Blood flows through the coronary arteries to supply oxygen and nutrients to the heart. Atherosclerosis, the gradual build-up of fatty substances on the walls of coronary arteries, may eventually lead to partial or complete blockage of blood flow. The result is coronary artery disease (CAD), or coronary heart disease (CHD). CHD is a silent disease until it results in serious chest pain, called angina, or a heart attack.
Who gets CHD?
We all develop some degree of atherosclerosis of the coronary arteries as we age, but not everyone has CHD. CHD causes symptoms of angina or heart attack in over 12 million American adults. About 1.1 million have a heart attack each year and just under 500,000 people die of heart attacks.
How is CHD diagnosed?
No single test is used to diagnose coronary heart disease. Blood tests and special procedures to Go to the Hospital if You Have:
Sudden crushing or squeezing chest pain ,pain radiating to the jaw and left arm ,sudden pain radiating to the back, chest palpitations plus shortness of breath, nausea, sweating or dizziness If your angina medication is not relieving your chest pain
The heart is a muscle that acts as a pump. The heart pumps blood, rich in carbon dioxide and depleted of oxygen, through the lungs. The lungs remove carbon and add oxygen. Once oxygenated, the blood returns to the heart to be pumped to the rest of the body. After blood circulates through body tissues, it is returned to the heart and the process is repeated.
For the heart to do its job, it needs oxygen. There are special blood vessels on the outside of the heart, called coronary arteries, which supply the heart with oxygen. When one or more of these vessels becomes blocked (usually from a clot that has formed in the vessel), blood cannot get through this area and into the heart. Within about 20 minutes of not receiving blood and oxygen, the heart begins to die. When heart tissue dies, it can no longer contract or function as it did before. Heart attacks can destroy different areas of the heart, depending on where the blockage is.
When should I go to the hospital if I am experiencing chest pain?
If you are having chest discomfort and believe you may be having a heart attack, immediately get to the nearest hospital. Do not drive yourself. Call your local emergency number.
Making the decision to get to a hospital immediately is often the most important factor in determining if you live. Research shows one in three people die from a heart attack within the first few hours after the heart attack begins.
For a few days following a heart attack, patients are observed in a special area of the hospital called the cardiac care or intensive care unit (CCU or ICU). During this time, physical activity and visitors may be restricted and patients are encouraged to rest. Special monitoring devices are used to help the medical team identify and treat any complications that may occur.
For many people, a heart attack is the first sign that they have coronary artery disease. Before a patient is discharged from the hospital, he or she will often undergo another series of diagnostic tests to assist the physician in evaluating the extent of the heart disease. Some examples of these tests include:
During this test, a small catheter is inserted through an artery in the arm or leg and then guided into the coronary arteries of the heart to obtain information about the coronary arteries. Dye is injected to visualize the coronary arteries. The test is not painful, but some patients report a warm sensation when the dye is injected.
If thrombolytic agents were not given or did not relieve the heart attack symptoms, your physician may decide to perform angioplasty. Angioplasty can be done during a cardiac catheterization. It involves the placement and blowing up of a small balloon at the site of a coronary artery blockage. The balloon can cause the vessel to stretch or it can compress the area of blockage, with the end result of increasing blood flow to the heart. Usually, a stent is also placed in the vessel to prevent it from collapsing or from having a blood clot form at the site of the blockage.
Coronary artery bypass grafting (CABG)
If angioplasty is not indicated, either because of the site of the blockage or the degree of blockage present, the physician may recommend bypass surgery. This procedure involves a major surgical operation where a portion of a vein taken from the patient’s leg, or an artery taken from the chest, is used to enable blood to flow around the blockage. If needed, several areas of blockage can be bypassed during this procedure. This surgery involves splitting the chest bone to gain access to the heart. Hospital stays vary but usually last four to six days.
A newer technique, called minimally invasive bypass surgery, which involves smaller incisions and does not necessitate opening the chest bone, is being used for a small percentage of patients requiring coronary artery bypasses.
What can I expect after hospital discharge?
Following discharge from the hospital, patients continue their recovery at home. It is not unusual for your physician to prescribe medications that you will need to take on a daily basis. These medications will vary, depending on the extent of heart disease and other existing medical conditions. Most people will be placed on a daily aspirin, a beta-blocker and a cholesterol-lowering statin. It is important to take the medication as directed and to report any unusual side effects to your physician.
Activity may be restricted initially. Before you leave the hospital your physician will discuss limitations regarding employment and sexual activity. Your treatment plan may include modifications to your diet and exercise routine. Of course if you smoke, it is essential that you quit.
Courtesy: The News