Thursday, January 24, 2013

What is a coronary heart disease? What are its symptoms, test, and treatment


What is a coronary heart disease? What are its symptoms, test, and treatment?
How is it detected during test?
Heart Diseases - 3 Answers
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1 :
Coronary heart disease (CHD), also called coronary artery disease (CAD) and atherosclerotic heart disease, is the end result of the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium (the muscle of the heart). While the symptoms and signs of coronary heart disease are noted in the advanced state of disease, most individuals with coronary heart disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a "sudden" heart attack, finally arise. After decades of progression, some of these atheromatous plaques may rupture and (along with the activation of the blood clotting system) start limiting blood flow to the heart muscle. The disease is the most common cause of sudden death. Symptoms --- The symptoms associated with coronary heart disease may be pronounced, but the disease can also exist with noticeable symptoms. Chest pain (angina) is the most common symptom, and it results from the heart not getting enough blood or oxygen. The intensity of the pain varies from person-to-person. Chest pain may be typical or atypical. Typical chest pain is felt under the sternum (breast bone) and is characterized by a heavy or squeezing feeling, it is brought on by exertion or emotion, and it is relieved by rest or nitroglycerin. Atypical chest pain can be located in the left chest, abdomen, back, or arm and is fleeting or sharp. Atypical chest pain is unrelated to exercise and is not relieved by rest or nitroglycerin. Atypical chest pain is more common in women. Typical chest pain and age indicate the chance of a person having CHD. For example, a 65-year-old woman with typical angina has a 91% chance of having CHD, while a 55-year-old woman with atypical angina has a 32% chance of having CHD. Other symptoms include: Shortness of breath -- This is usually a symptom of congestive heart failure. The heart at this point is weak because of the long-term lack of blood and oxygen, or sometimes from a recent or past heart attack. If the heart is not pumping enough blood to circulate in the body, shortness of breath may be accompanied by swollen feet and ankles. Heart attack -- In some cases, the first sign of CHD is a heart attack. This occurs when atherosclerotic plaque or a blood clot blocks the blood flow of the coronary artery to the heart. The coronary artery was likely already narrowed from CHD. The pain associated with a heart attack is usually severe, lasts longer than the chest pain described above, and is not relieved by resting or nitroglycerin. Signs and tests------- There are many tests that help diagnose CHD. Usually, more than one test will be done before a definitive diagnosis is made. Some of the tests include: Electrocardiogram (ECG) Exercise stress test Echocardiogram Nuclear scan Coronary angiography/arteriography Electron-beam computed tomography (EBCT) -- the purpose of this test is to identify calcium within the plaque found in the arteries. The more calcium seen, the higher the likelihood for CHD. Coronary CT Angiography Treatment Return to top The treatment for CHD varies depending on the symptoms and how much the disease has progressed. The general treatments include lifestyle changes, medications, and sometimes surgery. Lifestyle changes may include: Losing weight A low saturated fat, low cholesterol diet to help reduce cholesterol Reducing sodium (salt) to keep high blood pressure under control Regular exercise Quitting smoking Medications may include: Cholesterol-lowering medication Antiplatelet agents, such as aspirin, ticlopidine, or clopidogrel, to reduce the risk of blood clots Glycoprotein IIb-IIIa inhibitors, such as abciximab, eptifibatide, or tirofiban, to reduce the risk of blood clots Antithrombin drugs, such as blood-thinners (low-molecular heparin, unfractionated heparin), to reduce the risk of blood clots Beta-blockers to decrease heart rate and reduce oxygen use by the heart Nitrates such as nitroglycerin to dilate the coronary arteries and improve blood supply to the heart Calcium-channel blockers to relax the coronary arteries and all arteries in the body, thus reducing the workload for the heart ACE inhibitors, diuretics, or other medications to lower blood pressure Percutaneous Coronary Interventions (PCI's) include: Coronary angioplasty (Balloon PTCA) Coronary atherectomy Ablative laser-assisted angioplasty Catheter-based thrombolysis and mechanical thrombectomy Coronary stenting (placing a tube in the artery to keep it open) Coronary radiation implant or coronary brachytherapy Dr.Brijesh cw1067bk@yahoo.com
2 :
Heart disease, or coronary artery disease, is the result of plaque (fat) building up in the arteries (vessels that take blood away from the heart and feed the body) that stem directly from the heart. As it gets worse and time goes on, the symptoms can include being short of breath with minimal exercise. The worst case scenario is when the plaque ruptures (breaks free from the lining of the artery) and clogs blood flow, resulting in a heart attack (death of cardiac tissue). The symptoms of a heart attack are usually chest pain in the center of the chest, radiating down the left side or left arm. The tests they use in the hospital are EKG's, (electrocardiogram) and blood tests including CKMB's (creatine kinase myocardial bands) and troponins. If the heart has been damaged permanently it will cause cell breakdown and release these substances into the bloodstream, which is what the tests look for. Next step is a stress test, where they measure the effect of exercise on the heart. If it is positive, they will then do a cardiac cath. They put a small tube inside the biggest artery of your leg, feed the tube up into your heart, inject dye and watch on an Xray to see the pattern of blood distribution. They can detect artery constrictions this way and use the catheter to insert stents if necessary to keep the arteries open. If it is really bad, they will send the patient immediately for open heart surgery. I hope this answer helps. :)
3 :
Thank you Dr. Brijesh. It's good to know a doctor does these question and answer things



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