Coronary artery disease articles
Coronary artery disease (cad also known as ischemic heart disease (ihd refers to a group of diseases which includes stable angina, unstable angina, myocardial. What is coronary heart disease? What is coronary artery disease? The American heart Association explains the sometimes confusing terms cad and chd, the. Coronary heart disease refers to a narrowing of the coronary arteries, the blood vessels that supply oxygen and blood to the heart. It is also known.
This helps to determine how well your heart is working when it has to pump more blood. Uses x-rays to create a picture of the heart, lungs, and other organs in the chest. Cardiac catheterization, checks the inside of your arteries for blockage by inserting a thin, flexible tube through an artery in the groin, arm, or neck to reach the heart. Health care professionals can measure blood pressure within the heart and the strength of blood flow through the hearts chambers as well as collect blood samples from the heart or inject dye into the arteries of the heart (coronary arteries). Coronary angiogram, monitors blockage and flow of blood through the coronary arteries. Uses X-rays to detect dye injected via cardiac catheterization. Reducing your Risk for cad, if you have cad, your health care team may suggest the following steps to help lower your risk for heart attack or worsening heart disease: Lifestyle changes, such as eating a healthier (lower sodium, lower fat) diet, increasing physical activity. Medications to treat the risk factors for cad, such as high cholesterol, high blood pressure, an irregular heartbeat, waterproof and low blood flow. Surgical procedures to help restore blood flow to the heart.
Causes of cad, cad is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries) and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over time, which could partially or totally block the blood flow. Too much plaque buildup and narrowed artery walls can make it harder for blood to flow through your body. When your heart muscle doesnt get enough blood, you may have chest pain or discomfort, called angina. Angina is the most common symptom of cad. Over time, cad can weaken the heart muscle. This may lead to heart failure, a serious condition where the heart cant pump blood the way that it should. An irregular heartbeat, or arrhythmia, also spataderen can develop. Diagnosing natural cad, to find out your risk for cad, your health care team may measure your blood pressure, cholesterol, and sugar levels. Being overweight, physical inactivity, unhealthy eating, and smoking tobacco are risk factors for cad.
Coronary artery disease - wikipedia
Coronary artery disease is caused by plaque buildup in the wall of the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol voor deposits. Plaque buildup causes the inside of the arteries to narrow over time. This process is called atherosclerosis. Coronary artery disease (CAD) is the most common type of heart disease in the United States. For some people, the first sign of cad is a heart attack. You and your health care team may be able to help you reduce your risk for cad.
Coronary, artery, disease, coronary
6 Assessment of tissue viability The amount of impairment or damage caused by stenosis obstructing a coronary artery depends on how much of the myocardium the vessel supplies, the severity of the stenosis and any superimposed spasm, the level of demand in the tissue. When demand exceeds supply, the tissue becomes ischemic, which means blood supply is insufficient to maintain normal metabolism. Myocardial ischemia may cause chest pain, fatigue, shortness of breath, or another form of reduced exertion tolerance. Ischemia may have no symptoms but may be detected as impaired blood delivery, impaired contractile function (wall motion or wall-thickening abnormality on dynamic cardiac imaging series or interference with the movement of ions (resulting in depolarization and repolarization abnormalities on ecgs as st-segment shifts, changes. Ischemia may deplete high-energy phosphate carriers (eg, creatine, adenosine) that are needed for muscle contraction. Depletion may occur to the point that impaired motion may persist even when ischemia is relieved. Transiently impaired contractile function of muscle that persists after the relief from ischemia is called stun, and long-term dysfunction of viable muscle is called hibernation. Dead tissue converted to scar likewise loses contractile function. Therefore, a key issue when a region of heart wall shows loss of function is the determination of whether the myocardium is still viable.
Stress imaging has a complementary role in depicting zones with inducible ischemia (blood supply inadequate for the demands of the tissue). Stress may be produced with exercise, an infusion of a medication that increases the strength of cardiac contractions (eg, dobutamine or symptomen an infusion of a medication (eg, adenosine, dipyridamole) that dilates the vessels and thereby reduces the delivery of blood to diseased branches. More than a decade ago, mri was shown to be capable of imaging the coronary arteries and demonstrating stenoses without catheterization or injection of contrast material. 3 mdct is now proving to be a fast and useful alternative for defining the coronary anatomy. 4 mri takes more time than mdct and generally provides less detail of the coronary anatomy, but it avoids ionizing radiation and the use of iodinated contrast agent. Advances in mri and ct have hémorroïdes markedly improved the speed and resolution of imaging, making these modalities useful in the clinical evaluation of cad while improving their safety and convenience.
In addition to defining the anatomy, both mri and ct can be used to identify zones of impaired blood supply by timing of the arrival of contrast agentlabeled blood. In addition, mri is useful in identifying the location and thickness of myocardial scars. Although neither mri nor ct has replaced coronary angiography (XRA) as the clinical standard for the diagnosis of coronary stenosis, their use in determining if a vessel is open is increasing. Recently, 64-slice multidetector-row ct angiography (CTA) has shown potential as an alternative to coronary angiography for the identification of coronary blockages. 5 In a study of 15,207 intermediate likelihood patients without known cad, the severity of cad on coronary cta was predictive of the need for invasive coronary artery catheterization or revascularization. This suggests that coronary cta may be an effective gatekeeper for invasive catheterization.
Coronary, artery, disease - clinical journal of the American
Chest pain, coronary heart Disease, and, heart Attack. Severity of cad, the severity of cad is defined several ways, including the following: Anatomically, by visualizing the blood vessel branches and any blockages to blood flow along the pathways. Functionally, by estimating blood delivery to tissue supplied by each branch vessel. Clinically, by determining what symptoms correspond to inadequate blood delivery, what level of activity causes them, what relieves them, and the pattern of occurrences. Such patterns are described as unstable if the pattern includes variable or accelerating frequency, variable or increasing severity or changing character of symptoms, or variable or decreasing exercise threshold or if symptoms continue or recur just after a heart attack. In addition, one examines the consequences, including the location and extent of reversible and of permanent impairment, motion and thickening of affected segments of the heart, and whether the damage is causing or sustaining life-threatening arrhythmias.
One also evaluates the patient's overall cardiac performance, which is typically expressed as the ejection fraction (ef or percentage of the contents the left ventricle pumps forward in a heartbeat, and exertion tolerance, graded 1-4 (1normal, 4bedridden). The timi (Thrombolysis in myocardial Infarction) risk score looks at 7 factors that point to bad outcomes: Age 65 years or older, at least 3 risk factors for coronary artery disease. Prior coronary stenosis of 50 or more. St-segment deviation on electrocardiogram at presentation greater than.5. At least 2 anginal events in prior 24 hours. Use of aspirin in prior 7 days. Elevated serum cardiac markers, timi risk scores have the following risk of all-cause mortality, new or recurrent mi, or severe recurrent ischemia requiring urgent revascularization within the first 2 weeks: 15, 28, 313, 420, 526, 6/741. 2, imaging of cad, at present, achieving the best resolution on images of the coronary arteries requires catheterization, injection of an iodinated contrast agent, and use of a radiographic technique. As an alternative, multidetector-row ct (mdct) or mri may be used to clarify coronary anatomy and to determine whether a vessel is occluded.
Coronary, artery, disease, articles by cardiologist on myheart
The symptoms of zweettest a threatened heart attack may be very mild. Ischemia, when the heart has inadequate blood supply (ie, ischemia pressure may be felt in the chest that moves to the left arm; one may feel weak, sweaty, or short of breath or nauseated; palpitations (ie, change in heart rhythm) may occur; or there may. Many patients mistake the heart warning symptoms for heartburn or gas. If symptoms occur that may represent inadequate blood supply to the heart, one should rest immediately and take nitroglycerin, if available. If symptoms last more than 5 minutes, occur at rest, or keep coming back, one should call 911, chew a full-sized aspirin (325 mg) if not allergic, and continue taking nitroglycerin every 5 minutes as long as it does not cause dizziness or light-headedness. For excellent patient education resources, see emedicinehealth's. Also, visit emedicinehealth's patient education articles.
Coronary, artery, disease - harvard health
Unstable lesions activate blood clotting and/or vascular spasm. Indications that cad may be unstable include recent onset or familiar symptoms that are increasing in frequency, in duration, or in severity or with decreasing exertion tolerance or at rest. The term "chest pain" is a code phrase — the symptoms of cad do not have to regular be in the chest and do not have to include pain. I prefer the phrase "heart warning" symptoms. When a warning light is activated, you should resolve the problem quickly even if it is low in intensity. Unstable symptoms of cad may represent a threatened heart attack. After as little as 5 minutes, a wall of the heart may stop functioning but still be salvageable — that is called stun. After as little as 10-20 minutes permanent damage may accumulate, summarized by the phrase "time is muscle." If the symptoms are new or if they are familiar but unstable or are not reliably fully resolved in 5 minutes, emergency help is recommended because "time.
Selective injection image of the left coronary arteries. D1 first diagonal, lad left anterior descending artery, lcx left circumflex, lm left main coronary artery, and OM1 first obtuse marginal. View Media gallery, contrast-labeled blood to the heart is used to identify the territory at risk. The results of this assessment of the delayed arrival compares favorably to the findings of radionuclide stress kloven imaging, and stress induction of ischemia is not required to identify the zone at risk. View Media gallery, compared with radionuclide images of blood delivery, mris and ct scans improve resolution, depiction of the functional effect and the relationship to the coronary supply, and identification of the area at risk without stress. The advantage of radionuclide imaging is primarily its predictive value; stress echocardiography has similar predictive value. Mri and ct have been less available than other studies; therefore, data on their value are relatively limited. Stable and unstable lesions, lesions that cause blockages in the coronary arteries may be stable or unstable.
Coronary artery disease - wikipedia
Coronary artery disease (CAD) is a complex disease that causes reduced or absent blood flow in one or more of the arteries that encircle daikin and supply the heart. The disease may be focal or diffuse. Apart from rare congenital anomalies (birth defects coronary artery disease is usually a degenerative disease, uncommon as a clinical problem before the age of 30 years and common by the age of 60 years. One in four people will have a heart attack. The first recognized symptom may be death. The term coronary is derived from crown, referring to the way these arteries sit on the heart. The American College of Radiology notes that coronary artery disease has a long asymptomatic latent period and that early targeted preventive measures can reduce mortality and morbidity. Imaging modalities for evaluating patients at increased risk for cad include radiography, fluoroscopy, multidetector ct, ultrasound, mri, cardiac perfusion scintigraphy, echocardiography, and positron emission tomography (PET). 1, see the images below depicting the coronary arteries and cad.