A healthy lifestyle is the key to a long life. An improper lifestyle negatively affects our health. Health complications sometimes are life-threatening. Let’s get to know more about one of those health complications “Heart Disease”. Heart disease is medically termed coronary heart disease (CHD).
About coronary heart disease
Coronary heart disease is a condition developed when the blood supply to the heart muscles is reduced due to the accumulation of materials in the arteries1 that supply blood to the heart. These arteries are known as coronary arteries.2 The accumulation of materials in the inner walls of arteries is a reversible condition and can be medically described as atheroma.3
Scientific studies have proven that CHD is one of the most common causes of death. A study based on the Global Burden of Disease4 was used to generate data to assess the age and sex-specific causes of death. Statistics state that in the year 2015, at least 9 million deaths occurred due to CHD.5 Coronary artery disease is also known by other names such as ischemic heart disease or myocardial ischemia.
Symptoms of coronary heart disease
The well-known symptom of CHD is chest pain. Doctors call this condition angina. Patients often report discomfort in the chest after a meal or a strenuous activity. This is due to the narrowing of the inner walls of the artery. Chest pain is often categorised into two types: stable and unstable. It is seen that the discomfort in the chest is often expressed by the patients as feeling numb or heavy.6
If the disease is in an advanced stage the patients experience the symptoms very clearly after any physical activity because the heart functions erratically due to low blood supply.
Studies show that at least 3 out of 10 patients who were admitted to the hospital stating an unknown pain are known to be suffering from CHD. The unstable angina is often followed by a heart attack. A heart attack is a condition whereby the blood flow to the coronary artery is very low or completely stopped.7 Immediate medical attention is required in case of a heart attack to avoid fatal consequences.
Causes of coronary heart disease
CHD can be linked to various risk factors among which genetics play a key role. Studies state that the occurrence of CHD in patients is dependent on their genetics.8 Other key factors involved are lifestyle habits like smoking and consumption of alcohol. Conditions like high blood pressure and cholesterol play a key role in the occurrence of heart disease.9
It has been studied that if a person smokes even one cigarette daily, the risk of them suffering from heart failure is doubled. Habitual smokers who are employed in jobs that lack physical activity tend to become obese. Work-environment stress combined with habitual smoking in people who are obese is one of the key risk factors for CHD.10
One of the major complications that is known is an asymptomatic condition known as cardiac X syndrome in which patients who have blocks in their arteries do not exhibit any symptoms when an angiogram is performed. The cause of this condition is still not known.11
Diagnosing coronary heart disease
The diagnosis of CHD is based on the symptoms shown by the patient. Usually, the primary method of knowing heart activity is by performing an Electrocardiogram (ECG). This is a method that reports the functioning of a human heart in the form of a graph. The method involves the usage of small electrodes attached to the patient’s body to see minute electronic changes when the heart is beating.12 If these changes are detected they will be shown in a voltage versus time graph. Based on the changes seen on this graph, the type of ailment the patient is suffering from can be determined.
There are other methods to diagnose conditions like cardiac X syndrome. These are advanced methods like echocardiography, stress tests, and MRI.
Echocardiography is a method in which the image of the heart can be obtained by using ultrasound or echo.13
The stress test is used to determine the ability of the heart's response to physical stress. This is done in a controlled laboratory environment in which the patient is made to undergo stress by performing an activity, like walking or running on a treadmill where the stress is gradually levelled up and an electrocardiogram is taken parallelly to know the changes that are undergone by the heart at different levels of stress.
Another advanced method is an MRI. This stands for Magnetic Resonance Imaging. The method is used for imaging the organs in our body under the influence of strong electromagnetic fields. This method has a wide range of applications in cardiovascular imaging to analyse and diagnose different conditions.14
Risk assessment of CHD is done by an assessment system which considers various parameters like age, sex, blood pressure, cholesterol, smoking, and blood sugar levels. This study was designed by Boston University. The study is termed the Framingham Heart Study.15
Treating coronary heart disease
Treatment for CHD is done in one of two ways: medications and surgical intervention. The medications that are being prescribed for CHD include a class of drugs commonly known as statins.
Statins are usually prescribed for treating high blood cholesterol which is one of the major risk factors for CHD. These drugs have the ability to lower lipids, especially low-density lipids. The science behind this is that these drugs act as antagonists for a particular enzyme that is linked to lipid production in our body.16
Drugs like aspirin are also used in the treatment of CHD. This is employed in the case of patients with no previous heart complications and is highly recommended for adults who are at high risk for CHD.17
Surgical intervention is also carried out in cases of advanced stages of CHD. One of the widely used procedures in the event of multiple blocks in arteries is coronary artery bypass surgery. This procedure bypasses the lesions created due to the accumulation of plaques and restores blood supply to the heart. This procedure is known to increase the life expectancy of patients.18
Another method that is widely used is the introduction of coronary stents. These are tiny tube-shaped devices that are introduced into the arteries to keep them open. This is done non-surgically and this procedure reduces the risk of a heart attack.19
How to recover from a coronary heart disease
People who have suffered from a heart attack and undergone a bypass surgery are less likely to suffer from a recurrent attack if they avoid severe physical stress that might cause dysfunction of the heart.
Lifestyle changes play an important role in recovery from CHD. People with a history of heart disease should avoid smoking and consuming alcoholic drinks. Furthermore, a balanced diet is required to control blood cholesterol levels. Studies suggest that people who consume higher amounts of fruits are less prone to CHD. The reason behind this is that the high fibre content in fruits reduces the risk of CHD.20
Studies also suggest that mental health plays a key role in recovery from CHD. The perception of patients tends to change after surgical intervention. Post-surgical psychological intervention is known to reduce hospitalisation rates in patients.21
Preventing coronary heart disease
There is a saying that prevention is always better than a cure. The major risk factors can be avoided by changes in lifestyle. There are several ways to reduce the risk of CHD and some of these include managing body weight, consuming a balanced diet and avoiding trans fats (usually found in meat and dairy products).
Patients are recommended to control smoking, engage in light physical activity through jogging and walking regularly and reduce psychological stress in their day-to-day life. Studies also suggest that counselling plays a key role in dealing with stress. Support groups like the British Heart Foundation play a key role in research as well as in creating awareness among the masses.
The fact that CHD is one of the most common causes of death is a concerning issue. Researchers are exploring several methods to understand the disease from different perspectives. Advanced methods like dietary changes and stem cell therapies are being considered to reduce the risk of CHD. The key to effectively controlling the risks of CHD is having a proper understanding of our body’s metabolism as well as leading a healthier lifestyle. By avoiding the risk factors and consuming a balanced diet alongside a good work-life balance one can reduce the risk of developing CHD. Physical and mental health should be given equal priority. Thus, by leading a balanced life the risk of heart disease can be lowered.
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- Coronary arteries: Texas Heart Institute [Internet]. The Texas Heart Institute. 2021 [cited 2022Nov10]. Available from: https://www.texasheart.org/heart-health/heart-information-center/topics/the-coronary-arteries/
- Lusis AJ. Atherosclerosis. Nature. 2000;407(6801):233–41.
- Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: A systematic analysis for the global burden of disease study 2013. The Lancet. 2015;385(9963):117–71.
- Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet [Internet]. 2016 Oct [cited 2022 Nov 10];388(10053):1459–544. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673616310121
- Coronary heart disease [Internet]. Coronary Heart Disease | Johns Hopkins Medicine. [cited 2022 Nov10]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronary-heart-disease
- Kontos MC, Diercks DB, Kirk JD. Emergency department and office-based evaluation of patients with chest pain [Internet]. Mayo Clinic Proceedings. Elsevier; 2010 [cited 2022Nov11]. Available from: https://www.mayoclinicproceedings.org/article/S0025-6196(11)60415-1/fulltext
- What are the signs and symptoms of coronary heart disease? [Internet]. What Are the Signs and Symptoms of Coronary Heart Disease? - NHLBI, NIH. 2014 [cited 2022 Nov10]. Available from: https://web.archive.org/web/20150224034615/http://www.nhlbi.nih.gov/health/health-topics/topics/CHD/signs
- MS; DXWSEJPR. Genetics of coronary artery disease and myocardial infarction [Internet]. World journal of cardiology. U.S. National Library of Medicine; [cited 2022 Nov10]. Available from: https://pubmed.ncbi.nlm.nih.gov/26839654/
- E. UJC, Cross SS. In: General and Systematic Pathology. Edinburgh: Churchill Livingstone/Elsevier; 2011. p. 279.
- Lanza GA. Cardiac syndrome X: A critical overview and future perspectives [Internet]. Heart. BMJ Publishing Group Ltd; 2007 [cited 2022 Nov 11]. Available from: https://doi.org/10.1136%2Fhrt.2005.067330
- Jowett NI, Turner AM, Cole A, Jones PA. Modified electrode placement must be recorded when performing 12-lead electrocardiograms [Internet]. Postgraduate Medical Journal. The Fellowship of Postgraduate Medicine; 2005 [cited 2022 Nov 11]. Available from: https://pmj.bmj.com/content/81/952/122
- Cleve J, McCulloch ML. Conducting a cardiac ultrasound examination [Internet]. SpringerLink. Springer International Publishing; 1970 [cited 2022Nov11]. Available from: https://link.springer.com/chapter/10.1007/978-3-319-71617-6_2
- Petersen SE, Aung N, Sanghvi MM, Zemrak F, Fung K, Paiva JM, et al. Reference ranges for cardiac structure and function using cardiovascular magnetic resonance (CMR) in Caucasians from the UK biobank population Cohort - Journal of Cardiovascular Magnetic Resonance [Internet]. BioMed Central. BioMed Central; 2017 [cited 2022Nov11]. Available from: https://jcmr-online.biomedcentral.com/articles/10.1186/s12968-017-0327-9
- The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective [Internet]. Redirecting. [cited 2022Nov11]. Available from: https://doi.org/10.1016%2FS0140-6736%2813%2961752-3
- Prospective Studies Collaboration ‡Author Footnotes‡ Collaborators listed in full at end of paper, Collaboration APCS, Law MR Wald NJ Thompson SG, MR L, NJ W, SG T, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: A meta-analysis of individual data from 61 prospective studies with 55 000 vascular deaths [Internet]. The Lancet. Elsevier; 2007 [cited 2022Nov11]. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61778-4/fulltext
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- "A comparison of pharmacologic therapy with/without timely coronary intervention vs. primary percutaneous intervention early after ST-elevation myocardial infarction: the WEST (Which Early ST-elevation myocardial infarction Therapy) study" [Internet]. Digital Object Identifier System. [cited 2022Nov11]. Available from: https://doi.org/10.1093%2Feurheartj%2Fehl088
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- The effect of psychological intervention on recovery from surgery and heart attacks: An analysis of the literature. [Internet]. American Journal of Public Health. [cited 2022Nov11]. Available from: https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.72.2.141