Coronary Heart Disease (IHD)

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What it is?

Coronary heart disease (CHD) is an insufficient supply of blood to the heart muscle. Blood carrying oxygen and nutrients does not pass in the required quantity through the vessels of the heart (coronary or coronary arteries) due to their narrowing or blockage. Depending on how severe the “starvation” of the heart is, how long it lasts, and how quickly it arose, several forms of coronary heart disease are distinguished:

1. Sudden cardiac death is cardiac arrest, in most cases caused by a sharp decrease in the amount of blood supplied to it. The patient can be brought back to life only with immediate resuscitation measures.

2. Angina pectoris (angina pectoris) - in this form of coronary artery disease, insufficient nutrition of the heart is manifested by severe pain in the chest during physical activity, stress, going out into the cold or overeating.

3. Myocardial infarction is the death of a section of the heart muscle caused by its “starvation.”

4. Chronic heart failure. Due to oxygen deficiency, the heart ceases to perform its function normally, which leads to insufficient blood flow to all other organs.

There is also a “silent” form of IHD, when “starvation” of the heart does not manifest itself with clinical symptoms.

Causes and consequences

Coronary heart disease usually occurs due to atherosclerosis of the heart (coronary) vessels. In this condition, so-called plaques form on the walls of the arteries, which either narrow the lumen or clog the vessels completely. Also, the cause of insufficient blood flow to the heart may be a spasm of the coronary vessels or their blockage with a blood clot.

The above-mentioned direct causes of coronary heart disease, in turn, appear due to smoking, obesity, high blood pressure, uncontrolled use of medications, etc.

First, as a rule, there is a slight narrowing of the lumen of the coronary vessels, which is manifested by pain in the chest (angina pectoris). Then blood clots may appear in the narrowed vessels, which often lead to myocardial infarction. Consequences of a heart attack include heart rhythm disturbances or, in the worst case, blockage. After a massive heart attack, heart function is not fully restored and the next form of coronary artery disease occurs - chronic heart failure.

In developed countries, coronary heart disease has become the most common cause of death and disability, accounting for about 30% of mortality. It is far ahead of other diseases as a cause of sudden death and is more common in men. It is far ahead of other diseases as a cause of sudden death and occurs in one in three women and half of men.

Diagnosis

In order for a doctor to suspect coronary artery disease, as a rule, it is enough for a patient to complain about chest pain, cardiac arrhythmias, and shortness of breath. The final diagnosis can be made using an X-ray examination - cardiac angiography. Using this procedure, on a special monitor you can see the vessels of the heart, the places of their narrowing or blockage - the main causes of coronary artery disease.

You can also obtain images of the heart necessary to diagnose coronary artery disease using echocardiography or isotope scanning (myocardial scintigraphy). The diagnosis of coronary heart disease can also be made using electrocardiography.

Treatment

Most often, coronary heart disease is treated with medication. There are drugs that dilate the blood vessels of the heart, other drugs reduce the load on it, lowering blood pressure and equalizing the heart rate. There are also drugs that fight the main cause of coronary artery disease - they reduce cholesterol levels in the blood.

Narrowed arteries can also be widened using a simple operation - coronary angioplasty. In serious cases, cardiac surgeons resort to bypass surgery, in which clogged heart vessels are replaced with well-passable “new” ones – usually “