Coronary Heart Disease - Research Paper Example

? Coronary Heart Disease s Heart ailments and cardiovascular diseases are the most common causes of death in the U.S. It is acommon myth that heart problems target the old and the obese only, but in reality; just about anyone is prone to develop heart problems. The most common type of heart problem is the narrowing of the coronary blood vessels. This disease is known as Coronary Heart diseases and is the main cause of heart attacks. Coronary Heart disease (Coronary artery disease) is better known as Coronary atherosclerotic heart disease or simply atherosclerosis, in which the arteries become narrower and disrupt the blood flow. Atheromatous plaque deposits in the arteries, which gradually narrows down the arteries. The coronary arteries which supplies blood to the heart to enable smooth working of the cardiac muscles, fail to supply enough blood to the heart causing a number of complications. CAUSES OF PLAQUE ACCUMULATION The pathogenesis of the disease is not known however there are two proposes hypothesis that explain the accumulation of plaque on the artery walls. The first hypothesis is the Lipid hypothesis. The Lipid Hypothesis was proposed by Rudolf Virchow and according to this hypothesis high dietary intake of saturated fats increases LDL levels in the body which promotes lipid penetration into the walls of the coronary artery. The oxidized LDL cannot be easily removed and hence keeps on accumulating in the arteries. The other hypothesis which was proposed by Ross and Glomset is called the chronic endothelial injury hypothesis according to which the Atheromatous plaque is formed when the GAG layer of the arterial walls uncovers the walls causing accumulation of oxidized LDL’s in the walls. EFFECT ON PATIENTS Atherosclerosis mainly affects the patient in three ways causing further complications. Firstly, the patient experiences Angina or a sharp pain in the chest. Angina occurs at times of increased physical activity like exercising, walking or running. The increased physical activities demand an increased supply of oxygen; however, the presence of plaque on the arterial walls fails to provide the required supply of blood. Therefore, the cardiac muscles experience a sudden cramp which is felt by the patient as a sharp pain in the chest or on the upper arms. The pain subsides once the activity is stopped. Atherosclerosis also causes myocardial infarction, popularly known as heart attack. Coronary infarction occurs when the cardiac muscles of the heart are permanently damaged. When the fatty plaques block the entire artery thereby stopping the flow of blood to the heart, some cells of the heart die giving rise to a dead patch in the heart. The effect of this dead patch in the heart is dependent on the location of the patch. The pain experienced by the patient during myocardial infarction is somewhat similar to the pain experienced in Angina except for the fact that it is prolonged in this case. The most important and dangerous consequence of plaque formation is sudden death of the patient. The heart muscles stop functioning entirely owing to the formation of blood clots in the plaques (Calnan, 1991) STATISTICS The American Heart Association in collaboration with CDC and NIH brings together the most recent statistics of heart disease every year. According to the recent statistical analysis “more than 2200 Americans die of CVD each day, an average of 1 death every 39 seconds” (Heart Disease and Stroke Statistics,2011). In total, almost 82 million U.S citizens suffer from this disease. According to a survey conducted by the National Health and Nutrition Examination, it was seen that men were more prone to CHD than women. SURGICAL TREATMENT OPTIONS Surgical treatments are available to alleviate the symptoms of the disease. A patient may opt for Coronary Artery bypass surgery where blood vessels are taken from other parts of the patient’s body and used to bypass the blocked artery. Another option is a fairly new one and is known as TransMyocardial Laser Revascularization. In this surgical procedure a laser is used to create blood channel perfusion in the cardiac muscles which assist the working of the coronary arteries. In cases of severe and irreversible damage to the arteries, heart transplantation is the best option. However, incase human hearts are not available, researchers suggest Xenotransplantation using the heart of other animal species.” At present, baboons are considered to be the primate of choice and pigs are also considered good donors because their organs are about the same size as those of humans.” (Foster,2004) Another widely used method is Angioplasty. This procedure involves the opening of the blocked arteries with the help of a balloon catheter. Once the deflated balloon reaches the desired site it is inflated using water. The balloon forced removal of the blockage and expansion of the artery thereby normalizing blood flow. LIFESTYLE CHANGE TREATMENT Surgical options help control the symptoms only; however, the actual cause of the diseases can only be eliminated by changing one’s lifestyle. Maintaining a normal weight with the suitable BMI is important. Exercising daily is also a good habit.” It has been known for years that regular physical activity that is intensive enough to improve and maintain cardio respiratory fitness confers benefits to the heart” (Bijnen et al, 1994). One must also limit intake of alcohol and quit smoking altogether. Dietary intake should be monitored to maximize intake of nutritious foods intake of fatty foods. According to a study published in the Journal of American Medical Association by Doyle et al (1964), cigarette smoking increased the mortality rates in CHD patients and it was inferred that quitting smoking would help one lower the risk of CHD. MEDICATIONS FOR CHD A variety of medications for CHD are available that can help control the symptoms and prevent further complications. Hypercholesterolemic drugs help in lowering the levels of LDL in the blood system and the drug works wonderfully when combined with a transformed lifestyle. Beta blockers are another class of medicines that prevent heart failure by inhibiting the work of adrenaline and slow down the heart rate thereby relieving the heart from stress. ACE inhibitors are also prescribed to patients prone to heart failure. The drug works by inhibiting constriction of the blood vessels thereby ensuring normal blood flow. Statins also reduce the level of cholesterol in the bloodstream. Shepherd et al (1995) studied the effects of a statin drug on men with CHD and noticed that “Pravastatin lowered plasma cholesterol levels by 20 percent and low-density lipoprotein cholesterol levels by 26 percent”. REFERENCES Bijnen, F. C., & Et al (n.d.). Physical Inactivity as a Risk Factor for Coronary Heart Disease: A WHO and International Society and Federation of Cardiology Position Statement. Bulletin of the World Health Organization, 72(1), 1-5. Calnan, M. (1991). Preventing Coronary Heart Disease: Prospects, Policies, and Politics. New York: Routledge. Doyle, J. T. (1964). The Relationship of Cigarette Smoking to Coronary Heart Disease The Second Report of the Combined Experience of the Albany, NY, and Framingham, Mass, Studies. The Journal of the American Medical Association, 190(10), 1-4. Heart Disease and Stroke Statistics—2011 Update1. About 1. About These Statistics2. American Heart Association's 2020 Impact Goals3. Cardiovascular Diseases4. Subclinical Atherosclerosis5. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris6. Stroke (Cerebrovascular Disease)7. High Blood Pressure8. Congenital Cardiovascular Defects9. Cardiomyopathy and Heart Failure10. Other Cardiovascular Diseases11. Family History and Genetics12. Risk Factor: Smoking/Tobacco Use13. Risk Factor: High Blood Cholesterol and Other Lipids14. Risk Factor: Physical Inactivity15. Risk Factor: Overweight and Obesity16. Risk Factor: Diabetes Mellitus17. End-Stage Renal Disease and Chronic Kidney Disease18. Metabolic Syndrome19. Nutrition20. Quality of Care21. Medical Procedures22. Economic Cost of Cardiovascular Disease23. At-a-Glance Summary Tables24. Glossary. (2010, December 15). Circulation. Retrieved March 13, 2013, from http://circ.ahajournals.org/content/123/4/e18.long Shepherd , J., & Et al (1995). PREVENTION OF CORONARY HEART DISEASE WITH PRAVASTATIN IN MEN WITH HYPERCHOLESTEROLEMIA. The New England Journal of Medicine, 333(20), 1301-1303. The Mag: Dr FORSTER - Should We Use Animal Organs?; Coronary Heart Disease Is the Leading Cause of Death in the UK and the Most Effective Treatment Is Organ Transplantation. Dr George Forster Gives You the Facts. (2004, February 15). Sunday Mercury (Birmingham, England), p. 45. Read More