Issues and factors influencing the development and treatment of coronary heart disease.

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Harpreet Sekhon

Issues and factors influencing the development and treatment of coronary heart disease

Coronary heart disease is a condition in which the fatty deposits of atherosclerosis form in the coronary arteries that supply the heart muscle, narrowing them and restricting the blood flow. These arteries may already be hardened (arteriosclerosis).  If the hearts oxygen requirements are increased, as during exercise, the blood supply through the narrowed arteries may be inadequate, and the pain of angina results.  A heart attack occurs if the blood supply to an area off the heart is cut off, for example because a blood clot has blocked one of the coronary arteries. The subsequent lack of oxygen damages the heart muscle, and if a large area of the heart is affected, the attack may be fatal.

‘Arteriosclerotic depositions in the coronary arteries result in the narrowing of these vessels, causing insufficient blood flow and oxygen to the heart muscle, a condition known as coronary artery disease. The characteristic radiating chest pain, angina pectoris, is the most prominent symptom of this condition. Coronary arteries already narrowed by arteriosclerosis are made susceptible to blockage by a clot (coronary thrombosis), causing the death of the heart muscle supplied by the affected artery, a life-threatening event called a myocardia infarction, or heart attack.’  1  The blood clot severely limits or completely cuts off blood flow to part of the heart. In a small percentage of cases, blood flow is cut off when the muscles in the artery wall contract suddenly, constricting the artery. This constriction, called vasospasm, can occur in an artery that is only slightly narrowed by atherosclerosis or even in a healthy artery.  ‘A heart attack occurs when one of the coronary arteries becomes blocked. Part of the heart muscle is starved of oxygen and dies. Sometimes a heart attack affects the pacemaker and other parts of the system by which the heartbeat is controlled.  This results in heart block: a condition which, if not treated, is fatal.’   2

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Coronary artery disease, as its also known, tends to run in families and is linked to smoking, lack of exercise, and a diet high in saturated fats, which tends to increase the level of blood cholesterol.  It is a common cause of death in many industrialised countries; older men are the most vulnerable group.  The condition is treated with drugs or bypass surgery.   ‘Research shows that people who develop heart disease usually have one or more of the following: high blood cholesterol, high blood pressure, a history of cigarette smoking, diabetes mellitus, or an inherited (therefore genetic) tendency. They ...

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