease Small doses (80 to 160 mg/day) of this common drug are prescribed for some people to prevent blood clots, decrease pain, and reduce risk of heart attack and stroke. Risks are stomach ulcers, gastrointestinal bleeding, or bleeding in the brain during stroke. A doctor can make appropriate recommendations.

SURGICAL MANAGEMENT
Arterial Coronary Artery Bypass Grafts Coronary artery bypass surgery involves using grafts from the patients own veins and arteries to form new passageways around blockages. Thoracic arteries in the chest wall are the best grafts, though surgeons continue exploration and perform using veins from the leg, stomach and forearm. Bypass Surgery This procedure can restore normal blood flow to the heart by creating new pathways around blocked arteries, potentially using grafts from the patients own arteries and veins. An opening is made below the blockage. The graft is sewn into the opening to redirect blood flow to the heart.

PREVENTION AND CONTROL

Stop smoking. Smoking is the biggest risk factor for sudden cardiac death. Smoking even one to two cigarettes a day greatly increases the risk of heart attack, stroke, and other cardiovascular conditions or events. Cigarette, pipe, and cigar smokers all have more than double the risk of a heart attack than nonsmokers. Speak to your doctor about tools and programs to help you with smoking cessation. Lower your blood level of total cholesterol, LDL cholesterol, and triglycerides. Fatty substances in your blood such as LDL cholesterol and triglycerides cause fatty deposits to build up in your arteries. The deposits can reduce or block the flow of blood and oxygen to your heart. If your total cholesterol levels are above 240 milligrams per deciliter (mg/dL), your risk of CAD is high, but your risk begins rising when your total cholesterol is above 200 mg/dL. Without a family history of cardiovascular disease or high cholesterol, women should have a cholesterol profile done annually starting at age 40, men at age 30. If there is a family history of cardiovascular disease or hyperlipidemias, you should have your lipid profile checked at age 20 or even in childhood. Raise your level of HDL or "good" cholesterol. HDL cholesterol carries LDL, or "bad," cholesterol away from the arteries back to the liver, which removes it from the bloodstream. High levels of HDL apparently protect against cardiovascular disease.

Bring down high blood pressure. Blood pressure is an indication of the force applied in your arteries as your heart beats. High blood pressure (or hypertension) increases the workload of the heart and kidneys, increasing your risk of a heart attack, heart failure, stroke, and kidney disease. It is the biggest risk factor for stroke. Control diabetes. Controlling diabetes is essential for reducing your risk of CAD, because diabetes is a major independent risk factor for cardiovascular disease and raises the level of LDL and triglycerides, lowers HDL, and elevates blood pressure. In fact, in terms of heart attack risk, someone with diabetes, whether male or female, is put in the same category as someone with proven heart disease and is a candidate for secondary prevention. Diabetes increases the risk of heart disease in women more than in men. Maintain a healthy body weight. The more you weigh, the harder your heart has to work. Overweight individuals are much more subject to cardiovascular disease than are their trim counterparts. Excess weight raises blood cholesterol, triglycerides, and blood pressure, and lowers HDL cholesterol. It also increases your risk of diabetes. How excess weight is distributed is important. Fat concentrated in your midsection puts you at greater cardiovascular risk than extra pounds in the arms and legs. To identify the way your fat is distributed, measure your waist. Waist measurements for women should be less than 35 inches. Men should aim for a waist less than 40 inches. Move your body. Your heart, like any other muscle, needs a workout to stay strong. Activity and exercise, coupled with a healthy body weight, interact with many other risk factors and help you prevent heart disease. Follow a heart-healthy diet. The old saying, "You are what you eat," is true especially when you want to prevent cardiovascular disease. Four cardiac risk factors result from dietary mismanagement: high blood pressure, high blood cholesterol, diabetes, and obesity. Reduce stress. Several researchers have noted a relationship between cardiovascular disease risk and stressful responses, including free-floating hostility, to everyday events, intimate relationships, and particularly to their socioeconomic status. Limit alcohol consumption. Heavy drinking can raise your blood pressure, increase your risk of heart failure and stroke, as well as cause heart palpitations. It is also linked to obesity and cancer.