What is Coronary Heart Disease?
Coronary artery disease or coronary heart disease is a disease that occurs when vessels that supply blood to the heart gradually lose their structure and function. This is attributed to fat plaques that plug the lumen or inflammation in the wrong area.
Coronary arteries provide nutrients and oxygen to your heart. As fat accumulates in their lumen, they begin to supply less blood and starve the heart of oxygen and vital nutrients. This will cause symptoms such as chest pain (angina), fatigue and shortness of breath, and other life-threatening signs. If they are blocked completely, you risk getting a heart attack.
Because this is a chronic disease that takes years to develop, you may not be in distress until there’s a significant blockage in the arteries or a heart attack. Luckily, living a healthy lifestyle will prevent it or slow its progression.
How common is CHD?
CHD is one of the leading causes of death and disability in developed countries. As much as 30% of all deaths are because of CHD. About one in three women and half the male population are at risk of developing coronary artery disease in their lifetime.
When a woman hits menopause, she loses a vital hormone – estrogen. This is a protective hormone that keeps her from developing CHD, and this is the reason why women have a higher risk of developing and dying from CHD after menopause than men.
What are the causes and the mechanism of Coronary Heart Disease development?
Even though the heart pumps all blood in the body, it still needs some blood supply just like any other body tissue.
There’re vessels that supply the heart branch off the aorta and are known as coronary arteries (called coronary because they go around the heart and look like a crown).
Along their tracks, the coronary arteries divide into numerous smaller branches called arterioles that reach into all parts of the heart.
Because these two are the only vessels that supply the heart, it’s easily starved of oxygen and nutrients (ischemia) if one of their smaller branches gets blocked, and the result is coronary heart disease.
The leading cause of CHD is thought to be the deposition of fat plaques within coronary arteries in a process called atherosclerosis. As a result, less blood is able to pass through their narrow diameter.
Total blockage or arterial lumens leads to myocardial infarction, heart attack, and death. The severity of this disease depends on the size of the artery that is blocked and the level of the blockage. The larger the artery, the worse it gets. A sudden blockage is lethal and, most of the time, leads to death.
However, this disease is only noticed in the end-stage most of the time as it progresses slowly, and the heart remodels itself to cater to the mismatch in oxygen and nutrient supply. The artery duct also should be reduced by approximately 70%.
The course and prognosis
Coronary Heart Disease is a lifelong disease. This means that there is no chance of recovery except living with it and managing your symptoms. All interventions are aimed at controlling, slowing, or managing its symptoms but not recovering.
Unfortunately, because it affects such a vital organ, it causes diseases in almost all other parts of the body: brain, pancreas, liver, kidneys, and may simultaneously occur with other conditions such as hypertension, cardiovascular continuum, atherosclerosis, stroke, metabolic syndrome, atrial fibrillation, and others.
The main stages of the cardiovascular continuum can be described as follows.
Asymptomatic stage – the ducts are still wide enough, but the risk factors take a toll on the cardiovascular system.
The telltale signs are:
- High blood glucose
- Rise in cholesterol
In this early stage, fat plaques expand almost 50 times their original size. Cardiac muscles detect changes in oxygen and nutrient supply, go through remodeling, and results in heart failure.
The symptoms of acute heart failure
The typical symptoms of acute heart failure include:
- Dyspnea (shortness of breath)
- Missed beats and irregular heartbeats
- Chest pain
An ultrasound of the heart can depict an enlarged heart with larger than standard cavities. Ducts also appear narrow.
The hallmark of heart failure:
- Swollen ankles or body edema
- Lung congestions
- Deterioration in heart function
- Atrial fibrillation
- High blood pressure
- Angina-like pain (squeezing, sharp chest pain)
If any of these are present, a cardiac arrest or myocardial infarction is imminent.
Myocardial ischemia might not always lead to death, but it increases the chance of myocardial infarction. Know that it is easy to manage this condition through some straightforward lifestyle changes.
Risk factors for coronary artery disease include:
- Older age increases the risk of developing narrowed arteries.
- Men are generally affected more, but women are at higher risk after menopause.
- Family history. Scientists predict that there’s a chance of developing Coronary Heart Disease if a close family member also developed the disease.
- Both first- and second-hand smoking increases the risk of developing CHD.
- High blood pressure. Hypertension causes arteries to lose flexibility and get narrow, which impedes circulation.
- High blood cholesterol levels. There are two kinds of cholesterols: high-density lipoproteins (good fat) and low-density lipoprotein (bad fat)—low levels of HDL or high levels of LDL increaser the risk of developing atherosclerosis.
- Many factors, such as obesity and hypertension, are shared between diabetes and coronary artery disease.
- Uncontrolled weight (gain).
- Physical inactivity. This contributes to weight gain and high blood pressure, which only worsens all other factors.
- High stress. Stress has a negative effect on your immune system and may lead to uncontrolled inflammations in the body.
- Unhealthy diet. There is a thin line between eating too much food rich in fat, salt, and sugar and you developing CHD
One risk factor leads to another. For instance, obesity, hypertension, and diabetes are all linked and are lethal triad that increases the risk of coronary artery disease. On top of these, most of these factors are directly involved in the initiation of coronary artery disease. Some of these include metabolic syndrome – a condition associated with low amounts of HDL (“the good fat”), high triglycerides, obesity, and high blood pressure.