Coronary heart disease

Coronary heart disease (CHD) also known as coronary artery disease (CAD), atherosclerotic heart disease, ischemic heart disease (IHD) or coronary arteriosclerotic. It is a condition of narrowing or blockage of the coronary arteries that supply the heart, which is often result from atherosclerosis that lead to a limitation of coronary blood flow to the heart. This means that the heart is not getting enough blood and oxygen.

Coronary atherosclerosis is characterized by buildup of plaques (which is the accumulation of lipid, macrophages and smooth muscle cells) in the coronary arteries.

CHD causes

Atherosclerosis is the most common cause of CAD, atherosclerosis can effect one or all three major coronary arteries and their branches, which begins with an injury to the inner walls of the vessels, that lead to macrophage adhesion and plaque growth the initiating step of atherosclerosis. And this damage may cause by:

• Smoking
• High cholesterol
• High blood pressure
• Physical inactivity

Risk factors

• Increases with age
• Gender: occurs predominantly in males compared with females
• Diabetes mellitus
• Obesity
• Family history
• Hypertention
• Hyperlipidemia or high cholesterol
• Peripheral vascular disease
• Smoking habits

Coronary heart disease symptoms and diagnosis

The most common symptoms is angina, it is characterized by chest pain or pressure which subsides within a few minutes of rest. The pain may also cause by emotional stress and drug use (e.g. cocaine).

Angina pain symptoms include:

• Aching
• Pressure
• Heaviness
• Squeezing

However patients with coronary artery disease may feel the pain in their neck, throat or jaw.

The diagnosis of coronary heart disease is complicated because of the number of other causes of chest discomfort which are also of medical emergencies.

Treatment

1. Lifestyle modification: CAD due to smoking, high cholesterol, diabetes and obesity can be treat with lifestyle modification by:
   • Exercise: which minimizes emotional stress, maintain healthy weight and help reduce other risk factors.
   • Diet: reducing saturated fat intake.
   • Quit smoking
2. Medical therapy
   • Antiplatelet drugs (e.g. Aspirin)
   • Beta-blockers
   • Calcium channel blockers
   • Angiotensin converting enzyme inhibitors (ACE inhibitors)
   • Nitrates
3. Revascularization: Coronary artery bypass grafting (CABG)