✔ Cardiovascular diseases coronary heart disease
Отзывы Cardiovascular diseases coronary heart disease
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Cardiovascular diseases: coronary heart disease
Coronary heart disease (CHD), also called coronary artery disease referred to, is one of the most important cardiovascular diseases and is one of the leading causes of death. It is caused by a narrowing or occlusion of the coronary arteries, the heart muscle tissue supply with oxygen-rich blood.
Pathophysiology
The Central pathophysiological mechanism of coronary atherosclerosis is a chronic inflammation of the inner vessel wall with subsequent deposition of lipids, in particular LDL‑cholesterol. This leads to the formation of atherosclerosis‑Placken (Plaques), which narrow the Lumen of the coronary vessels. The narrowing reduces the flow of blood to the heart muscle (myocardium), which leads, in particular, in the case of physical or emotional stress to an oxygen supply (ischemia).
In severe cases, a complete closure of a coronary artery can occur as a result of thrombus formation, which leads to acute myocardial infarction.
Risk factors
A number of modifiable and non-modifiable risk factors conducive to the development of CHD:
Non-modifiable factors:
Age (the risk increases with age)
Gender (men are at the age of 65. The age of affected more)
Family history (genetic predisposition)
Modifiable Factors:
Hypertension (increased blood pressure)
Hyperlipidemia (elevated blood fats, in particular, LDL)
Diabetes mellitus
Smoking
Overweight and obesity
Lack of exercise
Stress and psychosocial factors
Clinical Symptoms
The typical symptoms of CHD are:
Angina pectoris: a tight, aching, or burning pain behind the breastbone, which broadcasts often to the left Arm, the shoulder, the neck or the jaw. It typically occurs with exercise, and from the sounds alone.
Shortness Of Breath (Dyspnea)
Fatigue and impaired performance
In atypical cases, Nausea, sweating, or upper abdominal discomfort may be experienced, especially in women and patients with Diabetes.
Diagnostics
The diagnosis of CHD is made by a combination of different methods:
History and physical examination
Laboratory tests (lipid spectrum of blood sugar, inflammatory markers)
Electrocardiogram (ECG) at rest and under stress (exercise ECG)
Echocardiography (ultrasound of the heart)
Nuclear Medicine Procedures (Myocardial Scintigraphy)
Coronary angiography (cardiac catheterization) narrowing as the gold standard for the direct visualization of the vessel
Therapy
The concept of therapy of CHD includes both non-pharmacological as well as pharmacological and interventional measures:
Lifestyle changes:
Smoking abstinence
a healthy diet (e.g., Mediterranean diet)
regular physical activity
Weight reduction in Overweight
Blood pressure and blood sugar control
Drug Therapy:
Anticoagulants (for example, acetylsalicylic acid)
Beta-blockers
ACE inhibitors or AT1 receptor blockers
Lipid-Lowering Drugs (Statins)
Nitrates for pain relief in Angina pectoris
Interventional and surgical procedures:
Percutaneous coronary Intervention (PCI) with stent implantation
Aortocoronary Bypass surgery (CABG) in the case of extensive vascular changes
Forecast and prevention
The prognosis of CHD depends on the expression of the vascular changes, the Presence of risk factors and treatment adherence. Early diagnosis and consistent treatment can slow the progression of the disease and the risk for heart attacks and sudden cardiac death is significantly lower.
Primary prevention-that is, the influence of risk factors even before the onset of the disease, and secondary prevention after myocardial infarction are Central elements in the fight against coronary heart disease.
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