What You Need to Know About Coronary Heart Disease (CHD)

What is CHD?

Coronary heart disease (CHD) is the disease that develops when there is an insufficient oxygen supply to the heart muscle by the coronary arteries. The most common reason for this is atherosclerosis of the coronary arteries with cholesterol plaques formation and narrowing of the arterial ducts.

It may occur acutely or chronically (long-term). The manifestations of coronary artery disease may include angina pectoris, myocardial infarction, cardiac arrhythmias, and sudden cardiac death.

How common is CHD?

In developed countries, ischemic heart disease is the most common cause of death and disability - it accounts for about 30 percent of all deaths. It is far ahead of other diseases, as the reason of sudden death and found in one in three women and in half of the male population.

This difference takes place due to the fact that female hormones are one of the means of the protection against atherosclerotic vascular lesions. As there are some changes in hormonal level occur in menopause, the risk of heart attacks in women during and after menopause increases significantly.

What are the types of CHD?

Depending on how pronounced cardiac oxygen deficiency is, how long it lasts, and how quickly it occurs, there are several forms of ischemic heart disease:

• Asymptomatic, or "silent" form of CHD does not cause complaints from the patient. 
• Exertional angina is a chronic form, manifested by shortness of breath and pain in the chest during physical exertion and stress, under the action of some other factors. 
• Unstable angina (stenocardia) is any attack, significantly surpassing the previous one or accompanied by new symptoms. Such intensifying attacks indicate a deterioration of the disease and may be precursors of myocardial infarction. 
• Arrhythmic type is manifested as the disorder of the heart rhythm, often as the atrial fibrillation. In most cases it's an acute condition, which can become chronic. 
• Myocardial infarction - an acute form, dying area of the heart muscle, often caused by a plaque detachment from the wall of the coronary artery or a clot, causing the occlusion of its duct, accordingly. 
• Sudden cardiac death - cardiac arrest, in most cases due to a sharp decrease in the amount of blood supplying it as a result of complete blockage of large arteries. 

These forms may be combined and overlap one another. For example, angina often joins arrhythmia.

What are the causes and the mechanism of CHD development?

Despite the fact that the heart pumps blood to the body, it requires some blood supply itself, as any other organ of our body.

The heart muscle (myocardium) is supplied with the blood by the two arteries that are the branches from the root of the aorta and are called coronary arteries (as they encircle the heart like a crown).

Further, these arteries are divided into several smaller branches, each of which feeds a particular part of the heart.

There are no more arteries that bring blood to the heart. Therefore, when the ducts get narrower or there is a blockage of one of them, the heart muscle lacks oxygen and nutrients (ischemia), thus the disease develops rapidly.
The main cause of coronary heart disease is now considered to be atherosclerosis of the coronary arteries with the deposition of cholesterol in them. As a result, blood cannot flow in a sufficient volume to the heart.

Complete blockage of the arterial ducts leads to myocardial infarction, cardiac arrest and even death. The degree of the damage to the heart muscle depends on the allocation of the artery occlusion or branch blockage. The larger the artery, the worse the consequences are.

In the condition in which myocardial infarction occurs, the artery duct should be reduced by at least 75%. The more slowly and gradually this happens, the easier the heart recovers. A sudden blockage is the most dangerous condition and often leads to death.

The course and prognosis

The course of ischemic heart disease is irreversible. This means that there is no way for the complete recovery from it. All current treatments allow to control the disease more or less and slow down its development, but it`s still irreversible.
CHD is continuous and goes simultaneously with other organs pathology: kidneys, brain, pancreas, (cardiovascular continuum), including diseases such as atherosclerosis, hypertension, stroke, atrial fibrillation, metabolic syndrome, and others.
The main stages of the cardiovascular continuum can be described as follows.

• Asymptomatic stage - risk factors exert their negative impact, in the heart vessels cholesterol deposits form, but the ducts are still wide enough.
• The first harbingers are 
  • high blood pressure, 
  • increased blood sugar, 
  • blood cholesterol rise. 

At this stage, cholesterol plaques in the blood vessels expand and already close to 50% of the arterial duct. In cardiac muscle remodeling begins, changing its structure, which leads to heart failure.

The symptoms of acute heart failure

• severe shortness of breath
• disruptions in heart
• chest pain. 
• in the ultrasound of the heart at this point, the enlargement of the heart cavities becomes obvious, and there is thinning of the heart muscle. The duct of the artery is narrowed even more. 

The appearance of congestive heart failure

• sharp deterioration of the heart
• occurrence of edema
• congestion in the lungs
• a sharp rise in the blood pressure 
• atrial fibrillation
• The pain in the chest appears at the slightest load, even at rest. 

In any of these stages, myocardial infarction or sudden cardiac arrest can develop rapidly.

A heart attack does not necessarily lead to death, but ischemic disease always accelerates the chance of having it.
Be aware, it is much easier to prevent the disease than to cure it. Take care of your heart before it's too late.