Life 70 _ Coronary artery disease
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CORONARY ARTERY DISEASE

Coronary artery disease, also known as coronary artery disease, is a condition that occurs when one or more branches of the major blood vessels supplying the heart are damaged or diseased. At this point, these blood vessels are narrowed or blocked by the plaque that builds up inside.
We know that the arteries in our body are inherently soft and elastic. Yet plaque, cholesterol plaques in the coronary arteries and inflammation are often the causes of Coronary artery disease, which causes the arteries to narrow and stiffen and the arteries to narrow and stiffen. This is also called arteriosclerosis. .
As coronary artery disease progresses, blood flow through the arteries becomes more difficult. As a result, the heart muscle cannot receive the required amount of blood and oxygen, which leads to angina. And the worst that can happen is a heart attack. Most heart attacks occur when a blood clot suddenly moves to a narrow part of a blood vessel. A complete blockage there can cause a heart attack, even immediate death or at least permanent heart damage, and comes with consequences such as heart failure, arrhythmias and many other dangerous complications.
In fact, coronary artery disease can develop silently for decades, so a person may not know they have it until they develop chest pain or a heart attack. Therefore, it is very important to recognize that you are suffering from coronary artery disease in order to take timely preventive and therapeutic measures, before the disease is too severe, and even when the disease is recognized, it was already too late.

SIGNS AND SYMPTOMS OF CORONARY ARTERY DISEASE:

If your coronary arteries are narrowed, they cannot supply enough oxygen-rich blood to your heart, especially when the heart is pounding, such as during exercise. At first, decreased blood flow may not cause any symptoms. However, as plaque continues to build up in your coronary arteries, you may develop the most common signs and symptoms of arterial disease, angina, or pain in the heart area, with specific signs that may include:

  • Chest pain, also called angina pectoris. You may feel pressure or tightness in your chest, as if someone is standing on your chest. This pain usually occurs in the middle or left of the chest and is often triggered by physical or emotional stress. The pain usually goes away within minutes of stopping a stressful activity. In some people, especially women, the pain may be brief or sharp and can also be felt in the neck, arms, or back.
  • Shortness of breath. If your heart cannot pump enough blood to meet your body’s needs, you may experience shortness of breath or extreme fatigue during the activity.
  • Heart attack. A completely blocked coronary artery will cause a heart attack. Classic signs and symptoms of a heart attack include pressure in the chest and pain in the shoulder or arm, sometimes shortness of breath and sweating.
  • Symptoms of Coronary artery disease are generally milder in women than in men, which means that women are a little less likely to have the typical signs and symptoms of a heart attack than men, such as pain in the chest. neck or jaw. However, women can often experience other symptoms such as shortness of breath, fatigue, sweating, and nausea more often than men.
  • And, what is very dangerous is that there may be cases where a heart attack occurs without any obvious signs or symptoms so that the person can be treated in time.

Additionally, people with coronary artery disease may also experience other symptoms that are not mentioned here. Therefore, if you have any concerns about the symptoms and signs of this disease, you need to see a specialist doctor so that you can proactively prevent and treat it in time.
In particular, when you notice or determine for yourself that you are having a heart attack, immediately call your local emergency numbers. Or, you can have someone else drive you to the nearest hospital. Please note that self-driving in the hospital is only a last resort.
If you have risk factors for Coronary artery disease, such as high blood pressure, high cholesterol, smoking, diabetes, obesity, and a family history of heart disease, talk to your doctor. Your doctor may want to check for coronary artery disease, especially if you have signs or symptoms of narrowing of the arteries.

CAUSES OF CORONARY ARTERY DISEASE

Classical risk factors, i.e., long-established risk factors

In fact, many risk factors have been identified as the causes that increase the risk of atherosclerosis, which causes Coronary artery disease. As following:

  • Age. The older you are, the higher your risk for Coronary artery disease. In fact, coronary artery disease typically occurs in men over 50 and women over 55.
  • Sex. In general, men are more at risk than women of contracting cardiovascular diseases. However, postmenopausal women also have a significantly increased risk of coronary artery disease compared to women of other ages.
  • Family story. A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative had heart disease as a child. Your risk is highest if your father or brother was diagnosed with heart disease before age 55 or if your mother or sister developed it before age 65.
  • Diseases associated with coronary artery disease. coronary artery disease easily occurs in patients with concomitant high blood pressure, diabetes or insulin resistance, dyslipidemia – high cholesterol, obesity, etc. or plaques made up of cholesterol and other cellular wastes tend to build up at the injured site. This process is called atherosclerosis. If the surface of the plaque breaks or ruptures, blood cells called platelets will clump together at this damaged site in an attempt to repair the artery. And, this block can clog an artery, leading to a heart attack.
  • Sedentary lifestyle. People who sit often, do not exercise regularly, are sedentary will have a higher risk of cardiovascular disease and other related diseases.
  • Smoke. Smoking habits not only increase the risk of diseases such as lung cancer, oropharyngeal cancer, but can also cause cardiovascular disease.
  • Alcohol addiction. Drinking too much alcohol is also a major cause of myocardial ischemia and angina pectoris.
  • Bad eating habits. Eating too many foods high in saturated fat, trans fat, salt, and sugar can increase your risk for coronary artery disease.
  • Mental stress. The unresolved stress in your life can damage your arteries and worsen other risk factors for coronary artery disease.

Other risk factors

Coronary artery disease can also develop without any of the above risk factors, called classic risk factors. Researchers are now also studying other risk factors that can also cause coronary artery disease, such as:

  • Sleep Apnea. This disorder causes the person to stop breathing intermittently while they sleep. The sudden drop in blood oxygen levels that occurs with sleep apnea increases blood pressure and puts stress on the cardiovascular system, which can lead to coronary artery disease.
  • High sensitivity C-reactive protein (hs-CRP). This is a special protein, usually present in higher than normal amounts when a person has inflammation somewhere in the body. When this protein is formed at high levels, it can be a risk factor for heart disease.
  • High triglycerides. It’s the name for triglycerides, a type of fat found in our blood. However, high levels of triglycerides can increase the risk of coronary artery disease, especially in women.
  • Homocysteine. Homocysteine ​​is an amino acid needed by the body to make proteins to build and maintain tissue. However, high levels of homocysteine ​​can increase the risk of coronary artery disease.
  • Preeclampsia. This condition can develop in women during pregnancy, causing high blood pressure and higher levels of protein in the urine. This can lead to a higher risk of heart disease later in life.
  • Alcoholism. Regular excessive consumption of alcohol can damage the heart muscle. It can also worsen other risk factors for coronary artery disease.
  • And autoimmune diseases. People with conditions such as rheumatoid arthritis and lupus (and other inflammatory conditions) have a higher risk of developing atherosclerosis.

COMPLICATIONS OF CORONARY ARTERY DISEASE

Coronary artery disease can lead to dangerous complications such as:

  • Chest pain is also known as angina pectoris. When the coronary arteries are narrowed, the heart may not be able to receive enough blood, especially when the need is greatest, such as during physical activity. This can cause chest pain or difficulty breathing.
  • Heart attack. If the cholesterol plaque ruptures and forms a blood clot, complete blockage of a heart artery can cause a heart attack. Lack of blood flow to the heart can damage the heart muscle, the extent of which depends in part on how quickly the treatment is correct and timely.
  • Heart failure. If certain areas of the heart are chronically deprived of oxygen and nutrients due to reduced blood flow, or if the heart is damaged by a heart attack, the heart may become weak and unable to pump enough blood to meet needs. of the body. This condition is called heart failure.
  • And, an abnormal heart rhythm (i.e. arrhythmia). Insufficient blood supply to the heart or damage to heart tissue can interfere with the heart’s electrical impulses, causing an irregular heartbeat.

TREATMENT OF CORONARY ARTERY DISEASE

Treatment for Coronary artery disease usually includes lifestyle changes and, if necessary, your doctor’s instructions on medications and possibly appropriate medical procedures.

Lifestyle change

If you’re at risk for or already have coronary artery disease, healthy lifestyle changes can help speed healing processes and make your arteries healthier, in particular….

  • Stop smoking and avoid second-hand smoke
  • A good diet: Avoid fast processed foods high in fat and eat a diet low in salt and sugar. Eat heart-healthy “golden foods” including whole grains, green vegetables, fruits, legumes, nuts and seeds.
  • Limit or say no to alcohol if necessary.
  • Regular exercise. However, for cardiovascular disease, patients should discuss with their doctor the choice of the form and intensity of exercise appropriate for their condition.
  • Good control of co-morbidities: Patients need regular check-ups to quickly detect and treat diseases linked to coronary artery disease, such as diabetes, obesity, overweight, dyslipidemia, hypertension, etc.
  • Adopt a positive, serene and happy lifestyle, avoid excessive stress, adopt a reasonable lifestyle, work in moderation, and manage your time effectively.

Drug treatment

Many medications can be used to treat coronary artery disease, including:

  • Drugs that regulate cholesterol. Your doctor can choose from a variety of medications, including statins, niacin, fibrates, and bile acid sequestrants. These drugs reduce (or change) large deposits on the coronary arteries. The result is a reduction in cholesterol levels – especially a reduction in “bad” cholesterol.
  • Aspirin. Your doctor may recommend that you take aspirin or another blood thinner daily. This can reduce your tendency to clot and can help prevent blockages in your coronary arteries.
  • If you’ve had a heart attack, aspirin can help prevent future attacks. But be aware that aspirin can be dangerous if you have a bleeding disorder or are taking any other blood thinner, so you should consult your doctor before taking it.
  • Beta-blockers. These drugs slow down the heart rate and lower blood pressure, thereby reducing the heart’s need for oxygen. If you’ve had a heart attack, beta blockers lower your risk of future attacks.
  • Calcium blockers. These medicines can be used in combination with or instead of beta blockers in cases where you cannot take them. These calcium blockers can help improve symptoms of chest pain.
  • Ranolazine. This medicine can help people with chest pain (angina). It can be prescribed with or instead of a beta blocker if you cannot take it.
  • Nitroglycerine. Nitroglycerin tablets, sprays, and patches can control chest pain by temporarily dilating the coronary arteries and reducing the heart’s need for blood.
  • ACE inhibitors and angiotensin II receptor antagonists (ARBs). These same drugs lower blood pressure and may help prevent the progression of coronary artery disease.

And, in case more aggressive treatment is needed. Doctors will decide for you the intervention options using modern medicine. Here are some options that are currently widely used for patients with coronary artery disease:

Modern medical methods

Here are some options that are currently widely applied to patients with coronary artery disease:

  • Angioplasty and stenting (percutaneous coronary revascularization). Doctors insert a long, thin tube (catheter) into the narrowed part of the artery, which helps blood flow to the enlarged artery. Most stents release medication slowly to help keep the arteries open.
  • Coronary artery bypass grafting. The surgeon will use an artery from another part of your body to create a graft to bypass the blocked coronary arteries. This allows blood to flow around the blocked or narrowed coronary artery. Since this requires open heart surgery, it is usually only done for people who have multiple narrowed coronary arteries.

Other methods

In addition, scientists are also studying other ways to treat coronary artery disease, such as:

  • Use of angiogenesis: this method applies properties related to stem cells and other genetic materials. Angioplasty is given intravenously or directly into damaged heart tissue
  • Improved External Counterpulsation (The exalted external counterpulsation _ Improved External Counterpulsation). This method is applied to cases of long-lasting coronary artery disease and angina pectoris that becomes chronic, for which nitrate-based drugs are not effective or the patient is not eligible for the intervention. This is a procedure that uses a ring in the leg to inflate and deflate, in order to increase the blood supply to the coronary arteries.

About Post Author

Maître VIKUDO

Docteur en Physiopathologie
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