Coronary heart disease (CHD), chronic circulatory disorders of the heart muscle or chronic ischemic heart disease is a heart disease that is caused by hardening of the arteries and circulatory disorders in the heart muscle. As a result, the heart is undersupplied with oxygen, so that important cardiovascular functions can no longer be fulfilled. Seen in this light, coronary artery disease can lead to angina pectoris or a heart attack.
What is Coronary Heart Disease?
Coronary heart disease, or CHD for short, is a cardiovascular disease and is referred to as ishemic. On the whole, it is about a narrowing of the coronary arteries, resulting in an undersupply of the heart muscle. If left untreated, this inevitably leads to an infarction of the heart in the case of coronary heart disease. It is a serious illness, which in most cases in Germany is to be regarded as the cause of death. See AbbreviationFinder for abbreviations related to Coronary Heart Disease.
Atherosclerosis, a type of calcification of the arteries, is one of the causes of coronary heart disease. The inner walls of the vessels are narrowed by fat-laden material, in which the life-threatening calcium deposits later. Due to the narrowing of the blood vessels, the blood cannot circulate, which results in the death of tissue particles.
This condition is called arteriosclerosis, but it can also spread to all vessels. When this happens and the heart vessels are affected, the experts speak of coronary heart disease. People who are heavy smokers are also at high risk of developing coronary artery disease. This also applies to people who eat a high-fat diet, suffer from high blood pressure and are under constant stress.
Other causes of coronary heart disease can be seen in the clinical picture of obesity (overweight). With these symptoms, the cholesterol levels of the patients are often significantly increased and they suffer from an efficient disturbance of the lipid metabolism. Causes of coronary heart disease can also be high sugar levels, as they occur in diabetes mellitus.
Symptoms, Ailments & Signs
The course of coronary heart disease is always chronic, because the advanced arteriosclerosis causes a slowly progressive deterioration of the clinical picture.
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Coronary heart disease (CHD) can manifest itself in a variety of symptoms. It is important to know that the signs can be very unspecific, especially if the disease is not yet advanced. This means that a symptom such as paleness can indicate, for example, an iron deficiency, a cold, too little sleep, but also coronary heart disease.
Clarification by the family doctor or, if necessary, a specialist is therefore important if the symptoms persist or become worse. This applies in particular if the symptoms are accompanied by risk factors such as obesity, smoking or a heart attack or stroke in the family.
Angina pectoris is a typical symptom of coronary heart disease. The term refers to chest tightness that may or may not radiate into the neck and jaw, arms and shoulders. There are also silent courses of CHD. This feeling of tightness is often associated with anxiety, sweating or a drop in blood pressure, known as hypotension.
A fast heartbeat (medical term: tachycardia) and shortness of breath (dyspnoea) are also classic signs. In women, the symptoms are often less specific. Upper abdominal pain, pallor or nausea can also indicate angina pectoris. Therefore, when in doubt, a visit to the doctor is always advisable in order to rule out coronary heart disease and its sometimes dangerous complications or to treat it with suitable measures.
course of the disease
The course of coronary heart disease is always chronic, because the advanced arteriosclerosis causes a slowly progressive deterioration of the clinical picture. In most cases, the quality of life of the affected patients also decreases at the same time. The first signs of coronary heart disease are not so easy to recognize because the disease progresses insidiously.
During exertion, only shortness of breath is evident, which comes about due to the undersupply of blood to the heart. The patients feel a tightness in the heart area, in this case experts speak of angina pectoris.
Coronary artery disease (CHD) can have serious complications. Early effects include cardiac instability associated with cardiac arrhythmia. A particularly serious complication of CHD is the acute myocardial infarction. The reason for this is the constriction of the coronary arteries within the vascular wall due to plaque formation.
If the plaque ruptures abruptly, blood coagulation starts locally, which leads to plaque accumulation. After that, it doesn’t take long until the affected coronary artery is closed. A lack of oxygen occurs in the parts that were previously supplied by this coronary artery, which doctors refer to as acute coronary insufficiency.
An acute heart attack is usually noticeable through sweating, shortness of breath, nausea and a feeling of fear of death. In such a case, a hospital that has a cardiac catheter laboratory must be visited immediately. Ventricular fibrillation is also one of the serious effects of CAD. This is evident in around 80 percent of all people who die as a result of cardiac arrest during a heart attack. The risk of this complication is particularly pronounced in the first hours of the infarction.
A subsequent consequence of coronary heart disease is heart rupture, in which the heart muscle wall breaks through. A hemorrhage appears within the pericardium.
When should you go to the doctor?
If symptoms such as tachycardia, shortness of breath and sweating are noticed, coronary artery disease may be the cause. Medical advice is required if the symptoms persist for more than a few days or increase in intensity over time. If other symptoms and complaints develop, such as chest pain or nausea, it is best to consult your family doctor immediately. Non-specific symptoms that impair well-being and quality of life should also be clarified quickly.
People suffering from arteriosclerosis are particularly susceptible to the development of coronary heart disease and should have the symptoms mentioned quickly examined and, if necessary, treated. The same applies to diabetes and high blood pressure patients. An unhealthy lifestyle is associated with an increased risk of developing heart disease, which is why smokers, people with obesity and alcoholics also need to seek medical advice. The right person to talk to is your general practitioner or a cardiologist. If the disease is very advanced, it may need to be treated in a heart disease clinic.
Treatment & Therapy
Coronary heart disease can be treated with medication or surgery. This is basically decided by the doctors after the course of the disease and the status of the disease have been clearly determined.
The severity of the coronary artery disease plays the overriding role. Drug therapy uses drugs such as clopidogrel, beta blockers, ACE inhibitors, statins and, of course, acetylsalicylic acid with the sole aim of lowering cholesterol levels. Existing angina pectoris is treated with a nitroglycerin spray.
The goal of surgical therapy is to improve blood flow to the heart muscle. To do this, doctors usually use a bypass. Coronary angioplasty followed by placement of a coronary stent can also be used as therapy. This medical implant is particularly suitable for widening small constrictions in the vessels.
In this very special way, the expected new occlusion of the blood vessels is efficiently prevented. These stents are not only available as supporting stents but also as coronary stents that release active substances that can additionally reduce or even prevent the blood vessels from becoming blocked.
Outlook & Forecast
In practice, it has been shown that bypasses (grafts) made from arterial material are more stable than bypasses from veins. More than 90% of arterial grafts are still completely patent 10 years after the operation. In contrast, bypasses from leg veins are only 70% free in the same period.
Since the cause of coronary artery disease, arteriosclerosis, cannot be cured, the patient must make appropriate lifestyle changes. Risk factors must be minimized in order to have a good future prognosis and not to jeopardize the success of the operation. Of course, this includes regular medical checks of the status quo.
Furthermore, one must pay attention to the body weight, because being overweight would have a negative effect. Nicotine and alcohol consumption should be stopped if possible. Reducing stress has a positive effect. It makes sense to familiarize yourself with various stress management methods. Regular exercise and sport promotes a good cardio situation. Health insurance companies also offer special courses such as heart sports groups, which are worth attending. Fats should be avoided in food preparation. Here the patient can orientate himself well on the Mediterranean cuisine. In general, the patient should pay close attention to his own body signals and, if in doubt, consult his cardiologist or family doctor.
How can you reduce or prevent the risk of coronary heart disease ? The following points can significantly reduce the risk of a heart attack and other heart diseases:
- You should (have) measure your blood pressure regularly. Adults over the age of 40 in particular should have their blood pressure checked at least once a year. High blood pressureputs a strain on the heart. Values below 130 to 80 are considered good.
- One should eat healthily. A conscious and healthy diet reduces the risk of a heart attack. Saturated fatty acids, especially in animal products such as butter, ahne, pork, etc., should be avoided, as they increase the cholesterol level in the blood.
- One should exercise enough. In particular, light endurance sports such as Nordic walking, cycling or swimming reduce the risk of a heart attack.
- If you are overweight, you should reduce this overweight. Already 10 kilos too much have a negative effect on our health, both blood pressure and blood lipid levels increase.
- One should give oneself a smoking ban. Just six cigarettes a day doubles the risk of a heart attack, so stay away from it!
- You should also avoid stress as much as possible. Basically, the body can withstand stressful situations, but you should not overdo it here, as this can lead to high blood pressure.
In the case of coronary heart disease, aftercare is almost as important as therapy. Patients need consistent follow-up care so that the findings do not worsen if possible. Regular check-ups by the treating physicians are therefore essential. Professional contacts in this context are the internist or cardiologist, but also the family doctor. In the case of acute symptoms, the nearest clinic is the right address.
Coronary heart disease often has behavioral causes. These must be included in the practice of aftercare to prevent further crises. Avoiding nicotine and too much alcohol is particularly important here. In addition, patients should also pay attention to a low-fat diet with lots of fruit and vegetables so that the blood lipids do not rise to an unhealthy level and endanger their health. Competent nutritional advice can help with this.
Weight and fitness should also be included in the follow-up care. Weight reduction and fitness building can be achieved through targeted physical activity. Lightly dosed endurance training or strength training with not too much weight are often helpful, but always to be coordinated with the doctor treating you. Coronary sports groups with qualified trainers are specially tailored to the needs of heart patients. Stress reduction is another important factor in the consistent aftercare of the coronary artery disease of those affected.
You can do that yourself
In addition to drug treatment, a healthy lifestyle makes a significant contribution to maintaining quality of life for a long time despite coronary heart disease.
The diet should be varied and versatile, high-fiber food with lots of fruit, vegetables and whole grain products is preferable to foods rich in fat and carbohydrates. Unsaturated fats affect blood lipid levels more favorably than saturated fats found in fried foods and meat products. Mediterranean cuisine, in which animal fats are replaced by vegetable oils and salt by spices, is a good example of how to prepare healthy meals.
It is also important to reduce risk factors: completely abstaining from nicotine can significantly increase life expectancy, alcohol should only be consumed in moderation. Physical activity helps to lose excess weight, improves physical condition and creates a positive attitude towards life. Endurance sports such as cycling, jogging or swimming are ideal, and brisk walks also have a positive effect on the heart and circulation. Several short units per week are more effective and gentler than one long one, the intensity must be adapted to your own performance. If in doubt, it is advisable to draw up a training plan together with the doctor treating you.
Stress and hustle and bustle damage the heart, so there should be enough space for rest and relaxation in everyday life. Maintaining social contacts also promotes well-being.