The Coronary Heart Disease: Symptoms and Treatment

Introduction

The human heart provides continuous pumping action throughout human life. The coronary artery supplies oxygen, nutrients, and other requirements in the blood to the heart tissue (Margolis & Gerstenblith, 2002). Due to different factors of varying significance, the flow of blood in the coronary artery may become obstructed. This results in coronary heart disease, abbreviated as (CHD). Over years, plaque settles on the walls of the vessel, and grows gradually to significantly obstruct blood flow (Hu & Willett, 2002). Total blockage of the coronary artery culminates in a cardiac arrest. This is a condition where a portion of cardiac tissue suffers trauma due to the obstruction of blood supply. Sometimes, the disease can be caused by other disorders within the heart’s vascular system. Diet and lifestyle affect the probability of occurrence of the disease (Hu & Willett, 2002). Atherosclerosis is the most common cause of the obstruction. Deposits of fat, minerals, and cholesterol in the coronary artery, and the hardening of the walls of the vessel are inherent characteristics of coronary heart disease.

Etiology

There is no single cause of coronary heart disease. Several conditions are described as risk factors that predispose an individual to the risk of developing the disease. Some hereditary risk factors occur due to inheritance of genes that contribute to occurrence of conditions that are favorable for the development of the disease. This leads to a family history of cases of the disease (Creemers et al., 2011). Disorders due to other diseases may also predispose an individual to risk. Persistent hypertension is one of the disorders that aid the development of the disease. Diabetes, a disease that is characterized by many disorders, including hypertension, is also a major risk factor regarding the development of coronary heart disease.

Certain lifestyles of an individual are major risk factors and are the causes of many cases of the disease. Consumption of excess alcohol is a major risk factor (Hu & Willett, 2002). However, smoking is a greater risk and a third of the cases are attributed to smoking. Smoking habit is known to interfere with the pace of the heartbeat. In addition, smoking causes hardening of the blood vessels. The narrowing of the coronary artery leads to coronary heart disease. Smoking also causes other risk factors such as hypertension, which develops because of narrowing of the blood vessels throughout the body (Maas & Appelman, 2010).

Inactivity and stress also cause a minor number of cases of the disease. However, the number of cases attributable to inactivity factor alone is small. Inactivity, or lack of exercise, causes other risk factors such as obesity, and thus it may indirectly lead to development of coronary heart disease. The contribution of stress to the development of the disease depends on the level and the time for which it lasts (Margolis & Gerstenblith, 2002). Consumption of certain fats such as the pomega-3 fats is also a contributor to the development of this disease.

Several other risk factors are not within the control of an individual. In addition to hereditary factors, age, effects of menopause and pregnancy are risk factors that cannot be effectively controlled by an individual. However, it is necessary to take more precaution if one is already predisposed to these risk factors.

Signs and Symptoms

Society normally associates coronary heart disease to men. However, it is the leading cause of death of women in developed nations. This fact is rarely noticed since most women never discover the presence of the disease until a fatality occurs. Most affected women do not survive the disease. More than half a million women die of cardiovascular disease in the United States (Maas & Appelman, 2010). This figure surpasses the number of deaths from all other terminal diseases. A quarter of all annual deaths of women in the US are due to CHD. Cardiovascular diseases are the diseases of the heart and the vascular system. The above statistics are according to statistics in a 2009 research (Maas & Appelman, 2010). Few women and medical practitioners believe that heart disease is a major threat to women’s lives. Only a tenth of the female population of the United States believe that there is a risk of development of such a disease in women. This sometimes leads to ignorance of the risk factors by women. One risk factor, vascular spasms of the coronary arteries, is more common in women than in men (Margolis & Gerstenblith, 2002).

Symptoms of coronary heart disease in women are different. However, they are not entirely different and women and men share a number of them. One common symptom of the disease is angina. This pain results from the trauma of the heart tissue. The pain may be more pronounced in men than in women. A typical symptom of a heart attack is a feeling of crushing pressure in the chest accompanied by severe pain. They may present a long time prior to the actual attack (Maas & Appelman, 2010). Cardiac arrest occurs due to the complete obstruction of the coronary artery when a blood clot lump becomes trapped in a thin coronary artery. Cardiac arrest is usually fatal, and the majority of its victims die from its effects on the brain and heart. When angina, the acute pain, sets in, the condition is usually in an advanced stage and some of the effects may not completely wear out even if the victim survives (Margolis & Gerstenblith, 2002).

Women may experience unusual fatigue several days prior to the actual myocardial infarction. Insomnia may also set in. This is also accompanied by unusual sweating even at a time, which an individual is relaxed. Pain is rarely reported in women prior to a heart attack (Mittal, 2005). During the actual cardiac arrest, shortness of breath and pain are usual symptoms. However, the severity of these symptoms is less in women. Some women may not experience any alarming symptoms prior or during the heart attack. When pain presents itself prior to the real heart attack, it is felt in other parts of the body rather than at the precise location of the heart in the chest (Mittal, 2005). Unusual pain in the back, the left arm, lower neck and the lower part of the head are some of the symptoms a woman may experience.

Women are not likely to suspect these as precursors to a cardiac arrest, and may ignore them. In addition, women may not identify these as symptoms. Thus, there is a tendency for medical practitioners to get reports of heart attacks with no prior symptoms at all (Creemers et al., 2011). Since the symptoms are not localized in the affected organ, some women may use painkillers while others may treat indigestion. This ignorance is the reason for the low survival rate of women affected by coronary heart disease.

Treatment

A risk assessment is used to diagnose the presence of the disease. This helps prevent myocardial infarction, whose ultimate consequences are death of the affected individual. Framingham Risk Estimation is used to predict the probability of occurrence of the disease in an individual in future (Creemers et al., 2011). In case of serious symptoms, a surgical form of coronary angiography is carried out to assess the condition of the arteries. This method is highly invasive. A less invasive method to perform the diagnostic test includes use of imaging technology such as CT. Echocardiograms and electrocardiograms are some of the methods that have little effect on the body. Magnetic resonance imaging is also used in the examination of the coronary artery.

Prognosis

Coronary heart disease can be avoided by living a risk free life. For individuals who are under medication to prevent the development of the disease, it is important to observe the recommendations of the physician. Bypass surgery to correct the obstruction in the coronary artery may also aid the survival of the victim (Mittal, 2005). Although the survival rate is very low, early identification of the symptoms and early treatment are important measures to avoid a cardiac arrest. Current studies indicate those medics are usually too optimistic of survival of people suffering from coronary heart disease. The prevailing health conditions of an individual are major determinants of the chances of survival of an individual who has suffered cardiac arrest. Younger people have higher chances of surviving a cardiac arrest due to the prevailing health of their bodies (Mittal, 2005). Extensive damage to the brain during a heart attack limits the probability of survival.

Conclusion

Although coronary heart disease is a disease associated with men, it is the leading cause of mortality among women in developed countries. It also causes a significant number of deaths in developing countries. It is important for women to take precaution against the disease and even seek early treatment. However, an awareness campaign is needed to initiate such efforts.

References

Creemers, E., Wilde, A., & Pinto, Y. (2011). Heart failure: advances through genomics. Nature Reviews Genetics, 12(5), 357-362.

Hu, F., & Willett, W. (2002). Optimal diets for prevention of coronary heart disease.. JAMA, 288(20), 2569-2578.

Maas, A., & Appelman, Y. (2010). Gender differences in coronary heart disease.. Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 18(12), 598-602.

Margolis, S., & Gerstenblith, G. (2002). Coronary heart disease. Baltimore, Md.: Johns Hopkins Medical Institutions.

Mittal, S. (2005). Coronary heart disease in clinical practice. London: Springer.

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