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Coronary Heart Disease Elucidated

Updated on June 25, 2018
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Introduction

The heart is one of the most vital organs found in the human body. The myocardium muscles (heart muscles) pump oxygenated blood to other body organs. They do this by rhythmically expanding and contracting resulting in blood circulation around the body.

The capability of the myocardium muscles to work interminably is one of the most profound mysteries of both animal and human physiology. In reality, however, the heart relaxes for very brief periods between beats. The myocardium muscles rest for tenths of a second; they receive blood and nutrients via the coronary arteries (Pamplona-Roger, 2002).

The proper functioning of the heart is of vital importance for both humans and animals. Aberrations in the heart may eventually be fatal. There are many diseases, disorders, and conditions that may impair the proper functioning they include: angina pectoris, myocardial infarction, arrhythmia and cardiac failure.

Angina Pectoris

This is the reversible narrowing of the coronary arteries. It manifests via severe, repressive pain on the left side of the thorax, progressing down the left arm. It is commonly experienced after arduous physical exertion, extreme emotions or stress (Pamplona-Roger, 2002).

Human Chest Cavity : Heart

Human Chest Cavity : Heart
Human Chest Cavity : Heart

Diet and risk factors of angina pectoris

Diet exerts significant influence on the condition and function of the coronary arteries.

Risk factors for angina are:

  • Arteriosclerosis (narrowing and hardening of coronary arteries). A diet that is rich in saturated fats and poor in green leafy vegetables and fruits is one of the principal causes of angina pectoris.
  • The tendency to spasms deficiency of magnesium and other nutrients fosters spasms

Myocardial Infarction

This occurs as a result of total obstruction of a coronary artery. It results in irreversible damage to the cardiac muscle causing necrosis (tissue death) in that area of the heart.

Causes of Myocardial Infarction

  • Arteriosclerosis: It is the narrowing and hardening of coronary arteries.
  • Thrombosis: this is the formation of blood clots in the inside of the narrowed artery, obstructing blood flow completely.

Arrhythmia

It is the variation in the rhythm of the heartbeat. It is usually perceived as a palpitation. If Arrhythmia is severe it may reduce the heart’s capability to proficiently pump blood throughout the tissues resulting to heart failure or cardiac arrest.

Causes of Arrhythmia

  • Diet
  • Toxins: tobacco, alcohol, and coffee may cause Arrhythmia


  • Hormonal imbalances: The thyroid gland may become hyperactive resulting in Arrhythmia

Coronary Heart Disease

Coronary artery disease refers to the condition that arises due to the narrowing of the coronary arteries (Nordqvist, 2018). It is also known also as ischemic heart disease. Coronary arteries are responsible for the supply of blood and oxygen in the human body.

The disease happens over many years due to a buildup of plaque in the coronary arteries. When the plaque builds-up, the arteries narrow and restrict the smooth flow of blood. When the heart is deprived of oxygen, it may result in angina or heart pain. The buildup of plaques results in a condition called arteriosclerosis (Department of Health & Human Services, 2018). It may also lead to heart attacks and ultimately death.

The human heart

This image shows the components of the human heart
This image shows the components of the human heart

Etiology

The disease is caused when fatty plaque forms inside the coronary artery subsequently constricting them. When the arteries narrow, the smooth flow of blood to the heart is severely restricted. In some cases, the disease has no symptoms but can manifest itself through angina pectoris (chest pains). Angina may feel like pressure or tighten in the chest area. The pain also can occur in the shoulders, arms, neck, jaw, or back. Angina pain may even feel like dyspepsia.

In severe cases, a person can have a heart attack. Some of the treatment options for the disease include medication, lifestyle changes, exercise, and surgery. However, a person is advised to consult a doctor when symptoms first appear.

Risk factors

Early detection can lead to successful treatment in most cases. Some of the risk factors for coronary heart disease include age, sex, obesity or overweight, diabetes, high blood pressure, high cholesterol in the blood, smoking, and family history.

Smokers have higher incidences of the disease than non-smokers. Foods rich in fats and cholesterol have a significant contribution to the progression of the disease. Heredity is another significant factor; families with a history of the disease are at a higher risk of the disease than those without.

Disease progression

The disease is caused when there is an internal buildup of a waxy substance in the coronary arteries. Cholesterol accumulates in the coronary arteries. The arteries narrow reducing the amount of blood flowing through them. The heart muscles become deprived of oxygen and they experience atrophy.

The nutrients and oxygen required for proper functioning of the heart become inaccessible to it. Some of the signs and symptoms of the disease include chest pains, nausea or indigestion, sweating, accelerated heart rate, light-headedness, and shortness of breath (Nordqvist, 2018).

Coronary artery disease leads to an unusual intercellular communication in the heart muscles.

The disease is also characterized by circulating microRNAs

Clinical manifestations and complications

It is essential to perform medical diagnosis in cases of coronary artery disease. The disease manifests itself through pain in jaw, chest, arms, and other areas of the body. There are some sharp sensations or paint in the breast, particularly after a person has taken a meal.

Most victims of the disease have angina (pain in the chest). The chest pains are due to stimulation of nerve endings. The victims of the disease experience extreme sweating. They also experience difficulty walking.

Heart Attack

A heart attack is also called a myocardial infarction. It occurs when the cardiac muscle does not have an adequate blood supply and oxygen. The cardiac muscle degenerates leading to a heart attack (Nordqvist, 2018).

A heart attack is experienced when a blood clot develops from the buildup of plaque in one of the coronary arteries. The clot, if large enough, can stop the supply of blood to the heart. The blood clot is known as coronary thrombosis.

Symptoms of a heart attack include:

  • nausea and vomiting
  • restlessness
  • sweating and clammy skin
  • shortness of breath
  • a pale face
  • chest pains (mild or severe)
  • coughing
  • dizziness

The initial symptom is normally angina that progresses from the neck to jaw, ears, arms, and wrists, and possibly the shoulder blades, the back, or the abdomen (Nordqvist, 2018).

Laying prostrate or changing positions offers a person no relief at all. The pain comes and goes at intervals. It can last from few minutes to several hours.

A heart attack is a medical emergency. It may be fatal or it may cause permanent damage to the heart muscle. If a person experiences any of the signs of a heart attack, it is crucial to call the emergency medical services immediately.

Diagnostics

In most cases, a doctor will ask questions regarding a person’s medical history. He or she will also perform a routine physical examination of the body. Normal blood tests are conducted to determine the level of cholesterol in the blood.

The physician may also perform other advanced tests like an electrocardiogram (ECG), stress test, heart scan, and echocardiogram among others. For example, a heart scan assists the doctor to detect calcium deposits in the arteries. A heart scan is vital because of shows whether the arteries narrowed by fat deposits (Department of Health & Human Services, 2018).

A doctor will diagnose coronary heart disease (CHD) based on a person's medical and family history, the risk factors for coronary heart disease, a physical exam, and the results from tests and procedures(Department of Health & Human Services, 2018).

There is no single test can that diagnose Coronary Heart disease. A doctor may recommend one or more of the following tests if they think a person has coronary heart disease.

EKG (Electrocardiogram)

An electrocardiogram is a straightforward, painless procedure that detects and records the electrical activity of the heart. The test shows the heart-rate and its rhythm (steady or irregular). An electrocardiogram also records the strength and timing of electrical signals as they pass through the heart (Department of Health & Human Services, 2018).

An electrocardiogram can indicate heart damage caused by coronary heart disease and signs of a previous or current heart attack.

Stress Testing

Stress testing is conducted through exercises that are geared towards increasing the heart rate. Tests are carried in tandem with the exercise. Medicine may also be administered to increase the heart rate if the patient is indisposed.

An increased heart-rate leads to increased demands for blood and oxygen by the heart. Coronary arteries that are narrowed by plaque are incapable of meeting the high oxygen and blood requirements of the heart (Department of Health & Human Services, 2018).

A stress test can show potential signs and symptoms of coronary heart disease for example:

  • Abnormal changes in your heart rate or blood pressure.
  • Shortness of breath or angina (chest pain).
  • Abnormal changes in your heart rhythm or your heart's electrical activity (Department of Health & Human Services, 2018).

If a person is unable to sustain exercise for a time period that is considered normal for their age, it may mean that the heart is not getting adequate oxygen-rich blood. Other factors may prevent a sustained bout of exercise, for example, certain diseases, anemia, and poor general fitness.

Images of the heart are taken during exercise as part of the stress testing and during rest.

The imaging stress procedures can demonstrate precisely how blood is flowing in the heart and how well the heart pumps blood when it is beating.

Echocardiography

Echo-cardiography (echo) utilizes sound waves to generate a moving picture of your heart. The image shows the size and shape of your heart and how efficiently the heart chambers and valves are working (Department of Health & Human Services, 2018).

Echo-cardiography identifies the areas of the heart with poor circulation, areas with abnormal contraction and atrophied areas of the heart muscle.

Chest X-Ray

A chest X-ray takes images of the internal organs and the structures inside your chest, such as your heart, lungs, and blood vessels (Department of Health & Human Services, 2018). A chest x-ray can reveal the signs of heart failure and also lung disorders and other causes of symptoms not related to coronary heart disease.

Blood Tests

Blood tests ascertain the levels of certain fats, triglycerides, cholesterol, sugar, and proteins in your blood. Abnormal levels might be a sign that you're at risk for coronary heart disease (Department of Health & Human Services, 2018).

Coronary Angiography and Cardiac Catheterization

A doctor may recommend coronary angiography if other procedures demonstrate that you're likely to have coronary heart disease. This test uses dye and special X- rays to show the insides of your coronary arteries (Department of Health & Human Services, 2018).To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization.

A narrow, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The narrow tube is inserted into your coronary arteries, and then the dye is released into your bloodstream. Special X-rays are taken while the dye is flowing through your coronary arteries. The dye lets the doctor examine the flow of blood through your heart and blood vessels.

Cardiac catheterization usually is done in a hospital.

A person is normally conscious during the procedure. The procedure produces a little discomfort; some soreness may be felt in the blood vessel where the doctor inserts the catheter. Treatments for coronary heart disease include adopting heart-healthy lifestyle changes, medications, medical procedures and surgery, and cardiac vascular rehabilitation. Treatment objectives may include:

  • Decreasing the likelihood of clot formation
  • Preventing complications of heart disease
  • Reducing the risk factors in an effort to decelerate, halt, or reverse the buildup of plaque
  • Alleviating symptoms
  • Broadening or bypassing clogged arteries

Heart-Healthy Lifestyle Changes

A doctor may recommend heart-healthy lifestyle changes if a person has coronary heart disease. Heart-healthy lifestyle changes include:

  • Heart-healthy eating
  • Maintaining a healthy weight
  • Handling stress properly
  • Exercise
  • Relinquishing smoking

Heart-Healthy Eating

The doctor may recommend heart-healthy diet which should include:

  • Fat-free or low-fat dairy products, such as fat-free milk
  • Fish high in omega-3 fatty acids, such as cod, salmon, tuna, and trout, about twice a week
  • Fruits, such as avocado, apples, bananas, oranges, pears, and prunes
  • Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
  • Vegetables, such as spinach, broccoli, cabbage, and carrots
  • Whole grains, such as wheat, oatmeal, brown rice, and corn tortillas

Reduce intake of these Foods

When following a heart-healthy diet, you should reduce the consumption of:

  • Red meat and processed meat
  • Palm and coconut oils
  • Sodium
  • Alcoholic beverages
  • Milk
  • Sugar
  • Saturated fat

Further Reading

https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease

https://www.medicalnewstoday.com/articles/184130.php

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© 2018 Jeff Zod

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