Coronary disease

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Coronary heart disease
Classification and external resources
ICD-10 I25.1
ICD-9 414.00
MedlinePlus 007115
MeSH D003327

Coronary heart disease (CHD) is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis (sometimes called “hardening” or “clogging” of the arteries) is the buildup of cholesterol and fatty deposits (called plaques) on the inner walls of the arteries. These plaques can restrict blood flow to the heart muscle by physically clogging the artery or by causing abnormal artery tone and function.

Without an adequate blood supply, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. This can cause chest pain called angina. If blood supply to a portion of the heart muscle is cut off entirely, or if the energy demands of the heart become much greater than its blood supply, a heart attack (injury to the heart muscle) may occur. Coronary heart disease (CHD) is the leading cause of death for both men and women and accounts for approximately 600,000 deaths in the United States every year.[1]

It is most commonly equated with atherosclerotic coronary artery disease, but coronary disease can be due to other causes, such as coronary vasospasm,[2] where the stenosis to be caused by spasm of the blood vessels of the heart it is then usually called Prinzmetal's angina.[3]

Contents

Causes [edit]

Coronary artery disease has a number of well determined risk factors. The most common risk factors include smoking, family history, hypertension, obesity, diabetes, high alcohol consumption, lack of exercise, stress, and hyperlipidemia.[4] Smoking is associated with about 54% of cases and obesity 20%.[5] Lack of exercise has been linked to 7–12% of cases.[5][6]

Job stress appear to play a minor role accounting for about 3% of cases.[5] In one study, women who were free of stress from work life saw an increase in the diameter of their blood vessels, leading to decreased progression of atherosclerosis.[7] Contrastingly, women who had high levels of work-related stress experienced a decrease in the diameter of their blood vessels and significantly increased disease progression.[7] Also, having a type A behavior pattern, a group of personality characteristics including time urgency, competitiveness, hostility, and impatience [8] is linked to an increased risk of coronary disease.[9]

Parental history of high blood pressure can also contribute to a higher risk of heart disease in an individual. People whose parents are hypertensive have greater systolic and diastolic blood pressure numbers when compared with individuals without hypertensive parents. High blood pressure has been shown to be a cause of heart disease.[10]

Diagnosis [edit]

For symptomatic patients, stress echocardiography can be used to make a diagnosis for obstructive coronary artery disease.[11] The use of echocardiography is not recommended on individuals who are exhibiting no symptoms and are otherwise at low risk for developing coronary disease.[11]

Treatment [edit]

Lifestyle [edit]

Lifestyle changes have been shown to be effective in reducing (and in the case of diet, reversing) coronary disease:

Medications [edit]

Surgery [edit]

Non-surgical [edit]

References [edit]

  1. ^ "Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC.". Retrieved 25 March 2013. 
  2. ^ Williams MJ, Restieaux NJ, Low CJ (February 1998). "Myocardial infarction in young people with normal coronary arteries". Heart 79 (2): 191–4. doi:10.1136/hrt.79.2.191. PMC 1728590. PMID 9538315. 
  3. ^ Rezkalla SH, Kloner RA (October 2007). "Cocaine-induced acute myocardial infarction". Clin Med Res 5 (3): 172–6. doi:10.3121/cmr.2007.759. PMC 2111405. PMID 18056026. 
  4. ^ "Causes". Coronary artery disease. Mayo Foundation for Medical Education and Research. 29 June 2012. DS00064. 
  5. ^ a b c Kivimäki M, Nyberg ST, Batty GD, et al. (October 2012). "Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data". Lancet 380 (9852): 1491–7. doi:10.1016/S0140-6736(12)60994-5. PMC 3486012. PMID 22981903. 
  6. ^ Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT (July 2012). "Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy". Lancet 380 (9838): 219–29. doi:10.1016/S0140-6736(12)61031-9. PMID 22818936. 
  7. ^ a b Wang HX, Leineweber C, Kirkeeide R, et al. (March 2007). "Psychosocial stress and atherosclerosis: family and work stress accelerate progression of coronary disease in women. The Stockholm Female Coronary Angiography Study". J. Intern. Med. 261 (3): 245–54. doi:10.1111/j.1365-2796.2006.01759.x. PMID 17305647. 
  8. ^ Andreassi, John L. (2000). Psychophysiology : human behavior and physiological response. Mahwah NJ: L. Erlbaum. p. 287. 
  9. ^ McCann S.J.H. (November 2001). "The precocity-longevity hypothesis: earlier peaks in career achievement predict shorter lives". Pers Soc Psychol Bull 27 (11): 1429–39. doi:10.1177/01461672012711004. 
    Rhodewalt; Smith (1991). "Current issues in Type A behaviour, coronary proneness, and coronary heart disease". In Snyder, C.R.; Forsyth, D.R. Handbook of social and clinical psychology: the health perspective. New York: Pergamon. pp. 197–220. ISBN 0080361285. 
  10. ^ Andreassi, John L. (2000). Psychophysiology: Human Behavior & Physiological Responses. Mahwah NJ: L. Erlbaum. 
  11. ^ a b American Society of Echocardiography, "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation (American Society of Echocardiography), retrieved February 27, 2013 , citing
    • Douglas, P. S.; Garcia, M. J.; Haines, D. E.; Lai, W. W.; Manning, W. J.; Patel, A. R.; Picard, M. H.; Polk, D. M. et al. (2011). "ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography". Journal of the American College of Cardiology 57 (9): 1126–1166. doi:10.1016/j.jacc.2010.11.002. PMID 21349406.  edit
    • Gibbons, R. J.; Abrams, J.; Chatterjee, K.; Daley, J.; Deedwania, P. C.; Douglas, J. S.; Ferguson, T. B.; Fihn, S. D. et al. (2003). "ACC/AHA 2002 guideline update for the management of patients with chronic stable angina—summary article". Journal of the American College of Cardiology 41 (1): 159–168. doi:10.1016/S0735-1097(02)02848-6. PMID 12570960.  edit
    • Greenland, P.; Alpert, J. S.; Beller, G. A.; Benjamin, E. J.; Budoff, M. J.; Fayad, Z. A.; Foster, E.; Hlatky, M. A. et al. (2010). "2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults". Journal of the American College of Cardiology 56 (25): e50–103. doi:10.1016/j.jacc.2010.09.001. PMID 21144964.  edit
  12. ^ Esselstyn CB (2001). "Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition". Prev Cardiol 4 (4): 171–7. doi:10.1111/j.1520-037X.2001.00538.x. PMID 11832674.  at Prevent and Reverse Heart Disease site
  13. ^ Morrison LM (June 1960). "Diet in coronary atherosclerosis". J Am Med Assoc 173 (8): 884–8. doi:10.1001/jama.1960.03020260024006. PMID 14424373. 
  14. ^ a b c "Treatments and drugs". Coronary artery disease. Mayo Foundation for Medical Education and Research. 29 June 2012. DS00064. 
  15. ^ "Coronary Heart Disease (CHD)". Penguin Dictionary of Biology. 2004. 
  16. ^ "Fish oil". MedlinePlus, Natural Medicines Comprehensive Database. U.S. National Library of Medicine. 23 July 2012. 
  17. ^ Linden W, Stossel C, Maurice J (April 1996). "Psychosocial interventions for patients with coronary artery disease: a meta-analysis". Arch. Intern. Med. 156 (7): 745–52. doi:10.1001/archinte.1996.00440070065008. PMID 8615707. 
  18. ^ Gutierrez, J; Ramirez, G; Rundek, T; Sacco, RL (2012 Jun 25). "Statin therapy in the prevention of recurrent cardiovascular events: a sex-based meta-analysis.". Archives of internal medicine 172 (12): 909–19. PMID 22732744. 

See also [edit]

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