Coronary Heart Disease

Coronary Heart Disease or Coronary Artery Disease is one of the leading causes of death in this world. And yet it is very much a preventable disease. Proper diet and exercise and a good lifestyle can help in keeping this problem away. Here is some info on why people are affected by this problem, ways to prevent it and the treatment.

What is Coronary Heart Disease?

The heart muscle, like any other, needs a continuous supply of oxygen and nutrients. These are supplied by the coronary arteries. If these arteries become narrow and clogged, then they cannot supply enough blood to the heart. This results in Coronary Heart Disease (CHD). The heart responds to the lack of oxygen, with a pain called angina, which is felt in the chest or in the left arm and shoulder. When there are no symptoms, the condition is called silent angina. When blood supply is completely cut off, the result is a heart attack. The affected portion of the heart muscle may be permanently damaged. A heart attack could result in death. In fact about one-third of the patients with heart attack die before they get to the hospital.

What are the causes of Coronary Heart Disease?

The main cause of Coronary Heart Disease is the blockage of the arteries by cholesterol. This is known as atherosclerosis. A high level of Cholesterol in the blood can make the situation worse. This process starts during the teens and progresses depending upon one’s diet and lifestyle. Family history of heart attack, increased blood cholesterol levels, hypertension, stress, obesity, diabetes, lack of exercise and smoking are all risk factors that promote coronary heart disease.

What are the symptoms of Coronary Heart Disease?

Angina or chest pain and shortness of breath are the early signs of CHD. A person suffering from CHD may feel a sense of tightness and pain in the chest, usually behind the sternum (breast bone), but sometimes even in the arm or the neck.  Some people, especially elders and those suffering from diabetes, may not experience any of these symptoms and yet have a heart attack.

How will the doctor diagnose a case of Coronary Heart Disease?

The medical history, symptoms and physical examination will lead a doctor to the diagnosis. But there are a few tests done to confirm the diagnosis. First is the ECG or EKG (Electrocardiogram), which will show abnormal heartbeats, any areas of the heart that have been damaged, inadequate blood flow and any heart enlargement. A stress test (also called a treadmill test or exercise ECG) is used to record heartbeats during exercise. This is done because some heart problems show up only when the heart is working hard. An ECG is taken before, during, and after exercising on the treadmill. Breathing rate and blood pressure are also measured. Such stress tests may not be completely reliable. Sometimes they may show a problem where none exists or may not show anything even when there is a problem.

What is the treatment for Coronary Heart Disease?

The treatment for CHD depends on the severity of the problem. While some people may benefit by Lifestyle changes and drugs, others with a more severe form of CHD may need surgery. Lifestyle changes include change in the diet, restriction of saturated fats, regulated and monitored exercise, quitting the habit of smoking, reducing obesity and controlling hypertension and stress. Exercise should be restricted if there is a more severe form of CHD. But some form of minimal exercise will definitely benefit those with CHD. Medications that are used to treat this problem, work by decreasing the workload on the heart (beta-blockers), relaxing the arteries (nitrates and calcium channel blockers), reducing the tendency to form clots (aspirin or anticoagulant drugs), lowering cholesterol and improving the pumping action of the heart (digitalis or ACE inhibitors). High Blood pressure and fluid retention if present, are also treated. There are many Surgical procedures used to treat CHD. These are adopted if the patient does not respond well to treatment with lifestyle changes and drugs, or if the coronary arteries are blocked very badly.

Coronary Artery Bypass Surgery is done to reroute the blood around clogged arteries (bypass the clogged arteries) and improve the supply of blood and oxygen to the heart. This is done by taking a blood vessel from another part of the body and constructing a detour around the blocked part of the coronary artery. An artery may be detached from the chest wall and the open end attached to the coronary artery below the blocked area. A piece from a long vein in the leg may be removed and one end sewn onto the aorta. The other end of the vein is attached or "grafted" to the coronary artery below the blocked area. Bypass surgery can relieve the symptoms of heart disease but cannot cure it. Lifestyle changes like restriction of cholesterol in the diet and not smoking are very important. Coronary angioplasty or balloon angioplasty begins with a procedure similar to angiography. However, the catheter positioned in the narrowed coronary artery has a tiny balloon at its tip. The balloon is inflated and deflated to stretch or break open the narrowing and improve the passage for the blood to flow. The balloon-tipped catheter is then removed. Strictly speaking, angioplasty is not a surgery. It is done while the patient is awake and may last 1 to 2 hours. If angioplasty does not widen the artery or if complications occur, bypass surgery may be needed. Atherectomy is a procedure in which surgeons shave off thin strips of the plaque blocking the artery and remove these strips. Laser angioplasty - In this procedure, instead of using a balloon to open up the blocked artery, surgeons insert a catheter with a laser tip that burns or breaks down the plaque. A metal coil called a stent could be permanently implanted in a narrowed part of an artery. Coronary Heart disease is mostly a preventable disease. Adopting a good lifestyle with proper diet, exercise and avoiding some habits such as smoking can go a long way in preventing CHD This in turn can prevent complications such as cardiac arrest, stroke and arrythmias (irregular beating of the heart).