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

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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.' ...read more.


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 may also be obese (fat) and may not have exercised regularly.' 3 'Smoking is a major contributor increasing the likelihood of both thrombosis and atherosclerosis. A raised level of fat, especially cholesterol, in the blood is a major cause of atherosclerosis. Saturated fat of the type found in most meat and animal products, such as milk is particularly dangerous. High blood pressure or hyper intensive disease, a high level of salt in the diet and diabetes are factors which contribute to atherosclerosis and hence coronary heart disease.' 4 'Type 2 is the form of diabetes suffered from about 80% of diabetics. It develops when the body produces too little insulin due to malfunction of the beta cells or when the target cells fail to respond to insulin. ...Diabetics have a 2-4 times greater than average risk of stroke (caused by damage to the arteries of the brain) ...read more.


A cold laser may be used to remove atherosclerotic plaques with bursts of ultraviolet light. It does little damage to the arteries and leaves the walls of the vessels smooth, without the burning and scarring created by hot lasers.' 1 Mechanical cutting devices, called atherotomes, are sometimes to ream atherosclerotic plaque material from the vessel in a procedure called atherectomy. Plaque is made of oily molecules known as cholesterol, fibrous proteins, calcium deposits, tiny blood cells known as platelets, and debris from dead cells. Plaque formation often begins by adolescence and progresses very slowly over the course of decades. Gradually, the growing plaque thickens the wall of the artery, reducing the space available for life-giving blood to flow through Another procedure is the endoscopic procedure, known as percutaneous transluminal coronary angioplasty (PTCA), involves the use of a balloon- tipped catheter to widen the diseased vessel. PTCA is cheaper and less invasive than CABG, but in roughly a third of cases further surgery is required in six months. The use of the balloon catheter often can be complicated by cracks or weakening of the walls of the vessels and may lead to rapid reclogging of the vessel. ...read more.

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