Understanding Coronary Artery Disease

Coronary artery diseaseCoronary artery disease, CAD also knows as ischemic heart disease (IHD) is a group of diseases that included: unstable angina, stable angina, myocardial infarction and sudden coronary death. Coronary artery disease is considered a cardiovascular disease, which is the most common condition.

A common symptom that individuals experience is chest pain and discomfort that can spread throughout the body, to the shoulder, neck, back, arm and even jaw. There are additional symptoms that appear when exercising or are under emotional stress. These symptoms can last for less than a few minutes,

There are times a person will a person may experience heartburn. Shortness of breath may also transpire and sometimes are no symptoms are present. The first could be the occurrence of a heart attack. Other complications include an irregular heartbeat and heart failure.

Risk factors for coronary artery disease include smoking, diabetes, lake of exercises, obesity, high blood cholesterol, poor diet and excessive alcohol consumption. Depression and is also a risk factor. The underlying mechanism involves atherosclerosis of arteries in the heart.

Some tests may help with diagnoses including electrocardiogram coronary computed tomographic angiography, coronary angiogram,

Prevention

Coronary artery diseaseYou can prevent healthy diet regular exercise, maintaining a healthy weight and not smoking, Sometimes medication for diabetes, high cholesterol of high blood pressure area also used. There is low evidence for screening people who are at love risk and do not have symptoms. Treatment involves the same measures as prevention. Additional medication such as antiplatelet including aspirin, beta blockers, or nitroglycerin may be recommended. Prevention can be achieved with procedures such as percutaneous coronary intervention (PCI or coronary artery bypass surgery (CABG, which may be used for people with severe cases of the disease. Those with stable coronary artery disease is till unclear if PCI or CABG, along with other treatments, improves the life expectant or decrease heart attack week.

Conary heart disease was the most common cause of death globally. It accounted for over 8.1 million deaths (16.8%) in 2013. This is up from 5.74 million deaths in 12% in 1990. The risk of CAD has decreased between 1980 specifically in developed countries. The likelihood of death has declined between 1990 and 2019, about 20% of those over the age of 65 has CAD and 7% of those aged 45 to 64 and 1.3% in those age 18 to 45. Those rates are higher in men than in women.

cardiology-conditions-coronary-artery-disease-cadSigns and symptoms of Coronary Artery Disease

Chest Pain is a symptom if it occurs regularly. after eating or certain times during the day.
Angina that changes characteristics, with frequency is considered unstable. This may precede a myocardial infarction or heart attack. In adults, who have pain severe enough to warrant emergency care, 30% of the cases the pain is due to coronary artery disease.

What are the Risk Factors for Coronary Artery Disease

CAD has several risk factors that affect a person’s likelihood to get the ideas. The most common risk factors include hypertension, obesity, family history, high blood lipids, stress, smoking and lack of exercise. Smoking is associated with nearly 36% of CAD and obesity is adopted with 20%. The lack of exercise is linked to 7 to12% cases. Also, the exposure to the herbicide known as Agent Orange can increase the risk developing CAD. In 3% of the cases, job stress is linked to developing the disease.

There have been several studies conducted. In which women who were stress-free in their work life saw an increase in their diameter of their blood pressure leading to lower progression of atherosclerosis. Women with high levels of stress on their jobs, experienced a decrease in diameter of their blood vessels and significantly increased disease progression.

Blood Fat Levels

High levels of blood cholesterol LDL typically leads to greater risk HDL or high-density lipoprotein has a protective effect on developing coronary artery disease.
High blood triglycerides can have an effect on CAD development
High levels of lipoprotein(A) a chemical formed when LDLD cholesterol combines with apolipoprotein(A)./
Dietary cholesterol does not appear to have a signal effect on blood cholesterol.

Coronary Artery Disease Pathophysiology

When blood flow is limited, it can cause ischemia of myocardial cells. Which are cells are deprived the oxygen they need. Myocardial cells may die because they are starved of oxygen, and this is called a myocardial infarction, which is referred to as a heart attack. This leads to heart muscle damage, muscle death, and myocardial scarring, in which there is no muscle regrowth to heal or replace damaged muscle tissue. Chronic high-grade stenosis of the coronary arteries can produce transient ischemia and leads to the initiation of a ventricular arrhythmia, which deteriorates into ventricular fibrillation causing death.
Normally, coronary artery disease occurs when a part of elastic, smooth lining inside coronary parties develops atherosclerosis. Atherosclerosis, which is the hardening of the artery lining. The artery becomes stiff and swollen with fatty deposits and tissue and cell and tissue inflammation, forming plaque. The deposits of calcium phosphates(hydroxyapatites ) in the body;s muscular layer of blood vessels appear to play a critical role in hardening artieries in the development of early phase coronary arteriosclerosis. Although people suggest from kidney dysfunction through the metastatic mechanism of calciphylaxis, almost half of these people die due to coronary artery disease. The plaque is large protruding into the artery channel causing partial obstruction to the blood flow. A patient may have as few as two, to dozens of instances of plaque. In severe cases, the complete obstruction can take places in three moths.

Diagnosis

For patients with CAD symptoms, a stress echocardiography is implemented to diagnose obstructions to coronary artery disease. The use of echocardiography, to monitor stress imaging, and the advanced noninvasive image is not recommended for people who have no symptoms or low risk of developing coronary disease.

CAD is a difficult disease to diagnose without use of invasive equipment and test that are stressful on the body. The Multifunction Cardiogram (MCG has changed the way CAD is diagnosed. MCG has 2 lead resting EKG signals that are transformed into mathematical models to compare results against tens of thousands of other clinical trials to diagnose a patients severity score. These findings from the MCG test have been validated in 8 clinical tirls and result in a 90% overall seveventive score and 85% specificity score. The level of accuracy comes from the advanced signal techniques and the systems analysis to combine with large-scale clinical databases, providing the quantitive evidence-based results to help doctors reach a diagnosis.

Treatment

Lifestyle changes are critical to reducing progression of CAD. A healthy diet with fruits, vegetables, full of vitamins, essential nutrients and minerals are key to maintaining a healthy balance.
Medical treatment – drugs (beta-blockers, nitroglycerin, cholesterol lowering medications, b, calcium antagonists, etc.);
Coronary operations such as an angioplasty and coronary stent
Coronary artery bypass grafting (CABG)

Medications and Drug therapy

  1. Statins, which reduce cholesterol, reduce risk of coronary disease
  2. Nitroglycerin
  3. Calcium channel blockers and beta-blockers.
  4. Antiplatelet drugs such as aspirin.
    It is suggested that blood pressure typically is decreased to less than 140/90 mmHg. The diastolic blood pressure, however, should not be lower than 60 mmHg. Beta blockers are recommended the first line for this use.

Aspirin
Aspirin is an option for peeople with no other heart problems, to decrease the risk of myocardial infarction in men. However, women may have an increase in of bleeding in the stomach. Asprin will not affect the overall death risk in men or women. It is recommended fo men with increased risked of CAD and men older than 90 years of age and women who are postmenopausal.
It is therefore only supported in adults who are at increased risk for CAD, including younger persons who have risk factors for coronary artery disease are at increased risk for heart disease and may wish to consider aspirin therapy.


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