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Coronary Heart Disease

Symptoms and treatment

What is coronary heart disease? It is a condition occurring when blood and oxygen supply to the heart diminishes due to narrowing blood vessels. Coronary artery disease and arteriosclerotic heart disease are two other names for coronary heart disease.

Cause

Atherosclerosis is the usual cause of coronary heart disease. This condition occurs when plaque builds up on artery walls, causing them to narrow. Angina (chest pains) or heart attack can occur as this narrowing slows or stops blood flow to the heart.

Men in their 40s are at a higher risk for coronary heart disease than women. However, the risk for women increases as they age, so by the time men and women are both in their 50s, the risk balances out and both genders are at equal risk. According to the American Heart Association, coronary heart disease is the leading cause of death in America. The following elements and conditions increase the possibility of contracting coronary heart disease:

  • Family history of the disease
  • High blood pressure
  • Obesity
  • Menopause
  • Smoking
  • High LDL ("bad" cholesterol)
  • Low HDL ("good" cholesterol)

Symptoms

One of the major misconceptions about coronary heart disease is that there are always warning signs. Sometimes a person has no symptoms and the first sign is an actual heart attack. When symptoms are present, the most prevalent is chest pain, and the degree of discomfort may vary among individuals. Chest pain may be accompanied by burning in the chest and upper abdomen, dizziness, sweating, fatigue and nausea. There are two prominent types of chest pain that warns of this condition:

  • Atypical chest pain is sharp and may dissipate and return. It may also occur in the abdomen, back or arm.
  • Typical chest pain is a very heavy pain, felt under the breast bone and may travel to the arm or jaw. Activity, emotional upset or excitement may start this pain. It may subside when the person is at rest or nitroglycerin is administered.

Shortness of breath may also occur with either type of pain.

Diagnosis

Most likely a doctor will order more than one test before making a diagnosis. He will have an electrocardiogram (ECG or EKG) performed which records the electrical waves that cause the heart to pump. This test will help the doctor find any abnormal rhythms of these electrical waves, deciding where heart damage may have already occurred. Here are some additional tests used to determine a diagnosis:

  • An exercise stress test, which monitors how the heart deals with physical stress.
  • An echocardiogram is an ultrasound of the heart, reporting on its size and shape.
  • Magnetic resonance imaging will provide detailed pictures of the heart.
  • Coronary angiography is administered with a catheter to look at coronary circulation and the chambers of the heart.
  • Electron beam computed tomography is used to determine the amount of calcium in the artery lining.

Treatment

Treatment for coronary heart disease can vary according to the patient's symptoms. The doctor may treat with only medicine or angioplasty, a procedure in which balloons are entered into blood vessels to widen them. Medication that may be used are: ACE inhibitors which lowers blood pressure, antiplatelet drugs which are blood thinners and will lower the risk of blood clots, beta blockers to reduce heart rate and blood pressure, calcium channel blockers to lessen the strain on the heart by relaxing arteries, diuretics to lower blood pleasure and nitrates (nitroglycerin) which helps supply blood to the heart.

For extreme cases of coronary heart disease, a coronary heart bypass may be required. In this procedure, arteries or veins from other body locations are used to graft to the coronary artery and form a bypass, improving blood circulation.

Prevention

It's not about going to extremes, because most people can't live with an extreme lifestyle for very long. Small changes can make a big difference. Decreasing your consumption of saturated fats, salt and high-cholesterol foods as well as increasing fish, nuts, fruits, vegetables and fiber in your diet is a good start to help prevent coronary heart disease. According to The American Journal of Cardiology, adding omega-3 rich foods such as fish, nuts and soybean oil can reduce your risk of cardiovascular disease by 60 percent.

Exercise also does not need to be taken to an extreme. If a person loves running, a marathon is in order. For the rest of us, keep weight in the normal range by starting with a half-hour walk each day; it can make a big difference in your heart health.

By Karen Ellis

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