Coronary Heart Disease

Coronary Heart Disease – Causes, Symptoms, Diagnosis, Treatment, Prevention

Have you heard of coronary heart disease or ischemic heart disease? In fact, these two are both nicknames for coronary heart disease. Once you suffer from coronary heart disease, you may have symptoms of angina pectoris, difficulty breathing, or even sudden death in severe cases. You need special attention! This article will introduce you to the causes, symptoms, treatment and prevention of coronary heart disease.

What is coronary heart disease?

The coronary arteries are mainly responsible for supplying blood to the myocardium, allowing the heart to continue working without interruption. Mainly can be divided into the following 4 types:

Right coronary artery (RCA)
Left coronary artery (LCA)
Left circumflex artery (LCA)
Left anterior descending artery (LAD)

When the inner walls of arteries are damaged, cholesterol, calcium, and waste products produced by other cells accumulate, forming fatty plaques in the damaged areas of the arteries. This process is called atherosclerosis and is the main cause of coronary heart disease. If this arteriosclerosis continues, it will clog the blood vessels in the long term, causing the blood vessel walls to lose elasticity and thicken, and the tubes to narrow, making it difficult for blood to flow, causing the heart to be damaged or die due to lack of oxygen and other nutrients transported by the blood.

In addition to the threat of chronic arteriosclerosis, rupture of atherosclerotic plaques can trigger platelet aggregation, making the already very narrow blood vessels blocked by platelets and fat. This situation is very likely to cause stroke or even sudden death.

Human heart anatomy

Don’t ignore the 3 major symptoms of coronary heart disease!

The formation of coronary heart disease takes time to accumulate. At the beginning, you may not feel anything abnormal. You may feel out of breath more easily when exercising. However, as time goes by, when the fatty plaques gradually form and become larger, symptoms related to ischemic heart disease will appear, which may mainly fall into the following three categories:

  1. Angina pectoris:
    During an attack, you will feel tightness and pressure in your chest, as if someone is stepping on it, making you breathless. The symptoms usually end within a few minutes. Angina pectoris can be caused by psychological or physical stress, and women, especially, may experience pain in their neck, arms, or back.
  2. Difficulty breathing:
    If the heart cannot pump enough blood to supply the body with enough oxygen, breathing will become difficult and the body will increase the breathing rate in order to obtain more oxygen.
  3. Myocardial infarction:
    If the coronary arteries are completely blocked, it will lead to a heart attack, which is often called myocardial infarction. Common symptoms of heart palpitations include chest, shoulder and arm pain, difficulty breathing, and sweating, but women may experience less common symptoms such as jaw or neck pain, and some people may even have a myocardial infarction without any symptoms. So the painful, chest-clutching experience of a heart attack may not apply to everyone.

How is coronary heart disease diagnosed?

If you suspect that you have coronary heart disease and go to the hospital for examination, in addition to basic blood tests, the doctor may use the following 6 methods to confirm your heart activity:

  1. Electrocardiogram:
    detects cardiac electrical activity, speed and regularity.
  2. Cardiac ultrasound:
    Use ultrasound to observe heart activity, and at the same time, capture and record cardiac images.
  3. Coronary angiography:
    Commonly known as cardiac catheterization, a thin tube is inserted from the groin or arm, a contrast agent is injected into the blood vessels, and an X-ray instrument is used to observe the blood flow in the coronary arteries.
  4. Exercise stress test:
    Use exercise equipment such as a treadmill or stepper to observe the blood circulation and delivery when the heart is exercising.
  5. Coronary artery calcium scan:
    Uses a computed tomography (CT) scan to look at plaque buildup in the coronary arteries.
  6. Myocardial perfusion scan:
    Injecting radioactive isotopes such as thallium-201 (Tl-201) and TC-99 into the body can observe the flow of blood in blood vessels.
A state-of-the-art angiographic suite equipped with modern scanners, monitors and resuscitation equipment.

Who is susceptible to coronary heart disease? You should know about the 7 major groups prone to coronary heart disease

Iron deficiency heart disease is often caused by several factors at the same time, and the same factor may also be a contributing factor to other diseases or other types of heart disease. Obesity, for example, increases the risk of diabetes and various types of heart disease. The following is a brief list of 7 common groups that are prone to coronary heart disease.

  1. Men:
    Men are more likely to develop ischemic heart disease than women, but women who have gone through menopause have an increased risk due to a decrease in estrogen.
  2. Elderly people:
    The aging caused by aging not only affects the appearance, but also occurs on the coronary arteries, making them less tolerant to behaviors harmful to health. Therefore, older people should pay more attention to their physical condition.
  3. Family history:
    If a loved one has coronary heart disease, others in the family are more likely to have the disease than the average person.
  4. People with high cholesterol:
    High blood cholesterol levels will increase the risk of atherosclerosis, but not all cholesterol is bad. For example, low-density lipoprotein (LDL, commonly known as bad cholesterol) will increase the risk of atherosclerosis, but high-density lipoprotein High-Density Lipoprotein (HDL, commonly known as good cholesterol) actually helps prevent plaque accumulation.
  5. People with high blood pressure:
    High blood pressure can cause the walls of arteries to harden and thicken, leading to narrowing of the tubes.
  6. Diabetics:
    People with type 2 diabetes usually have obesity and high blood pressure, and these two factors also increase the chance of coronary heart disease.
  7. People with unhealthy diets:
    Frequent consumption of foods high in salt, sugar, saturated and trans fats will increase the risk of coronary heart disease.

Complications of coronary heart disease

When arteriosclerosis and blockage reach a certain level, in addition to symptoms such as angina pectoris and difficulty breathing, the following complications may also occur:

  1. Heart failure:
    Certain areas of the heart weaken due to a lack of blood, or the heart cannot pump enough blood throughout the body.
  2. Arrhythmia:
    Blocked blood flow to the heart affects the heart’s electrical activity, causing abnormal heart rate.
  3. Heart attack:
    The rupture of fatty plaque accumulated in the blood vessels will attract platelets, which can easily lead to complete blockage of the blood vessels and cause a heart attack (myocardial infarction).

2 major treatments for coronary heart disease

1.Drug treatment of coronary heart disease

Medications can help lower blood pressure, heart rate, blood fats or cholesterol, improve symptoms of coronary heart disease and reduce the chance of complications:

  • Statins:
    can lower bad cholesterol and blood lipids to reduce the incidence of heart disease and stroke.
  • Angiotensin Converting Enzyme Inhibitors (ACEI):
    The main function is to prevent the conversion of angiotensin I to angiotensin II to prevent an increase in blood pressure; the other function is to prevent angiotensin from catalyzing the slowing down of blood pressure. The hydrolysis of Bradykinin to promote vasodilation.
  • Nitrates:
    Mainly used to prevent myocardial infarction and reduce ventricular preload (Preload), which is the pressure on the ventricular muscles when the heart contracts, to achieve the purpose of enhancing coronary blood flow. In practical applications, nitroglycerin tablets, patches or sprays are used to relieve angina.
  • Calcium channel blockers (CCB):
    help relax vascular smooth muscles, dilate blood vessels, reduce myocardial contraction to lower blood pressure.
  • Beta-blockers (β-Blockers):
    Can reduce heart rate and blood pressure, reducing the heart’s demand for oxygen. If a patient has had a heart attack before, taking beta-blockers can help reduce the chance of another heart attack in the future.
  • Ranolazine:
    Like nitrate drugs and beta-blockers, it has the effect of relieving angina pectoris. If the patient cannot use beta-blockers, ranolazine can be used instead.

2.Surgical treatment of coronary heart disease

  1. Percutaneous coronary intervention (PCI):
    also known as balloon angioplasty, the doctor will insert a thin catheter into the narrowed part of the artery, and then send the balloon into the artery through the catheter , when the balloon is inflated, it can open the blood vessel wall and improve blood circulation. To prevent the artery from narrowing again after surgery, a stent is usually left in the artery to help open the wall.
  2. Coronary Artery Bypass Graft (CABG):
    By transplanting blood vessels elsewhere to bypass blocked coronary arteries and allow blood to circulate. Because this type of “open heart surgery” carries higher risks, this surgery will only be considered if the patient has multiple coronary artery stenoses.
Angioplasty and Stent Placement

Master 7 tips to prevent coronary heart disease

The best way to avoid the threat of coronary heart disease is to improve your lifestyle. Here are 7 ways to prevent coronary heart disease:

  1. Check your cholesterol:
    After reaching the age of 20, you should have your cholesterol checked at least every 5 years, and the LDL level of most people should be below 130mg/L or 3.4mmol/L. If you are at high risk for heart disease, your LDL level may need to be controlled below 100mg/L or 2.6mmol/L.
  2. Measure blood pressure:
    Track and control blood pressure. The average blood pressure should be lower than 120mmHg for systolic blood pressure and 80mmHg for diastolic blood pressure to avoid the harm of high blood pressure.
  3. Healthy diet:
    Adopt a low-oil, low-sugar, low-salt and high-fiber diet to reduce blood lipid accumulation and reduce the chance of obesity.
  4. Moderate exercise:
    Exercise for at least 30 minutes a day can lower blood pressure by an average of about 4 to 9 mmHg. It is recommended to choose aerobic exercise such as running, swimming or cycling.
  5. Avoid alcohol abuse:
    Excessive alcohol consumption can increase blood pressure and triglycerides. Triglycerides are a type of fat in the blood. Excessive levels of triglycerides may increase the risk of atherosclerosis.
  6. Quit smoking:
    Smoking can damage blood vessels and increase the risk of atherosclerosis; the nicotine in cigarettes can also increase blood pressure; the carbon monoxide emitted can reduce the oxygen-carrying capacity of the blood.
  7. Lose weight:
    Losing weight may be one of the most effective ways to lower blood pressure. For every 10 kilograms of weight lost, blood pressure will decrease by 5 to 20 mmHg. However, for the sake of health, it is not recommended to lose more than 1 kilogram per week.
Healthy food for heart care: overhead view of healthy food rich in Omega-3 and antioxidants and a blood pressure monitor, tape measure and stethoscope shot on wooden table. The composition includes a salmon fillet, sardines, avocado, extra virgin olive oil, brown lentils, celery, artichoke blueberries, celery, carrots, brown lentils, asparagus, artichoke, broccoli, flax seeds, chia seeds and some nuts like almonds, pistachio and pecan. High resolution 42Mp studio digital capture taken with SONY A7rII and Zeiss Batis 40mm F2.0 CF lens

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