By Morgan Ahn
Introduction
“Coronary Heart Disease is a type of heart disease where the arteries of the heart cannot deliver enough oxygen-rich blood to the heart.” (National Heart, Lung, and Blood Institute)
Coronary Heart Disease (CHD) has been a detrimental factor in death in the 21st century. According to the Centers for Disease Control and Prevention (CDC), Heart disease is an overall leading cause of death in the United States regardless of ethnic group. It has been mentioned that “One person dies every 34 seconds from cardiovascular disease.” Specifically, in 2020, approximately 697,000 people in the United States died. Among them, about half suffered from Coronary Artery Disease. Moreover, about 20.1 million people have CHD or CAD. The percentage of the death rate of the race or ethnic groups varies; however, they have a low percent percentile difference and an average of 18.2%.
Compared to other body diseases, CHD/CAD is severe since it can weaken the heart muscle over time, which may lead to a heart murmur and heart failure. This happens because the heart cannot pump the blood properly for the entire body system as it should. Also, by having a CAD, the patient may show chest pain and feel a block of blood flow to the heart and other muscles. A heart attack may also occur, which has symptoms of chest pain, nausea, or shortness of breath.
Overview of the Heart System
The heart is the most significant organ in the body. It serves as a pump to circulate the blood to the entire body system. It has four rooms of blood (based on humans): atria and ventricles on both the left and right. Humans have a closed circulatory system in which blood moves from the heart to the lung and circulates the same route continuously. It is beneficial for fast and long-distance transport and controlling blood flow. Going back to the heart composite, a ventricle is the heart chamber that pumps blood out of the heart. On the other hand, the atrium is the heart chamber where blood re-enters the heart. Lastly, we call the blood vessel that carries the blood out of the heart an artery, and the blood vessel carries blood into the heart as a vein. All the other small blood vessels that we cannot distinguish easily are called capillaries. An artery has thick elastic walls and a small circumference since the blood pressure it needs to endure is very high. However, a vein has thin, less elastic walls with valves and a large circumference. To prevent the case of blood from flowing backward, valves are very important in a vein. The capillary is extremely thin and transfers materials between blood and the body. Our heart passes through the diastole and systole, relaxation, and contraction. Initially, cardiac diastole happens, atrial systole and ventricular diastole, and atrial diastole and ventricular systole occur. To conclude, humans should have rhythmic heart beating: SA node and AV node. If the person has a problem with it, we call it arrhythmia, a heart rate disorder. SA node is a sinoatrial node when a group of specialized cardiac muscle cells in the right atrium – pacemaker - makes a sound. AV node is an atrioventricular node - it is also called delay electrical impulse from the atria to the ventricle to allow atria to empty blood. (based on this information, QRS complex can be established)
Introduction to Three types of CAD
There are three types of CAD: obstructive, nonobstructive, and spontaneous.
Obstructive Coronary Artery Disease occurs when the arteries gradually get narrower due to plaque or other material compilation. This is the most common disease that happens to the majority of CAD patients. It can eventually block the artery and stop the blood from going through the heart, and if a sudden blockage happens, it is called a heart attack.
Nonobstructive Coronary Artery Disease, however, is not related to plaque compilation. There are a few causes, such as constrictions at inappropriate times (coronary vasospasm), damage of artery lining (endothelial dysfunction), malfunction in smaller artery branches (microvascular dysfunction), and compression of coronary arteries from heart muscle (myocardial bridging). Although the cause of CAD is quite different, it can still cause similar symptoms, including shortness of breath. This type can develop regardless of age and race, but females are more likely to gain compared to males.
Spontaneous Coronary Artery Disease Dissection (SCAD) is when the wall of the artery partially or fully blocks the blood flow. This happens unexpectedly and often results in a heart attack. The symptom of it is unique from others: neck/back pain and sensation of pressure.
Treatment of CAD
The treatment of CAD depends on the type of CAD that person has. Some might need surgery, but others can be okay by just changing their lifestyle.
For Obstructive CAD, it is trivial to maintain a healthy weight, eat a healthy diet, exercise, reduce alcohol intake, and sleep seven to eight hours each night. Additional medical pills that lower blood pressure or cholesterol might be helpful. There are also minimal invasive procedures: Percutaneous coronary intervention (PCI) and Atherectomy. PCI sends a thin tube called a catheter with the deflated balloon and inflates it inside the artery, which helps compress the plaque. Also, an atherectomy can be used if the plaque is very hard and cannot compress with the PCI. It is a small drill-like machine that is lasered through the catheter, breaks, and then removed. The ultimate process of treatment is open-heart surgery. It is called a coronary artery bypass graft (CABG).
Nonobstructive CAD can be changed by altering the lifestyle such as increasing physical activity and eating. If there is muscle compression - myocardial infarction - it is preferred to get surgery.
SCAD is pinning down on restoring blood flow to the heart. Medication is the common way to prevent heart attacks and relieve the symptoms. Or cardiac rehabilitation can be helped for recovery.
Conclusion: Preventing CAD
In real life, 88 years old female with Chronic Coronary Artery disease got a heart attack and passed away. Aging is unavoidable causing factor for coronary heart disease. However, a few steps can prevent you from this disastrous disease.
Eating a healthy and balanced diet is the easiest and most effective way to prevent CAD. For example, try to avoid food containing saturated fats, which will increase the cholesterol in your blood. Foods with high cholesterol include meat pies, sausages, butter, lard, cream, cheese, etc. Avoid unsaturated fats such as oily fish, avocados, nuts, and seeds. Moreover, try to maintain a healthy weight and be more physically active. Try to work out at least 3-5 hours per week. The last thing you need to remind yourself is to keep your blood pressure under control. Normal and healthy blood pressure needs to be between 90 and 140 mmHg.
By following these simple rules, you will be able to prevent CAD.
References
Centers for Disease Control and Prevention. (2021, July 19). Coronary artery disease. Centers for Disease
Control and Prevention. Retrieved February 6, 2023, from https://www.cdc.gov/heartdisease/coronary_ad.htm#:~:text=Narrowed%20arteries%20can%20cause%20chest,the%20rest%20of%20your%20body.&text=Over%20time%2C%20CAD%20can%20weaken,blood%20the%20way%20it%20should.
Centers for Disease Control and Prevention. (2022, October 14). Heart disease facts. Centers for Disease
Control and Prevention. Retrieved February 6, 2023, from https://www.cdc.gov/heartdisease/facts.htm#:~:text=Heart%20disease%20is%20the%20leading,groups%20in%20the%20United%20States.&text=One%20person%20dies%20every%2034,United%20States%20from%20cardiovascular%20disease.&text=About%20697%2C000%20people%20in%20the,1%20in%20every%205%20deaths.
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https://www.aurorahealthcare.org/services/heart-vascular/conditions/coronary-artery-disease/types
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