Coronary Heart Disease : Causes , Symptoms , Diagnosis , Treatment : MDLifeIndia

Coronary Heart Disease

 Coronary heart disease (CHD), or coronary artery disease, develops when the coronary arteries become too narrow. The coronary arteries are the blood vessels that supply oxygen and blood to the heart. 

CHD tends to develop when cholesterol builds up on the artery walls, creating plaques. These plaques cause the arteries to narrow, reducing blood flow to the heart. A clot can sometimes obstruct the blood flow, causing serious health problems.



Coronary arteries form the network of blood vessels on the surface of the heart that feed it oxygen. If these arteries narrow, the heart may not receive enough oxygen rich blood, especially during physical activity.


Causes 

Causes Of Coronary Heart Disease







CHD develops as a result of injury or damage to the inner layer of a coronary artery. This damage causes fatty deposits of plaque to build up at the injury site.

These deposits consist of cholesterol and other waste products from cells. This buildup is called atherosclerosis.

If pieces of plaque break off or rupture, platelets will cluster in the area in an attempt to repair the blood vessel. This cluster can block the artery and reduce or block blood flow, which may lead to a heart attack.


Symptoms


CHD can lead to angina. This is a type of chest pain linked to heart disease.

Angina may cause the following feelings across the chest:

  • squeezing
  • pressure
  • heaviness
  • tightening
  • burning
  • aching

Angina might also cause the following symptoms:

  • indigestion
  • heartburn
  • weakness
  • sweating
  • nausea
  • cramping

CHD can also lead to shortness of breath. If the heart and other organs do not receive enough oxygen, any form of exertion can become very tiring, which may cause a person to pant for air.



Complications

Heart attack occurs when the heart muscle does not have enough blood or oxygen, such as when a blood clot develops from plaque in one of the coronary arteries.

The formation of a blood clot is called coronary thrombosis. This clot, if it is big enough, can stop the supply of blood to the heart.

Symptoms of a heart attack include:

  • chest discomfort
  • mild or crushing chest pain
  • coughing
  • dizziness
  • shortness of breath
  • a gray pallor in the face
  • general discomfort
  • panic
  • nausea and vomiting
  • restlessness
  • sweating
  • clammy skin

The first symptom is usually chest pain that spreads to the neck, jaw, ears, arms, and wrists, and possibly to the shoulder blades, back, or abdomen.

Changing position, resting, or lying down is unlikely to bring relief. The pain is often constant but may come and go. It can last from a few minutes to several hours.

A heart attack is a medical emergency that can result in death or permanent heart damage. If a person is showing symptoms of a heart attack, it is vital to call the emergency services immediately.


There is no cure for CHD. However, there are ways that a person can manage the condition.

Treatment tends to involve making healthful lifestyle changes, such as quitting smoking, adopting a healthful diet, and getting regular exercise.

However, some people may need to take medications or undergo medical procedures.


Medications that people can take to reduce the risk or impact of CHD include:

  • Beta-blockers: A doctor may prescribe beta-blockers to reduce blood pressure and heart rate, especially among people who have already had a heart attack.
  • Nitroglycerin patches, sprays, or tablets: These widen the arteries and reduce the heart’s demand for blood, as well as soothe chest pain.
  • Angiotensin-converting enzyme inhibitors: These bring down blood pressure and help slow or stop the progression of CHD.
  • Calcium channel blockers: These will widen the coronary arteries, improving blood flow to the heart and reducing hypertension.
  • Statins: These may have a positive impact on outcomes in CHD. One 2019 review found that although taking statins cannot reduce the overall risk of death from CHD, they can prevent development and reduce the risk of non-fatal heart attacks. However, they might not be effective for people with cholesterol disorders such as hyperlipidemia.

In the past, some people used aspirin to lower their risk of CHD, but current guidelines only recommend this for people with a high risk of heart attack, stroke, angina, or other cardiovascular events. This is because aspirin is a blood thinner, which increases a person’s risk of bleeding.

Doctors now recommend focusing on lifestyle strategies, such as adopting a healthful diet and getting regular moderate to intense exercise. These strategies can reduce the risk of atherosclerosis.


Surgery

The following surgical procedures can open or replace blocked arteries if they have become very narrow, or if symptoms are not responding to medications:

  • Laser surgery: This involves making several very small holes in the heart muscle. These encourage the formation of new blood vessels.
  • Coronary bypass surgery: A surgeon will use a blood vessel from another part of the body to create a graft that bypasses the blocked artery. The graft may come from the leg, for example, or an inner chest wall artery.
  • Angioplasty and stent placement: A surgeon will insert a catheter into the narrowed part of the artery and pass a deflated balloon through the catheter to the affected area. When they inflate the balloon, it compresses the fatty deposits against the artery walls. They may leave a stent, or mesh tube, in the artery to help keep it open.

On rare occasions, a person may need a heart transplant. However, this is only if the heart has severe damage and treatment is not working.

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