COMMON LIFESTYLE DISEASES: CHD EMS 355 By: Dr. Bushra Bilal

Coronary artery disease (CAD), also called heart disease, refers to the narrowing of heart arteries due to atherosclerosis The heart muscle does not get enough oxygen when heart arteries are narrowed. If the heart is starved of oxygen, chest pain (angina) occurs. If an artery is completely blocked, a heart attack results. A heart attack is medically referred to as a myocardial infarction (MI). INTRODUCTION:

RISK FACTORS Controllable Risk Factors high blood pressure, high blood cholesterol, and diabetes. There are other controllable risk factors related to lifestyle, such as not smoking, maintaining a healthy weight, reducing alcohol consumption, and getting physically active.

CAUSES A low supply of oxygen in the heart is most often caused by atherosclerosis, also called "hardening of the arteries." In this condition, fatty deposits called plaques form in the linings of the blood vessels. The plaques make the arteries narrower as they build up, and less blood is able to get through to the heart, depriving it of oxygen. Atherosclerosis is often the result of too much "bad" cholesterol (low density lipoprotein, or LDL) and triglycerides circulating in the bloodstream.

RISK FACTORS You are at risk for developing atherosclerosis and CAD if you: have high levels of "bad" (LDL) cholesterol low levels of "good" (HDL, or high density lipoprotein) cholesterol have high blood pressure are a smoker have diabetes sedentary lifestyle are overweight (particularly if you are obese in the torso or have a large waist circumference) have a family history of heart disease consume alcohol excessively

SYMPTOMS tightness or a squeezing sensation across the chest burning or pressure beneath the breast bone pain or ache radiating to the shoulders, jaw, arms, throat, neck, or upper abdomen fatigue nausea or vomiting nauseavomiting sweating weakness shortness of breath lightheadedness

Diagnosing Coronary Artery Disease An electrocardiogram (ECG) detects abnormal electrical cardiac charges. An exercise electrocardiogram (or stress test) checks your heart for changes during periods of activity, and it can also show if the coronary arteries are too narrow. Coronary angiography (or arteriography) is a test used to explore the coronary arteries.

TREATMENT Cholesterol-lowering medications can reduce the levels of "bad" (LDL) cholesterol in your blood while increasing the levels of "good" (HDL) cholesterol. Blood pressure reducing agents. Antiplatelet medications prevent clots from forming. Acetylsalicylic acid* (ASA) reduces the chances of having a heart attack. Beta-blockers, calcium channel blockers, and nitroglycerin-type medications are the three main classes of medications used to treat stable angina over time.

SURGICAL INTERVENTIONS Percutaneous coronary intervention. This is also known as an angioplasty with stent. In this non-surgical procedure, your doctor uses a thin tube (catheter) to place a mesh tube, or stent, in the narrowed artery. The stent keeps the blood vessel open to allow blood to flow. Some stents also release medication that keeps the artery from narrowing. Coronary artery bypass surgery. This procedure involves using a blood vessel from another part of the body to create a "bypass" or detour around the blocked or narrowed coronary arteries. Because this requires open heart surgery, this procedure is usually for people who have many blocked arteries or whose blocked arteries are in a place that's difficult to place a stent.

TIPS FOR PREVENTING CHD Quit smoking. Eat a healthy diet. It should be low in salt and fat and high in fiber, fresh fruits, legumes (beans), nuts, and seeds. Avoid saturated fat, fried foods, and refined carbohydrates. Losing weight can also offset the risks associated with CAD. Get your blood sugar under control. Diabetes increases the risk of CAD, especially if blood sugar levels are not properly controlled

Have your cholesterol levels checked regularly. People with diabetes should have this done every 1 to 3 years. Men at least 40 years old and women who are at least 50 years old or postmenopausal should have their cholesterol levels monitored regularly if they do not have CAD or a history of high cholesterol. Get regular exercise. Along with reducing the chances of having a heart attack, regular physical activity lowers the heart rate, improves cholesterol levels, helps control high blood pressure and also helps you lose weight Manage your stress levels. This will also benefit those with high blood pressure. As well, it reduces the levels of some hormones that may increase the risk of having a heart attack.