Coronary Artery Disease the Heart

Coronary Artery Disease

The heart is a structurally equipped and well-functioning muscle, which sustains life. Healthy coronary arteries are clean, smooth, flexible and can expand to respond to the need of the heart for more oxygen. But faulty, fatty diet, and perhaps infection, can injure the functioning of the arteries. Coronary artery disease can develop. It begins with atherosclerosis or the accumulation of fatty substances. It can progress to angina or a heart attack. The disease affects other body systems (De Milto, 2001; American Heart Association 2007).

It is the leading cause of death in both sexes in the United States at one in every 4.8 (American Heart Association, 2007). Every 29 minutes, an American will have a heart attack and every minute, one will die of it. Many have silent coronary disease, which can lead to sudden death (American Heart Association).

Various treatments have been devised, such as antibiotics, statins and a regimen of work and social support (Barry, 2006; Hemingway, 1999; USA Today, 2006; Tarbutton & Mitra, 2007). High level of coronary artery calcium is said to increase the risk of developing the disease (Women's Health Advisor, 2008). The overall prognosis is said to be bright.

Coronary Artery Disease 2

Normal Aspects

The normal heart is a muscle, which is only a little bigger than a fist (American Heart Association, 2007). It beats 100,000 times a day and pumps approximately 2,000 gallons of blood daily and continuously through the circulatory system. It has two upper and two lower chambers. The upper chambers are the right atrium and the left atrium. The lower chambers are the right and left ventricles. It also has four heart valves, which open and close to allow blood flow in one direction. These are the tricuspid valve, the pulmonary valve, the mitral valve and the aortic valve. Blood is pumped through the chambers and aided by the valves. It returns to the heart through the veins and then enters the right atrium. The right atrium empties the blood into the right ventricle through the tricuspid valve (American Heart Association).

Dark bluish blood is pumped under low pressure by the right ventricle through the pulmonary valve into the pulmonary artery (American Heart Association, 2007). At this point, blood gets fresh oxygen, turns bright red. It then goes back to the left atrium through the pulmonary veins, crosses the mitral valve and goes to the left ventricle. Red oxygen-rich blood is pumped by the left ventricle through the aortic valve into the aorta. The aorta brings the blood throughout the body (American Heart Association). Healthy coronary arteries are clean, smooth, flexible and able to expand when needed (De Milto, 2001)

Deviations from Normal Anatomy and Physiology

The disease process in arteries generally begins with an injury to their linings and walls (De Milto, 2001). The injury renders them vulnerable to atherosclerosis and blood

Coronary Artery Disease 3 clots (thrombosis). Atherosclerosis is the accumulation of fatty materials in the linings of the arteries. In coronary artery disease, the arteries and blood vessels, which carry oxygen and nutrients to the heart, are restricted or partly blocked. A complete block to the flow results in a heart attack (De Milto).

Effects on Other Organ Systems

The blockage in coronary artery disease limits blood flow from the coronary arteries to the heart (De Milto, 2001). The heart has to work harder to produce more needed oxygen. The arteries then expand. If they cannot, the heart is deprived of oxygen and results in myocardial ischemia. If the block is limited, chest pain or pressure, called angina, results. Other symptoms are shortness of breath and heaviness on the chest, a sensation of tightness, pain, burning sensation, squeezing or pressure on the breastbone or in the arms, neck and jaws. However, some persons showed no symptoms of coronary artery disease before a heart attack and just died suddenly (De Milto).

Beneficial and Adverse Effects of Treatment

The finding that atherosclerosis is an inflammatory response brought attention to the beneficial use of antibiotics in the treatment of coronary artery disease (Tarbutton & Mitra, 2007). The assumed infecting agent is Chlamydia pneumonia, which responded to the use of antibiotics in clinical trials. However, these first trials were small and need to be supplemented and confirmed by larger and multi-center trials (Tarbutton & Mitra).

Test findings showed that the use of statins reduce cardiovascular mortality and morbidity (Barry, 2006). Those with the least risks appeared to derive the greatest

Coronary Artery Disease 4 benefits from the drugs. The tests, however, did not specify the effects of the drugs on specific lipid or cholesterol levels (Tarbutton & Mitra).

The frequently prescribed statin drug, Pravastatin, promises two benefits in the treatment of coronary artery disease (USA Today, 2006). It lowers cholesterol level and increases that of endogenous stem cells. These cells help repair heart damage. High doses have also been said to improve heart function and coronary blood flow in some tests (USA Today).