Coronary heart disease is a heart condition that results from the blockage of the coronary artery that supplies the heart with oxygen and other nutrients for nourishment. The blockage of the coronary artery is caused by a plaque that forms along the artery. Coronary heart disease starts to develop when cholesterol is deposited on the walls of the coronary artery and forms a plaque. With time, more cholesterol is deposited and the plaque grows bigger. Consequently, the artery gets inflamed and the risk of the formation of blood clot increases. The plaque may also release chemicals that promote the process of healing. However, the chemicals also make the inner walls of the artery sticky. As a result, substances such as lipoproteins, calcium, and inflammatory cells traveling through the artery stick to the surface of the inner walls of the coronary artery, thus further narrowing the walls of the blood vessel. As the artery continues to narrow, some blood vessels form that enable the blood to pass to the heart. However, during exertion, the newly formed vessels may not supply adequate oxygen and nutrients to the heart. Sometimes, the plaque may block the artery completely, hence causing heart attack. Sometimes, the artery supplying the brain is blocked by the plaque or a clot. In such cases, stroke occurs.
Coronary heart disease is caused by factors that make it easy for a plaque to form along the coronary artery. While some risk factors for developing coronary heart disease can be prevented, other factors are beyond the human control. For example, age, sex, and family history are some of the risk factors for coronary heart disease that cannot be prevented. However, other risk factors such as smoking, high level of cholesterol and high level of sugar in blood can be prevented or controlled. The association between the various risk factors and coronary heart disease has been reported in several studies. Smoking, for instance, has been reported to be the most common risk factor for coronary heart disease. Studies associating smoking with coronary heart disease were conducted as early as the 1990s. The risk of coronary heart disease and other cardiovascular diseases among people who smoke do does not vary in terms of sex. Rather, women who smoke have the same level of risk of developing coronary heart disease as their male counterparts who smoke.
The extent to which cholesterol contribute to coronary heart disease depends on the type of the lipoprotein that carries the cholesterol through the bloodstream. There are two main types of lipoproteins: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Lo-w-density lipoprotein cholesterol is referred to as the bad cholesterol mainly because is contributes significantly to the formation of plaque in the blood vessels. Consequently, it is responsible for most cases of coronary heart disease. High-density lipoprotein cholesterol, on the other hand, is referred to as good cholesterol. While LDL deposits cholesterol into the arteries, HDL remove them, hence explaining why HDL cholesterol is referred to as a good cholesterol. Other than the cholesterol, triglyceride also contributes significantly to the development of coronary heart disease. Indeed, high levels of triglycerides in blood are associated with increased risk of atherosclerosis. Overweight and obesity lead to a high level of triglyceride in the body. In this sense, obesity and overweight contribute to increased risk of coronary heart disease and other heart disease. The mechanisms by which these factors contribute to coronary heart disease differ from one risk factor to another. Smoking, for instance, releases chemicals to the linings of the coronary artery that damages its lining. Consequently, the damaged vessel becomes prone to blood clotting and attracts plaque.
Coronary heart disease is the heart disease with the highest prevalence in the United States. According to the Center for Disease Control and Prevention (CDC) (2015, August 10), coronary heart disease accounts for 370,000 deaths in the United States every year. The United States has also reported an increase in the prevalence of heart disease. Since coronary heart disease is the most prevalent heart disease in the United States, its prevalence is likely to be on the rise too.
Coronary heart disease manifests itself in various ways. Some of the most common signs and symptoms of this condition include the following: shortness of breath, chest pain (angina), and heart attack. Chest pain (angina) is the most common symptom of coronary heart disease. It occurs when a given area of the heart muscle is not supplied with sufficient oxygen and nutrients. It characterized by a feeling of pressure in the chest, and may also be felt arms, jaws, and the shoulders. The pain usually occurs when one undergoes a physical or emotional stress. On stopping the activity causing the stress, in case of physical stress, the pain often disappear. Heart attack is also a common symptom of coronary artery disease. It is caused by a complete obstruction of the coronary artery so that the muscle cells in a given area of the heart fail to get oxygen and other nutrients. Heart attack is characterized by a feeling of crushing pressure on the chest. The pressure is accompanied by pain in the arm or shoulder, and shortness of breath. Sometimes, sweating is also exhibited. Women are less likely than men to experience typical signs and symptoms of coronary artery disease. Shortness of breath, also a common symptom of coronary artery disease, results from the failure by the heart to pump enough blood to meet the body’s needs. Consequently, the body gets exhausted leading to the shortness of breath.
A cardiologist or a doctor can detect that one has coronary artery disease in several ways. Some of the main ways of detecting coronary artery disease are the following: performance of physical examination, performing diagnostic tests, and taking note of the signs and symptoms. The main diagnostic test conducted to detect coronary artery disease includes the following: laboratory tests, electrocardiograph tests, invasive tests, ultrasound tests, radiographic tests, and nuclear imaging among others. Electrocardiograph tests measure the electrical activity generated by the heart while one is at rest and while undertaking an activity. Two main electrocardiograph activities include exercise stress test and electrocardiogram (ECG). In irregular rhythm may indicate coronary artery disease.
Coronary heart disease can be treated through healthy lifestyles, cardiac rehabilitation, medical procedures and surgery, and medications. The main goals of the various treatment approaches for coronary heart disease are; to lower the risk of the formation of blood clot, to relieve symptoms, to widen or bypass the clogged arteries, and to prevent the complications associated with the condition. Lifestyle practices recommended for people with coronary artery disease involve healthy dietary practices. In this case, foods low in cholesterol and triglycerides should be removed from the diet. Saturated fats intake should also be lowered significantly and replaced with more healthy fats. Some of the common nursing diagnosis for coronary artery disease includes the following:
Acute Pain related to cardiac tissue ischemia or blockages in the coronary arteries.
Risk for Decreased Cardiac Output related to changes in the rate, rhythm, cardiac conduction, decrease preload or increased SVR, miocardial infarction.
Some of the most common preventive measures against coronary heart disease include preventing exposure to tobacco smoke and reducing the intake of cholesterol.
References
Center for Disease Control and Prevention. (2015, August 10). Heart Disease Facts. Heart Disease. Retrieved from http://www.cdc.gov/heartdisease/facts.htm
