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Coronary
Heart Disease (CHD)
A
Summary
by:
George Pararas-Carayannis, Ph.D.*
A
brief summary prepared under contract for the Regenesis Medical
Center
*
Disclaimer -
I am not a medical doctor. All material provided at this website
is for informational purposes only. Readers are encouraged to
confirm the information contained herein with other sources.
Patients and consumers should review the information carefully
with their professional health care provider. The information
is not intended to replace medical advice offered by physicians.
I will not be liable for any direct, indirect, consequential,
special, exemplary, or other damages arising therefrom.
What
is Coronary Heart Disease (CHD)?
 Like
any muscle, the heart needs a constant supply of oxygen and nutrients
that are carried to it by the blood in the coronary arteries.
When the coronary arteries become narrowed or clogged and cannot
supply enough blood to the heart, the result is Coronary Heart
Disese (CHD). If not enough oxygen-carrying blood reaches the
heart, the heart may respond with pain called angina. The pain is usually felt in the chest or sometimes
in the left arm and shoulder. However, the same inadequate blood
supply may cause no symptoms, a condition called silent angina.
When the blood supply
is cut off completely, the result is a heart attack. The part
of the heart that does not receive oxygen begins to die, and
some of the heart muscle may be permanently damaged.
What causes
CHD?
CHD is caused by a
thickening of the inside walls of the coronary arteries. This
thickening, called atherosclerosis, narrows the space through
which blood can flow, decreasing and sometimes completely cutting
off the supply of oxygen and nutrients to the heart.
Atherosclerosis usually
occurs when a person has high levels of cholesterol, a fat-like
substance, in the blood. Cholesterol and fat, circulating in
the blood, build up on the walls of the arteries. The buildup
narrows the arteries and can slow or block the flow of blood.
When the level of cholesterol in the blood is high, there is
a greater chance that it will be deposited onto the artery walls.
This process begins in most people during childhood and the teenage
years, and worsens as they get older.
In addition to high
blood cholesterol, high blood pressure and smoking also contribute
to CHD. On the average, each of these doubles your chance of
developing heart disease. Therefore, a person who has all three
risk factors is eight times more likely to develop heart disease
than someone who has none. Obesity and physical inactivity are
other factors that can lead to CHD. Overweight increases the
likelihood of developing high blood cholesterol and high blood
pressure, and physical inactivity increases the risk of heart
attack. Regular exercise, good nutrition, and smoking cessation
are key to controlling the risk factors for CHD.
 What are the symptoms of CHD?
Chest pain (angina)
or shortness of breath may be the earliest signs of CHD. A person
may feel heaviness, tightness, pain, burning, pressure, or squeezing,
usually behind the breastbone but sometimes also in the arms,
neck, or jaws. These signs usually bring the patient to a doctor
for the first time. Nevertheless, some people have heart attacks
without ever having any of these symptoms.
It is important to
know that there is a wide range of severity for CHD. Some people
have no symptoms at all, some have mild intermittent chest pain,
and some have more pronounced and steady pain. Still others have
CHD that is severe enough to make normal everyday activities
difficult.
Because CHD varies
so much from one person to another, the way a doctor diagnoses
and treats CHD will also vary a lot. The following descriptions
are general guidelines to some tests and treatments that may
or may not be used, depending on the individual case.
What
is Congestive Heart Failure?
Heart failure occurs
when the heart loses its ability to pump enough blood through
the body. Usually, the loss in pumping action is a symptom of
an underlying heart problem, such as coronary artery disease.
The term heart failure
suggests a sudden and complete stop of heart activity. But, actually,
the heart does not suddenly stop. Rather, heart failure usually
develops slowly, often over years, as the heart gradually loses
its pumping ability and works less efficiently. Some people may
not become aware of their condition until symptoms appear years
after their heart began its decline.
How serious the condition
is depends on how much pumping capacity the heart has lost. Nearly
everyone loses some pumping capacity as he or she ages. But the
loss is significantly more in heart failure and often results
from a heart attack or other disease that damages the heart.
The severity of the
condition determines the impact it has on a person's life. At
one end of the spectrum, the mild form of heart failure may have
little effect on a person's life; at the other end, severe heart
failure can interfere with even simple activities and prove fatal.
Between those extremes, treatment often helps people lead full
lives.
But all forms of heart
failure, even the mildest, are a serious health problem, which
must be treated. To improve their chance of living longer, patients
must take care of themselves, see their physician regularly,
and closely follow treatments.
The
Basics of Angina
 Angina Pectoris ("Angina") is a recurring
pain or discomfort in the chest that happens when some part of
the heart does not receive enough blood. It is a common symptom
of coronary heart disease (CHD), which occurs when vessels that
carry blood to the heart become narrowed and blocked due to atherosclerosis.
Angina feels like
a pressing or squeezing pain, usually in the chest under the
breast bone, but sometimes in the shoulders, arms, neck, jaws,
or back. Angina is usually precipitated by exertion. It is usually
relieved within a few minutes by resting or by taking prescribed
angina medicine.
What brings
on angina?
Episodes of angina
occur when the heart's need for oxygen increases beyond the oxygen
available from the blood nourishing the heart. Physical exertion
is the most common trigger for angina. Other triggers can be
emotional stress, extreme cold or heat, heavy meals, alcohol,
and cigarette smoking.
Does angina
mean a heart attack is about to happen?
An episode of angina
is not a heart attack. Angina pain means that some of the heart
muscle in not getting enough blood temporarily--for example,
during exercise, when the heart has to work harder. The pain
does NOT mean that the heart muscle is suffering irreversible,
permanent damage. Episodes of angina seldom cause permanent damage
to heart muscle.
In contrast, a heart
attack occurs when the blood flow to a part of the heart is suddenly
and permanently cut off. This causes permanent damage to the
heart muscle. Typically, the chest pain is more severe, lasts
longer, and does not go away with rest or with medicine that
was previously effective. It may be accompanied by indigestion,
nausea, weakness, and sweating. However, the symptoms of a heart
attack are varied and may be considerably milder.
When someone has a
repeating but stable pattern of angina, an episode of angina
does not mean that a heart attack is about to happen. Angina
means that there is underlying coronary heart disease. Patients
with angina are at an increased risk of heart attack compared
with those who have no symptoms of cardiovascular disease, but
the episode of angina is not a signal that a heart attack is
about to happen. In contrast, when the pattern of angina changes--if
episodes become more frequent, last longer, or occur without
exercise--the risk of heart attack in subsequent days or weeks
is much higher.
A person who has angina
should learn the pattern of his or her angina--what cause an
angina attack, what it feels like, how long episodes usually
last, and whether medication relieves the attack. If the pattern
changes sharply or if the symptoms are those of a heart attack,
one should get medical help immediately, perhaps best done by
seeking an evaluation at a nearby hospital emergency room.
Is all chest
pain "angina"?
No, not at all. Not
all chest pain is from the heart, and not all pain from the heart
is angina. For example, if the pain lasts for less that 30 seconds
or if it goes away during a deep breath, after drinking a glass
of water, or by changing position, it almost certainly is NOT
angina and should not cause concern. But prolonged pain, unrelieved
by rest and accompanied by other symptoms may signal a heart
attack.
Can a person
with angina exercise?
Yes. It is
important to work with the doctor to develop an exercise plan.
Exercise may increase the level of pain-free activity, relieve
stress, improve the heart's blood supply, and help control weight.
A person with angina should start an exercise program only with
the doctor's advice. Many doctors tell angina patients to gradually
build up their fitness level--for example, start with a 5-minute
walk and increase over weeks or months to 30 minutes or 1 hour.
The idea is to gradually increase stamina by working at a steady
pace, but avoiding sudden bursts of effort.
Miscellaneous
Summaries on Chronic Illnesses
heart disease | |
stroke | diabetes |
| high blood
pressure
| | high cholesterol | | Alzheimer's | |
Parkinson's
| |
arthritis | |
chronic
fatigue
|
| poor circulation | | brain injury | | multiple sclerosis | | cerebral palsy | | life extension | | memory
loss |
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