Introduction: near your lungs. Can you feel it

Introduction:

“Take a moment and place
your hand over your chest on the left-hand side near your lungs. Can you feel
it beating”?

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This continuous beating
which you could feel is a mind-blowing Organ called “The Heart” of Human body
which plays a key role in how the body functions (A Look at the Human Heart: Acls.net, 2017). The heart is
situated in the thoracic pit average to the lungs and back to the sternum. The
heart is a solid organ about the extent of a shut clench hand that facilitates
as the body’s circulatory pump. It takes in deoxygenated blood through the
veins and conveys it to the lungs for oxygenation before directing it into
different courses (which give oxygen and supplements to body tissues by
transporting the blood throughout the body) (Heart: Innerbody.com, 1999-2017).

But think if such an
important organ stops working because of our day to day misdeeds. One such
result of our silly ignorant attitude is the disease called “Coronary Heart
Disease”.

Definition:

Coronary Heart Disease
(CAD) (Also called: CAD, Coronary arteriosclerosis or Coronary Artery Disease, hardening
of the arteries, Heart disease, Ischemic heart disease) is a disease in which a
waxy substance called plaque develops inside the coronary conduits. These veins
supply oxygen-rich blood to your heart muscle. At the point when plaque
develops in the supply routes(artery), the condition is called atherosclerosis.
The development of plaque happens over numerous years.

Over
some time, plaque can solidify or burst (tear open). Solidified plaque limits
the coronary corridors and diminishes the stream of oxygen-rich blood to the
heart. If the plaque breaks, a blood coagulation can shape on its surface. A
vast blood clump can block the most part or totally does not allow blood to
move through a coronary supply route (What is :Coronary Heart
Disease-Nhlbi.nih.gov, 2015).

Symptoms:

·        
Chest
Pain (Angina): A typical symptom of a coronary illness
(CHD). Emotional and physical pressure likewise can trigger the pain. It may feel like pressure or squeezing in your chest. The pain also can
occur in your shoulders, arms, neck, jaw, or back. Usually
occurs on the middle or left side of the chest. You may feel pressure or
tightness in your chest, which usually goes away within minutes after stopping
the stressful activity. Angina pain may even feel like
indigestion. (Symptoms:Coronary artery
disease,Diseases & Conditions,Mayoclinic.org, 1998-2017) (Conditions:AnginaChestPain,Heart.org,
2015)

·      
Shortness
of Breath: Another normal indication of CHD. This
side effect happens if CHD causes heart disappointment (failure). When you have
heart failure, your heart can’t sufficiently direct blood to address your
body’s issues. Liquid develops in your lungs, making it difficult to relax.
(Symptoms:Coronary artery disease,Diseases &
Conditions,Mayoclinic.org, 1998-2017)

A
few people who suffer from CHD have no signs or symptoms—a condition called
‘Silent CHD’. The infection won’t be analysed until the patient has signs of a
heart attack, heart failure or an arrhythmia (a sporadic pulse).

·        
Heart
Attack: A totally blocked coronary artery may
cause a heart attack. The typical sign and side effects of a heart attack
incorporate pulverizing weight in your chest and agony in your shoulder or arm,
some of the time sweating. ladies are to some degree more probable than men are
to encounter less signs and side effects of a heart attack, for example, neck
or jaw torment. Sometimes heart attack comes with no clear signs or side
effects. (Symptoms:Coronary artery
disease,Diseases & Conditions,Mayoclinic.org, 1998-2017)

·        
Arrhythmia: An
arrhythmia is an issue with the rate or beat of the pulse/ heartbeat. When you
have an arrhythmia, you may see that your heart is skipping beats or pulsating
too quick.

A few arrhythmias can make your heart suddenly quit
pulsating. This condition is called sudden cardiac arrest (SCA). SCA, for the
most part, causes death if it’s not treated within few minutes (Symptoms:Coronary
artery disease,Diseases & Conditions,Mayoclinic.org, 1998-2017)

Causes:

Coronary artery disease
is thought to begin with damage or injury to the inner layer of a coronary
artery, sometimes as early as childhood. The damage may be caused by various
factors, which includes:

·        
Smoking: -Smoking damages blood vessels,
lead to unhealthy cholesterol levels, and raise blood pressure. Smoking also
can limit the oxygen supply to body tissues.

·        
High cholesterol (and certain fats): – High
LDL cholesterol (sometimes called “bad” cholesterol) and low HDL cholesterol
(sometimes called “good” cholesterol) can harm the blood supply.

·        
High blood pressure: – Uncontrolled high blood pressure can result in
hardening and thickening of your arteries, narrowing the channel through which
blood can flow.

·        
Diabetes or
insulin resistance: -Body is not able to use its own insulin and hence Diabetes
is occurred leading to excess blood sugar affecting the purity of blood and
oxygen supply.

·        
Blood vessel
inflammation: -Blood vessel inflammations leads to narrowing the artery and
blocking the blood flow.

·        
Sedentary
lifestyle: -The unhealthy lifestyle leads to loosing metabolism, being
overweight and early ageing leading to pressure on heart (Causes and
Risk Factors:Coronary artery disease,Diseases & Conditions,Mayoclinic.org,
1998-2017)
and (Causes and Risk Factors :Coronary Heart Disease-Nhlbi.nih.gov, 2015).

Treatment:

The most favourable treatments for CHD would be
Healthy Lifestyle, medicines, medical procedures and surgery, and cardiac
rehabilitation. Treatment goals for CHD should include:

·        
Lowering the risk of blood clots forming
(blood clots can cause a heart attack)

·        
Preventing complications of coronary heart
disease

·        
Reducing risk factors to slow, stop, or
reverse the build-up of plaque

·        
Widening or bypassing clogged arteries

Heart-Healthy Lifestyle:

Healthy lifestyle is
nothing but maintaining your health and preventing yourself from disease.

1.     
Heart-healthy eating:

Do’s

Don’ts

Fat
Free products like Fat-Free milk, Peanut Butter

Saturated
Fats which are in mostly Animal Products such as Red meat

Fish
High in Omega-3 Fatty Acids: Salmon, tuna etc. twice a week

Palm
and coconut oils
 

Fruits,
such as apples, bananas, oranges, pears, Avocados, Tofu and prunes

Sugary
foods and beverages
 

Legumes,
such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans.
Oils like Corn, Sunflower, Safflower etc.

Trans
Fatty Acids such as stick margarine; baked goods, such as cookies, cakes, and
pies; crackers; frostings; and coffee creamers.

Vegetables,
such as broccoli, cabbage, and carrots.

Salty
Foods and lowering sodium intake

Whole
grains, such as oatmeal, brown rice, and corn tortillas

Limit
Alcohol Intake

 

 

2.     
Maintaining Weight:

Maintaining
weight is always good for healthy life as well as keeps you away from Heart
Diseases. Ideally, you should always have a check on your Body Mass Index(BMI)
as follows:

 

Weight
Classifications

BMI Levels

Underweight

Below 18.5

Normal/Healthy
Weight

Between 18.5 and 24.9

Overweight

Between 25 and 29.9

Obese

Of/Above 30

 

Being
Obese leads to high cholesterol levels, high blood sugars and a higher risk of
heart attacks. A person should maintain normal/healthy BMI levels to reduce
heart attack risks.

3.     
Managing Stress:

The
most common trigger for heart attack is an emotionally event especially Anger.
Stress can be coped up easily by various ways such as below: Meditation,
Physical Activity, Relaxation therapy, being with family and friends.

4.     
Physical Activity:

Physical
Fitness is the key to Healthy Life. Everyone should exercise for at least 2
hours and 30 mins/week with a combination of moderate to high intensity workouts.
Physically fitness reduces bad cholesterol levels, high blood pressure, and
excess weight reducing the risk of Diabetics and improvement in good
cholesterol levels preventing from CHD.

5.     
Quitting Smoking:

Smoking
increases the risk of Coronary Heart Diseases and Heart Attacks. To help quit
smoking take help from doctors or counsellors who would give you good programs.
Also, avoid being a passive Smoker. 

Medicines:

Sometimes lifestyle
changes aren’t enough to control your blood cholesterol levels. By lowering
your cholesterol level, you can decrease your chance of having a heart attack
or stroke. Doctors usually prescribe statins for people who have Coronary heart
disease, peripheral artery disease, or had a stroke, Diabetes, High LDL
cholesterol levels. Your doctor also may prescribe other medications to:

·        
Decrease risk of heart Attacks and lower
your blood pressure.

·        
Prevent blood clots, which can lead to
heart attack or stroke.

·        
Prevent or delay the need for a stent or
percutaneous coronary intervention (PCI) or surgery, such as coronary artery
bypass grafting (CABG).

·        
Reduce your heart’s workload and relieve
coronary heart disease symptoms 

 

Medical Procedures and Surgery:

Both PCI and CABG
are used to treat blocked coronary arteries.

1.     
Percutaneous Coronary Intervention

Percutaneous coronary
intervention, commonly known as angioplasty, is a nonsurgical procedure that
opens blocked or narrowed coronary arteries. A thin, flexible tube with a
balloon or other device on the end is threaded through a blood vessel to the
narrowed or blocked coronary artery. Once in place, the balloon is inflated to
compress the plaque against the wall of the artery. This restores blood flow
through the artery.

During the procedure, the
doctor may put a small mesh tube called a stent in the artery. The stent helps
prevent blockages in the artery in the months or years after angioplasty.

2.     
Coronary Artery Bypass Grafting

CABG is a type of surgery
in which arteries or veins from other areas in your body are used to bypass
(that is, go around) your narrowed coronary arteries. CABG can improve blood
flow to your heart, relieve chest pain, and possibly prevent a heart attack.

Cardiac
Rehabilitation:

The cardiac rehab team
may include doctors, nurses, exercise specialists, physical and occupational
therapists, dietitians or nutritionists, and psychologists or other mental
health specialists.

Rehab has two parts:

·        
Education, counselling, and training. This
part of rehab helps you understand your heart condition and find ways to reduce
your risk for future heart problems. The rehab team will help you learn how to
cope with the stress of adjusting to a new lifestyle and how to deal with your
fears about the future.

·        
Exercise training. This part helps you
learn how to exercise safely, strengthen your muscles, and improve your
stamina. Your exercise plan will be based on your personal abilities, needs,
and interests. (Treatment
:Coronary Heart Disease-Nhlbi.nih.gov, 2015)

Prognosis:

Long-term
prognosis in the individual patient with coronary heart disease is
unpredictable. However, there are broad patterns of survival in the various
clinical syndromes which may be expressed in sufficiently quantitative terms to
allow an estimate of insurability.

Prognosis
is expressed most conveniently in terms of mortality ratios (actual to expected
deaths), i.e., the relative number in a group succumbing compared to the
relative number in the general population of the same age and sex dying in the same
period. In most clinical studies the long-term prognosis, i.e., survival after
the initial period of acute coronary attacks, has been analysed in terms of the
percentage alive after five and ten years.

Mortality
in the first two years after a coronary attack is of the order of six to seven
times normal (mortality ratio of 600 to 700 per cent). Thereafter it falls
progressively, with increasing intervals of time after the attack.

The milder
the acute attack, the more complete the recovery, and the older the age at
which it occurs, the more favourable the long-term outlook.

 In
such groups, life expectancy may far exceed the over-all average experience,
which in most studies has been that 3 of 5 persons surviving acute infarction
live a further five years, and 1 of 3 survives ten years. Conversely, in
persons who have accompanying disorders predisposing to progression of coronary
disease, such as diabetes, the long-term outlook is poorer than average.

Mortality
ratios are somewhat better in persons with angina pectoris than in those who
have had known attacks of myocardial infarction, although in one very extensive
study the five- and ten-year survival rates were not significantly higher.
Long-term prognosis is slightly better in females than in males both in
instances of angina pectoris and after coronary attacks.

The risk of
developing overt disease may be multiplied several fold in the presence of
various predisposing factors, particularly when multiple factors are present
concurrently. Among these are elevated serum cholesterol, obesity,
hypertension, diabetes, strong family history of coronary disease, heavy
smoking, sustained stressful personality pattern, and arcus senilis.

There are
indications that the course of coronary heart disease may be modified, and that
the pattern of survival may begin to approach that of the average population by
controlling some of the predisposing factors, and by application of such
measures as dietary restriction of fat and prolonged anticoagulation.

Clinical
and actuarial experience indicates that long-term mortality ratios following
attacks of myocardial infarction and in other syndromes of coronary heart
disease are not prohibitive; and insurability may be considered in appropriate
circumstances.

References:

A Look at the Human Heart: Acls.net. (2017, December 18). Retrieved from Acls Training
Center: https://www.acls.net/a-look-at-the-human-heart.htm
Causes and Risk Factors :Coronary Heart
Disease-Nhlbi.nih.gov. (2015).
Retrieved from National Heart,Lung and Blood Institute,U.S. Department of
Health and Human Services:
https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease
Causes and Risk Factors:Coronary artery
disease,Diseases & Conditions,Mayoclinic.org. (1998-2017). Retrieved from Mayoclinic:
https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
Heart: Innerbody.com. (1999-2017). Retrieved from Innerbody:
http://www.innerbody.com/image/card01.html
Symptoms:Coronary artery disease,Diseases &
Conditions,Mayoclinic.org.
(1998-2017). Retrieved from Mayoclinic:
https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
Treatment :Coronary Heart Disease-Nhlbi.nih.gov. (2015). Retrieved from National Heart,Lung and
Blood Institute,U.S. Department of Health and Human Services:
https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease
What is :Coronary Heart Disease-Nhlbi.nih.gov. (2015). Retrieved from National Heart,Lung and
Blood Institute,U.S. Department of Health and Human Services:
https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease
 

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