Coronary
Heart Disease
Coronary
heart disease - a worldwide epidemic Many
people worldwide suffer from coronary heart disease (CHD). CHD is
the leading cause of death throughout the world. In industrialized
countries every up to 4th to 14th death is due to CHD (World Health
Statistics Annual 1997-1999). The incidence of CHD in Eastern Europe,
the former Soviet Union and in developing countries is increasing
at an alarming rate.
Causes
of coronary heart disease
Coronary heart disease is caused by a narrowing of the
coronary arteries supplying the heart with blood, oxygen and nutrients
(see diagramm above). Deposits of cholesterol, cells and fat-like
substances build up plaques in the artery wall which in turn causes
a narrowing and hardening of the arteries, called arteriosclerosis.
This process starts in childhood and progresses over decades. In
the course of this process the artery diameter shrinks and the blood
flow decreases, resulting in an insufficient supply of oxygenated
blood to the heart muscle cells. What are the consequences
of coronary heart disease and arteriosclerosis in general?
Narrowed arteries may get blocked through blood clots resulting
from plaques which break away from the arterial wall. If this occurs
in a coronary artery, the heart muscle is not supplied with blood,
oxygen and nutrients. Heart muscle cells suffer permanent injury
and die - thus causing a heart attack (myocardial infarction). If
a blockage takes place in a blood vessel that supplies the brain
it may trigger a stroke (apoplexie).
Arteriosclerosis may not only cause a heart attack or stroke, but
can also have consequences in other arteries in the body. Arteriosclerosis
may likewise lead to a:
- widening
of the aorta, the main artery leading from the heart (aortic aneurysm).
- narrowing
or even complete occlusion of the arteries of the legs with intermittent
claudication - pain on walking - and even gangrene.
obstruction
of the lung artery triggering a pulmonary embolism, which results
in breathlessness (dyspnea), anxiety of suffocation and spasm or
death. View of a blood vessel:
Progression of a healthy to a completely occluded artery
Healthy
artery
deposits of fatty substances
(plaque starts building up)
progression
of narrowing and hardening
of the arterial wall; decrease of lumen size
plaque
rupture;
the resulting blood clot blocks an artery;
consequences: heart attack, stroke or thrombosis
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Angina
Pectoris – a symptom of coronary heart disease
Angina pectoris literally means "strangling of the chest".
It refers to a severe pain in the chest which occurs when blood
supply to the heart muscle is limited by narrowing of a coronary
artery. This pain is often crushing in nature and may spread to
the left arm or jaw. It is sometimes accompanied by a feeling of
suffocation. In many cases, however, coronary artery disease progresses
silently and only becomes manifest when a heart attack or myocardial
infarction - death of part of the heart muscle due to lack of oxygen,
occurs "out of the blue".
Heart
attack warning signs
A heart attack
may occur suddenly and intensely. But most heart attacks begin slowly,
with minor pain or discomfort. Persons in the latter group are often
unsure about the cause of their pain and discomfort and may wait
too long before getting help. The warning signs of a heart attack
are
- Discomfort
such as an uncomfortable pressure or squeezing of the chest, or
a feeling of fullness or pain in the center of the chest that
lasts for more than a few minutes or that comes and goes.
- Pain or discomfort
in one or both arms, or in the back, neck, jaw or stomach.
- Shortness
of breath that may occur before or at the same time as the chest
discomfort
- Cold sweat,
nausea or a feeling of lightheadedness.
If you have
chest discomfort alone or one or more of the other symptoms, call
emergency services immediately. Every minute counts!
Coronary
heart disease – a multifactorial disease!
Several risk factors are involved in the development of coronary
heart disease. Risk factor identification and control is crucial
for preventing CHD and stroke. Everybody can contribute to the prevention
of a heart attack by adapting a risk-diminishing lifestyle. This
website provides you with respective recommendations and advice.
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