Coronary Heart Disease
Coronary heart disease which is also called coronary artery disease is the narrowing of the coronary arteries, the blood vessels that feed oxygen and blood to the heart.
Coronary heart disease is a major cause of illness and death. It often happens when cholesterol accumulates on the artery walls and creates plaques.
In the process, the arteries narrow down which leads to reduction of blood flow to the heart. A clot may also hinder the floor of blood to the heart.
When plaques build up, it decreases blood flow to the heart that may lead to chest pain (angina), shortness of breath, or other signs and symptoms coronary artery disease. A complete blockage can lead to a heart attack.
According to World Health Organization, cardiovascular heart disease of which coronary heart disease is one of them, causes 17.9 million deaths every year. This represents 31% of all deaths worldwide and unfortunately, 75% of these deaths occur in low-and middle-income countries such as Kenya.
At the same time, 85% of these deaths occur due to heart attacks, strokes, and unmanaged irregular heartbeats. In Kenya, it is estimated that 25% of hospital admissions and 13% of deaths are due to cardiovascular diseases.
If your coronary arteries narrow, they cannot supply oxygen-rich blood to the heart particularly when it is beating hard, such as during workout. Initially, the minimized blood flow may not lead to any signs of coronary artery disease.
However, as plaque continues to accumulate in the coronary arteries, a person may develop coronary artery disease whose signs and symptoms are as follows:
- Shortness of breath
- Chest pain (angina)
- Heart attack
Other symptoms coronary artery disease include
- Pain in arms and shoulders
Note that some of these symptoms may be mistaken indigestion or heartburn. You may equally experience more signs when your blood floor is more limited.
In case the plaque cuts blood flow completely or almost completely, the heart muscle begins to die if not restored – this is heart attack.
Coronary heart disease is thought to begin with damage or injury to the inner layer of a coronary artery. The damage leads to deposition of fatty plaque that accumulates to the inured site.
The deposits comprises of cellular waste products and cholesterol. The accumulation is termed as atherosclerosis. The injury may occur because of factors such as:
- High blood pressure
- High cholesterol
- Sedentary lifestyle
- Insulin resistance or diabetes
That is how coronary heart disease comes about and if not managed early, it can easily cause heart attack.
Risk factors for CAD include:
- Sex: Men are at greater risk for CAD than women but the risk for women increases after menopause
- Age: The older you become the more vulnerable to CAD you become
- Family history: Your risk increases if your father or a brother was diagnosed with CAD before age 55.
- High blood pressure
- High cholesterol levels in the blood
- Physical inactivity
- High stress
- Overweight or obesity
- Unhealthy diet
The doctor will begin by reviewing your medical history, conduct a physical examination, and wind up with medical testing. The tests include:
- Electrocardiogram: It monitors electrical signals that travel through the heart.
- Echocardiogram: It uses ultrasound waves to create an image of your heart. The outcomes reveal whether the heart functions properly or not.
- Stress test: It measures stress on your heart at rest and during physical activity.
- Cardiac catheterization (left heart catheterization): a special dye is injected into the coronary arteries through a catheter inserted via an artery in your forearm or groin. The dye enhances the radiographic image of the arteries to identify plaques.
- Heart CT Scan: The doctor may use it to identify calcium deposits in the arteries.
Note that coronary heart disease cannot be cured but today’s technology makes it possible to manage it effectively.
Treatment involves lifestyle changes, and probably certain medical procedures and medications. Lifestyle recommendations include eating a healthy diet, avoiding sedentary lifestyle, quitting smoking, and exercising regularly.
- Beta blockers: Reduces blood pressures and heart rate particularly in an individual who has already experienced a heart attack.
- Statins: They are the only medications that have a positive impact on outcomes associated with CHD. However, they may not be effective if a person has an underlying cholesterol disorder.
- Low-dose aspirin: It reduces blood clot and minimizes the chance of a heart attack or angina in individuals with a high risk of a cardiovascular event.
- Angiotensin-converting enzyme (ACE) inhibitors: They minimize blood pressure and help slow down or stop the progression of CHD.
- Nitroglycerin patches, tablets, or sprays: They control chest pain and minimize the hearts demand for blood through broadening the coronary arteries.
- Calcium channel blockers: It widens the coronary arteries and allows them to experience greater blood flow to the heart, and minimize hypertension.
Similar lifestyle habits that can help treat CAD can also help prevent it from developing in the first place. To improve the health of your heart:
- Quit smoking
- Stay physically active
- Control conditions such as high cholesterol levels, diabetes, and high blood pressure
- Maintain a healthy weight
- Eat a low-fat, low-salt diet that is rich in vegetables, fruits, and whole grains
- Minimize and manage stress
For more information on diagnosis and/or treatment, speak to a doctor, or get access to a hospital near you through the Uzima Health App.