Coronary Heart Disease. The arteries are the cylinders that carry blood from the heart to the rest of the body. As part of the getting old process, the arteries become less flexible and their diameter may narrow. For instance, a clot may form in a narrowed artery and block it. The muscle of the heart has four most important coronary arteries nourishing it. These arteries are likely to harden atherosclerosis. As the arteries become diseased their volume is reduced and the heart muscle may become weaker. This chronic problem may lead to angina, central chest pain on effort or heart failure. Sometimes a blood clot forms blocking a coronary artery, coronary thrombosis. The heart muscle suddenly deprived of oxygen is the site of the typical acute central chest pain. A severe heart attack is one of the commonest causes of death. An exciting recent development has been marked that coronary artery disease may have a transmittable cause. One study has shown that men who had received antibiotics for infections were later less likely to have coronary problems. Impedance or blockage of one or more arteries that supply blood to the heart usually due to atherosclerosis hardening of the arteries. Abbreviated CAD.
A major cause of illness and death CAD starts when hard cholesterol elements plaques are placed within a coronary artery. The plaques in the coronary arteries can lead to the development of tiny clots that can block the flow of blood to the heart muscle making symptoms and signs of CAD as well as chest pain, angina pectoris heart attack, myocardial infarction, and sudden death. Treatment for CAD includes bypass surgery balloon angioplasty and the use of stents.
1 2 Prevalence and Incidence. Cardiovascular diseases are becoming a major health burden in developing countries. These are the number 1 cause of death globally more people die annually from Cardiovascular diseases than from any other cause. An assessed 17.7 million people died from CVDs in 2015 representing 31 of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6 7 million were due to stroke. Over three-quarters of CVD deaths take place in low and middle-income countries. Out of the 17 million premature deaths under the age of 70 due to noncommunicable diseases in 2015, 82 are in low and middle-income countries and 37 are caused by CVDs. World Health Organization WHO guesses that in the low-income countries the number of deaths due to cardiovascular disease CVD is on the fixed rise. Eighty percent of deaths due to CVD and 86 of the global burden of CVD are in the evolving countries including Pakistan. Of the 2000 persons who studied 125 6 25 had documented IHD. Pakistans population is currently estimated as 163 million. Only half this population is more than 20 years old. Therefore the results are applicable to 81.5 million persons. The disease burden of IHD is therefore estimated as 5 09375 million IHD was seen more commonly in men compared to women in all age groups despite variation in other risk factors. The relative difference in CHD prevalence between sexes was largest among the youngest subjects up to 50 years old and the smallest among the subjects 58- 65 years old.
Pakistani population has one of the highest risks of coronary heart disease CHD in the world. In Pakistan 30 to 40 percent of all deaths are due to cardiovascular diseases CVD. The CHD deaths in Pakistan has reached about 200 000 per year that is 410 100 000 of the population. But the Incidence of Ischemic heart disease IHD in developing countries is very scarce and routinely collected data are often incomplete and unreliable. 1 3 Mortality and Morbidity of Coronary heart disease Ischaemic heart disease IHD is estimated to be the important cause of mortality in the world and in high-income countries it is also the important cause of premature mortality and disability. Each year IHD kills an estimated 7 million people representing 13 of all male deaths and 12 of all female deaths. Moreover, 56 of those deaths occur before age 75 years. Recently recorded death rates from IHD vary widely across countries, age-standardized rates for males for the population aged over 30 range from more than 900 per 100 000 in some Eastern European countries Turkmenistan, Republic of Moldova, Belarus, Ukraine to 84 per 100 000 in Japan for females the matching range is from more than 500 per 100 000 in Turkmenistan, Republic of Moldova and Ukraine to less than 50 per 100 000 in France and Japan.
Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2015 were in men. 1 About 630 000 Americans die from heart disease each year that’s 1 in every 4 deaths. 1. 1.4 Signs and Symptoms.
The most common sign of coronary artery disease is angina or chest pain. Angina can be defined as a discomfort heaviness pressure aching, burning fullness squeezing or painful feeling in your chest. It can be mistaken for indigestion or heartburn. Angina may also be felt in the shoulders, arms, neck, throat, jaw or back. Other symptoms of coronary artery disease include Shortness of breath, Palpitations, irregular heartbeat. A faster heartbeat Weakness or dizziness, Sweating 1 5, Risk Factors of CHD High blood cholesterol and triglyceride levels, a type of fat found in the blood. High blood pressure Diabetes and prediabetes.Overweight and obesity. Smoking, Lack of physical activity, Unhealthy diet, Stress. 1 6 Diagnosis. To test CHD your doctor will Ask about your medical and family history. Check your blood pressure. Do a blood test to assess your cholesterol level. Before having the cholesterol test you may be asked not to eat for 12 hours so there is no food in your body that could affect the result.
Further tests To confirm a suspected diagnosis, you may be referred for more tests. Many different tests are used to diagnose heart-related problems including electrocardiograms. ECG Exercise stress tests. X rays Echocardiogram, Blood tests, Coronary angiography, Radionuclide, tests Magnetic resonance, imaging MRI scans. Computerized tomography CT scans. 1 7 Prevention. The importance of preventing and controlling risk factors such as smoking fatty diet inactive lifestyle and stress should be avoided as they are the main areas of focus in prevention. Avoiding foods rich in saturated fats is vital to reduce lipid levels in the blood and prevent arteriosclerosis. Adequate regular exercise is also important. 1 8 Introduction of CABG Surgery Coronary artery bypass grafting CABG is a type of heart surgery for patients with severe coronary heart disease CHD an important cause of death in Western countries The disease is categorized by a gradual build-up of fatty and calcium deposits plaque within the arteries that supply blood to the heart. This reduces the amount of blood flow to the heart causing chest pain or if the arteries are blocked completely causing a heart attack The aims of CABG surgery are to decrease symptoms decrease the risk of heart attack and improve survival Currently around half a million patients worldwide undergo CABG each year.
There is a real likelihood that these numbers will increase with a growing elderly population an increasing epidemic of diabetes and obesity, which all influence to the development of CAD and growing realization that PCI may merely delay definitive treatment. 1 8 1 Definition CABG is a technique that involves using an artery or vein from elsewhere in the body to bypass the congested vessels restoring suitable blood flow to the heart. The artery or vein is attached around the blockage so that there is a new path for oxygenated blood to spread the heart muscle. CABG is one treatment for CHD During CABG a strong artery or vein from the body is connected or grafted to the blocked coronary artery The grafted artery or vein bypasses that is going around the blocked portion of the coronary artery This creates a new passage and oxygen-rich blood is routed around the blockage to the heart muscle. 1 9 Goals of CABG Surgery. Improving your quality of life and reducing angina and other CHD symptoms. Permitting you to resume a more active lifestyle Improving the pumping action of your heart if it has been injured by a heart attack. Lowering the risk of a heart attack in some patients such as those who have diabetes Improving your chance of existence.
