CORONARY HEART DISEASE

1. Causes

1.1. CHD is believed to start with injury or damage to the inner layer of a coronary artery. This damage causes fatty plaque deposits to build up at the site of the injury. The accumulation is called atherosclerosis. If pieces break off or rupture, platelets will clump in the area, attempting to repair the blood vessel. This clump can block the artery, reducing or blocking blood flow, leading to a heart attack.

1.2. Vast majority of CHD occurs in patients with atherosclerosis of the coronary arteries that starts before adulthood.

2. Clinical Syndromes

2.1. Angina - Chest Pain - indigestion, heartburn, weakness, sweating, nausea, cramping, and shortness of breath

2.1.1. Stable Angina: Discomfort in the chest, shoulder, back, or arms elicited by stress or exertion relieved by rest or nitroglycerin Unstable angina: This is often caused by blood clots in the coronary artery. It occurs at rest, it is surprising, it lasts longer, and it may worsen over time. Variant angina: This type occurs at rest, and it is usually severe.

3. Diagnosis

3.1. Electrocardiogram (ECG), Holter monitor, Echocardiogram, Stress test, Coronary catheterization CT scans, Nuclear ventriculography Blood tests

4. Management of complications

4.1. Heart Failure -oxygen, IV furosemide, nitrates

4.1.1. Arrhythmias -Beta blockers because of their anti-arrhythmic potential

4.1.1.1. Blood Glucose -control blood glucose levels

5. Coronary Artery Disease (CAD) Ischemic Heart Disease (IHD)

5.1. A group of diseases that includes: stable angina, unstable angina, myocardial infarction, and sudden coronary death

6. Risk Factors

6.1. Hypertension

6.2. Cigarette Smoking

6.3. Sedentary lifestyle

6.4. Diabetes

6.5. Obesity and personal stress

6.6. Raised serum cholesterol

7. Treatment

7.1. Lifestyle changes and exercise must be tailored according to the patient's threshold for angina.

7.1.1. Statins

7.1.1.1. Low Dose Aspirin

7.1.1.1.1. Beta blockers

7.2. Statins

7.2.1. Nitroglycerin

7.3. Low Dose Aspirin

7.3.1. Ace inhibitors

7.4. Beta blockers

7.4.1. Ca Channel Blockers