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Coronary heart disease (C.H.D), also known as Coronary Artery Disease, is a disorder that occurs when a person's coronary arteries become restricted due to the continuous buildup of fats and cholesterol material within the artery walls. The purpose of the human arteries is to send oxygen-rich blood to the heart muscle. The arteries, which should be elastic and smooth, tend to develop plaque, which is a waxy substance that builds up on the inner lining of the walls, narrowing and stiffening them. The result observed is the difficulties in restriction of blood flow to the heart that will make the heart to receive less oxygen thus starved. The result can lead to angina, a fatal heart attack, or even sudden cardiac death.
Angina is the discomfort that feels like pressure or squeezing due to the pain in the chest. One may also feel the pain in upper back, shoulders, arms, neck regions, jaw or even the entire back. The heart attack will mainly occur when the oxygen-rich blood flow is stopped or cut off from flowing into a section of the heart. This section of the heart will die due to insufficient oxygen-rich blood. Without a quick diagnostic and treatment, this will lead to complicated health problems such as heart failure, which is a condition in which the heart cannot pump enough blood to meet the requirements of the body and even death. The coronary artery disease can start from a young age, and as one grows, the plaque builds up raising the risks of heart attacks and blood clots. The coronary heart disease affects women and statistics show that 1 in 4 women die from the heart disease. Statistics also indicates that it is seen on older women but affects men more commonly than the pre-menopause women but men older than 45 years and females older than 55 years are at greater risks.
The heart disease is the result of the narrowing of or blockage of the heart's coronary arteries or their walls by plaque formed by excess fat or cholesterol by a process known as atherosclerosis. The risk factors that are related to the disease are classified as either controlled or uncontrolled.
Controlled factors can be easily controlled and depend on a person's lifestyle. They include; high blood fat or cholesterol, a condition known as hyperlipidemia in which the blood of an individual becomes rich in cholesterol the condition can be due to physically being inactive, poor diets and eating habits and also obesity which are all controlled factors. Smoking also can cause coronary artery and can be controlled.
Non-controlled factors may be hard to control and include; age that is the disease is mainly seen at a certain age with men more prone to it falling between 45 and above years while female at age 55 and above. The second factor is family history which may include some adverse childhood experiences such as psychological, physical or sexual abuse, violence against a mother or the experience of living with someone who was a drug and substance user. It may also have been that the family member suffered from the diseases such as diabetes and hypertension that may be seen in the subsequent generations. Ethnicity and medical history also become hard to control.
The most common symptom of the Coronary Heart Disease is the Angina. This is the pain in the chest region or discomfort which is due to part of the heart muscle not receiving enough oxygen-rich blood. Emotional stress can also cause it. There might be shortness of breath due to heart failure as the heart cannot pump enough blood which meets the needs of the body. It may also occur before or with chest discomfort. Others include fatigue, amnesia, nausea, vomiting, fainting, and arrhythmia which is a problem due to the heartbeat. The heart may beat too fast or even skip beats. There might also be a heart attack or heart failure due to cutting off of oxygen-rich blood from flowing to a section of heart muscle. When these signs are manifested or if a person has the disease, an assessment of the symptoms and the risk factors leads to additional diagnostics which may include;
Conducting blood tests to check levels of the blood cells, electrolytes in the blood, clotting factors and blood hormones is a necessary diagnostic tool. There are some specific enzymes and proteins, which tend to indicate problems with the heart. Hence this will give more information concerning the Coronary Heart Disease.
Electrocardiography is also a viable method in which electrical activity of the heart can be measured. A Resting Electrocardiogram shows the heart's electrical activity at rest hence will indicate the changes in the heart muscle at the times when the heart is not receiving enough oxygen. Electrodes are placed either on the legs, arms or the chest then electrical activities of the heart are recorded.
Exercise Tolerance Test is designed to assess the responses of the heart in response to physical activities and stress. ETT involves either walking on an exercise treadmill or riding an exercise bicycle up to a period of 12 minutes at different speeds. The blood pressure and the electrocardiogram ECG recorded then the symptoms of coronary artery recorded. Symptoms such as pain at the chest and shortness of breath, blood pressure recordings and any other symptoms will be observed by a physician or an ECG expert to indicate presence or absence of Coronary heart disease.
Echocardiography technique involves the administration into the blood stream certain medications via a drip in the hand or arm at the time echocardiogram is performed. The administered drugs will stimulate the heart and imitate the effects of the exercise and is mainly applied to people who are unable to carry out activities due to some medical reasons.
Also, an angiogram which is a medical formula or practice that involves the insertion of a small flexible tube known as a catheter into an artery at the groin or in the wrist, tied with a thread in the aorta through the artery positioned at the entrance of the coronary artery acts as an additional diagnostic tool. An x-ray dies that has iodine is then injected into the coronary artery through the catheter and then observed on the screen. This different dye will tend to produce any narrowing outline or blockage in the arteries. The function of the heart can also be found during this period.
CT Angiography is an electronic X-ray technology that uses images to create a 3D picture of the heart. A person lies on an X-ray table, and a contrast dye injected into a vein in the arm. The dies spread into the arteries then to the heart and its chambers hence enabling them to be seen on the x-ray 3D pictures which can indicate fat deposits, the narrowing of the arteries. The information gathered may also include how the heart and the heart valves function. It is a fast process that tends to give maximum information within a short span of time. Furthermore, Nuclear Isotope Imaging, a process involving the injection of an active radioactive element called tracer into a patient's bloodstream, and computer generated pictures being taken as the tracer moves through into the heart is another option.
The treatment of Coronary Artery will depend on the test results and is aimed at either eliminating or reducing the symptoms and lessen the risk of having a heart attack. The treatments may include;
Medication can be grouped as; beta blockers, which slow the heart rate and reduce blood pressure hence reducing the workload. Nitrates widen the blood arteries making the blood rich in oxygen very easy to be pumped through. The ACE inhibitors prevent contraction of the heart arteries and the blood vessels hence reducing pressure in which the heart must pump. Lastly, calcium channel blockers which slow down the entry of calcium into the blood, the blood vessels, the walls of the vessels and the heart. This lowers the pressure and reduces the workload of the heart.
Coronary arteries bypass surgery which involves the use of blood vessel from elsewhere in the body to restore the rate of blood flow beyond the area of the artery narrowed is another treatment option. It includes the process of grafting one end of the blocked coronary artery that falls below the narrowing end and the other end to the blood vessel, aorta hence to bypass the blockage. The arteries from the forearm, the leg veins and most probably chest wall arteries can be used in the grafting of vessels.
Coronary Artery Angioplasty and Stent, a non-surgical method applied to widen the narrowed coronary artery. This procedure is similar to the angiogram that involves the insertion of a balloon-tipped catheter into a narrowed coronary artery. Once the balloon is inserted, it is then inflated so as to compress the plaque and to increase or stretch the wall of the artery. The arterial diameter is increased so as to increase the blood flow in the heart and the chambers.
Some steps that can be used either to prevent or to reduce the risks of developing the Coronary heart disease may include; lifestyle and dietary change such as eating a healthy and a well-balanced diet and maintaining a healthy blood fat or cholesterol levels. One needs to watch what they eat and also to have lots of physical exercises. There should also be limiting the use of alcohol and drug intake such as avoiding smoking at all costs. Prevention also entails practicing regular physical exercises in the most days of the week. This is mainly done to maintain a healthy body and reduce cholesterol in the body. Maintaining a healthy body weight is also important and goes hand in hand with diet and exercise. A person also needs to be self-aware on the risk factor and being educated in minimization of the risk factors. Lastly, treating the medical conditions such as diabetes and high blood pressure diseases and decreasing the psychosocial stress that may occur.
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