Coronary Disease - Coursework Example

Coronary Disease Introduction In America, it is approximated that more than 80 million adults (one out of every three) suffer from one or more cardiovascular diseases. Among the total number, 38 million are those aged 60 years and above. These cardiovascular diseases include CAD (Coronary Artery Disease), Coronary Heart Disease (CHD) and myocardial MI (Myocardial infraction) (AHA 6). Annually, about one million more people suffer from a new form of myocardial infraction. CAD is in many cases caused by the atherosclerotic occlusion of the victim’s coronary arteries (AHA 6). The process of atherosclerosis can affect many of the body vessels of the victim’s body, and when it affects coronary arteries, it triggers the development of CAD (CDC 1138). Coronary Heart Disease (CHD) results from the lack of oxygen, following the impairment of the functionality of the heart – due to the inadequacy of the blood flowing to the heart. The inadequacy of blood flow to the heart is caused by the obtrusion of the flow of blood, due to atherosclerosis (restrictions in the blood circulation leading to the heart). The risk factors for CHD include modifiable factors, including high blood pressure, cigarette smoking, obesity stress, diabetes, and elevated serum cholesterol (CDC 1138). The second cluster of risk factors is the non modifiable factors, including genetic factors, sex, age and personality. The symptoms and the signs of CHD include a sudden heart attack, angina (chest pain) and a reduction of exercise tolerance. Discussion Among the affluent, coronary artery disease is the leading cause of death and disability than all other diseases, among them cancer. The symptoms of coronary disease include silent ischemia, myocardial infraction, unstable angina, arrhythmias, myocardial infraction, sudden death and heart failure. The pathophysiology of coronary disease Coronary disease is in most cases caused by the athermanous narrowing of vessels, leading to the occlusion. The initial development of atheroma starts during young adulthood. Mature plaques will be formed from two major contents, and the two main constituents are produced by a different cell population (Libby and Theroux 3481). The core lipids are produced by necrotic cells, which move to the intima and cause the ingestion of lipids. The connecting tissue matrix comes from smooth cells from muscles; these cells transit from the source to the intima, and then they proliferate and their phenotype is altered to form a fibrous casing, which encloses the lipid core. The accumulation of the two constituents leads to a developmental reduction in the cross-sectional area of the arteries. After the plaque leads to a diameter stenosis of 50 percent or the reduction of the cross-sectional area of the vessel by 75 percent, the outcomes include a reduction in the blood flow passing through the coronary artery, and during the conditions of exertion; it leads to angina (felt as chest pain) (Libby and Theroux 3482). Acute coronary incidents follow, after the formation of thrombus follows the disruption of a plaque. The injury of the intimal leads to the denudation of the lipid pool or the thrombogenic matrix, and that initiates thrombus formation. During the cases where myocardial infraction is acute, the occlusion process is much more complete as compared to the case of unstable angina. The downstream process of thrombus embolism may trigger the production of microinfarcts. The progression of the development of the restraining blood flow through the vessels leading to the heart, the degenerative processes that culminates as coronary disease starts developing. The degeneration stops or limits the flow of blood in one or more of the arteries that surround the heart. The compromised functionality of the heart arises from the vascular inflammation of vessels or the build-up of cholesterol, lipids, cellular debris and calcium inside the intima of the walls of the given vessels (processed discussed earlier). Coronary Artery Disease (CAD) refers to the accumulation of atherosclerotic matter at the walls of the coronary vessels, triggering the obstruction of blood flow, resulting in myocardial ischemia. Ischemia connotes the deprivation of oxygen, resulting from the insufficient perfusion, due to the insufficient supply that does not meet the demands for oxygen. The deprivation of oxygen leads to the development of IHD (Ischemic Heart Disease), which is a chronic, serious and life-threatening coronary disease in the US (Libby and Theroux 3481). The clinical problems related to coronary disease A patient’s illness is presented to the doctor as the clinical problems that are caused by the underlying health problem. The problems that make the patient to seek the services of the doctor could take the form of signs, symptoms, complaints or the finding from a diagnosis. The most common clinical problem for coronary disease is angina, where the patient complains of chest discomfort or chest pain (Libby and Theroux 3481). The pain or discomfort arises from the situation, where a given area of the muscles of the heart does not get enough blood, which is rich in oxygen. In many cases, the patient will report that they experience squeezing and pressure at the chest area, or at surrounding areas, including the arms, shoulders, jaw, neck and the back. In some cases, patients may report angina as the symptoms of indigestion. The distinction between the clinical problems of coronary disease with ordinary pain is that it intensifies during times of activity and relief during rest. Emotional distress is also likely to trigger the incidence of the pain. Other patients will consult medical personnel with complaints about shortness of breath, although this problem is reported among the patients likely to suffer from heart failure (Libby and Theroux 3482). In the case of heart failure, the heart is unable to pump enough blood for the body, and that leads to the build-up of fluids at the lungs, making breathing difficult. The severity of the symptoms depends on the extent of plaque build-up at the coronary vessels, leading to the narrowing of their cross-sectional size. Symptoms of Coronary disease Some of the patients of coronary heart disease do not show signs and symptoms; they suffer from silent coronary heart disease (CHD). In such cases, the condition may not be discovered, until the patient is showing the symptoms and the signs of arrhythmia, heart failure or heart attack. A heart attack takes place after the inflow of oxygenated blood is limited from reaching a given part of the heart muscles (Libby and Theroux 3481). This could take place, after plaque accumulation raptures, or in the case that a blood clot forms at the area with a plaque. Heart failure refers to the condition where the heart is unable to pump enough blood for the body, and the symptoms include shortness of breath. Arrhythmia takes place during a case when the heart beats too fast or skips some beats. Treatment of Coronary heart disease After CHD is diagnosed, there is no cure for the conditions, but the condition can be managed effectively using a blend of medicine, lifestyle change and in some cases, surgery. Using the proper treatment for CHD, the symptoms of the disease can be managed and reduced, and the functionality of the heart improved considerably (Smith 1050). Some of the changes that can help a patient in managing CHD include stopping smoking; it reduces a patient’s vulnerability to suffering from a heart attack considerably (Deckelbaum et al. 2010s). Other changes include exercising regularly and eating more healthy foods will also reduce a person’s risk of suffering from a heart attack (Dauchet et al. 2588). The prevalence of CHD The mortality rates caused by CHD have reduced in the US, since the 1960s, following improvements in the treatment and the management of the risk factors (CDC 1377). In 2010, the prevalence of CHD was highest among the population aged 65 and above, at 19. 8 percent; followed by the group aged between 45 and 64 years at 7.1 percent; 18 to 44 percent had a level of 1.2 percent. CHD was higher among men, at 7.8 percent and women at 4.6 percent (CDC 1377). Summary So far, there is no curative treatment for coronary disease, and that gives enough evidence to warrant more research in the field. One area that could be a priority is that of channeling more research into the role that n-3 fatty acids could play in addressing the problem of CHD and related conditions (Deckelbaum et al. 2010s). Medical personnel and dieticians should also explore the role of diet in preventing or sustaining the health of the people suffering from coronary diseases or those that are vulnerable to the disease (Dauchet et al. 2588). Works Cited AHA. Heart Disease & Stroke Statistics. American Heart Association: 2009 Update At-A- Glance, 2009. Web. 22 May. 2014. CDC. Prevalence of coronary heart disease--United States, 2006-2010. MMWR Morb Mortal Wkly Rep, 60.40(2011):1377-81. Dauchet, Luc, Amouyel, Philippe, Hercberg, Serge, and Dallongeville, Jean. “Fruit and vegetable consumption and risk of coronary heart disease: a metaanalysis of cohort studies.” J. Nutr, 136 (2006): 2588–2593. Deckelbaum, Richard, Leaf, Alexander, Mozaffarian, Dariush, Jacobson Terry, Harris, William, and Akabas, Sharon. “Conclusions and recommendations from the symposium, Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n-3 Fatty Acids.” Am J Clin Nutr, 87.6(2008):2010S-2S. Libby, Peter, and Theroux, Pierre. Basic Science for Clinicians: Pathophysiology of Coronary Artery Disease. Circulation, 111(2005): 3481-3488. Smith, Peter. Treatment selection for coronary artery disease: The collision of a belief system with evidence. J Thorac Cardiovasc Surg, 137.5(2009):1050-3. Read More