This is the occlusion of one or more arteries supplying blood to the heart, usually because of atherosclerosis. This causes a limit of blood supply to the heart muscles. Coronary artery disease is also known as coronary heart disease.
The etiology(cause) of the disease is commonly an accumulation of lipid and fibrous materials to form a hard substance in the walls of coronary arteries. This hard substance is known as plaque. As a result, the lumen of the arteries of the heart get narrowed and hence blood flow to the heart is limited or blocked.
Risk factors of coronary heart disease can be classified into modifiable and non-modifiable. The modifiable risk factors include:
Sedentary life style
Consuming diets with high levels of saturated fatty acids
High serum lipids levels/cholesterol in blood
Smoking of cigarettes. Second hand smoking is also a risk factor for coronary artery disease
The non-modifiable risk factors include:
Age. Susceptibility increases with age.
Sex. Men are more susceptible. Women have a decreased risk upto menopause.
Positive family history
Clients with Type 2 diabetes, i.e Diabetes mellitus.
Most of the non-modifiable risk factors can be corrected by acting on the modifiable risk factors.
The pathogenesis of coronary heart disease follows that the build up of plaque in the walls of the coronary arteries causes progressive narrowing of the lumen of these arteries. This causes resistance to blood flow to the heart.
A person with this disease can have no symptoms or show the following:
Chest pain. This is known as angina.
Shortness of breadth
Heart attack when blood supply to the heart has been completely occluded.
Complications of coronary artery disease include:
Myocardial infarction-Heart attack
Coronary heart disease can be diagnosed with the following tests:
Exercise stress test
Nuclear stress test
CT scan of the heart. This may show calcium deposits in the arteries of the heart.
The management of coronary heart disease involves treatment with:
Medications which reduce cholesterol in blood.
Aspirin. This decreases the tendency of the blood to clot hence preventing the obstruction of coronary arteries.
Calcium channel blockers- alleviate chest pain
ACEIs and ARBs. These drugs decrease blood pressure and thus help slow or prevent the progression of coronary artery disease.
Station which decreases production of harmful cholesterol in the liver.
Antianginal-Reduce chest pain or pressure caused by blockages in the heart arteries.
Calcium channel blockers-relaxes blood vessels
N/B: Before using any of these drugs, please consult your doctor.
A coronary artery bypass surgery to restore blood flow to the heart may also need to be performed
Prevention of the disease can be effected by lifestyle changes such as: