Symptoms, Diagnosis and Treatment Options of Coronary Heart Disease

Coronary Heart Disease: Symptoms, Diagnosis, And Treatment Options

Coronary Heart Disease

Among the common diseases that affect the heart, coronary heart disease is the most common in the U.S., and is the leading cause of heart attacks among men and women. Coronary heart disease, in some quarters referred to as coronary artery disease (CAD), is the inability of blood vessels to supply the required amount of oxygen and blood to the heart as a result of plaque buildup in the inner walls of the coronary artery (National Institute of Health, 2015). According to the Centers for Disease Control and Prevention (2015), a total of 720,000 Americans have heart attacks every year and, of these, 380,000 die from CAD. Recent studies have established that majority of these deaths are caused by the ignorance of warning signs and symptoms and the inability of people to respond promptly in the incidence of heart attacks. The CDC also states that the U.S. incurs costs amounting to $108.9 billion from medication, medical services and declines in productivity as a consequence of the condition. This text looks at CAD in detail and examines its symptoms, diagnosis, and current treatment options.

The prevalence of coronary heart disease in the U.S.

On the basis of the analysis of the Behavioral Risk Factor Surveillance System (BRFSS) in 2010, the CDC established that the prevalence of CAD was 1.2% in those aged between 18 and 44 years, 7.1 for those aged between 45 to 64 years, and greatest for people aged above 65 years of age at 19.8% (CDC, 2015). However, in 2015, the American Heart Association found out that the prevalence was greatest among men and women aged 80 or higher, and according to its National Health and Nutrition Examination Survey, more men were affected than women (AMA, 2015). Declines in mortality rates have been reported, which may be as a result of improved treatments and reduction of the risk factors. Over the years, the risk factors that have been identified include high levels of cholesterol, smoking, diabetes, lifestyles with no physical activity, and an established family history of premature vascular disease (Shah, 2006)

Epidemiology

The process that leads to CAD is referred to as atherosclerosis. This is the process whereby cholesterol deposits that make plaque accumulate in the arteries overtime, making them narrow. When the arteries become narrow, the right amount blood does not get to the heart, resulting in the weakening of the heart muscles and causing individuals to experience some pressure, pain, or discomfort in the chest - a condition referred to as angina (CDC, 2015). Eventually, the heart becomes unable to pump blood in the right way, leading to heart failure and irregular heartbeats. When the plaque completely seals off the artery that carries blood to the heart or causes a clot on the coronary artery, the individual is bound to have a heart attack.

Risk factors

Over the years, the risk factors that have been identified include high levels of cholesterol, smoking, diabetes, lifestyles with no physical activity and an established family history of premature vascular disease (Shah, 2006). It has been established that women with high levels of stress either at work or at home are more likely to get CAD. Some personality traits such as worrying, hostile behavior, lack of patience, and a high level of urgency also aggravate the disease. There have been new risk factors established to predispose individuals to CAD. These include: increased levels of lipoprotein and homocysteine, inflammation, insulin resistance syndrome and infections (Shah, 2006).

Symptoms of CAD

In the early stages of the disease, symptoms are rarely noticeable. However, in later stages, angina becomes the most noticeable symptom of CAD. As mentioned earlier, this is pressure or pain that is felt in the chest. One feels as if the heart is being squeezed, and experiences difficulty in breathing. Sometimes the pressure is also felt in the upper back, stomach area, neck, and in the arms. Apart from chest pains, NIH (2015) claims that diabetics, females and the elderly may experience general weakness of the body, difficulty in breathing arising from shortness of breath and fatigue.

Diagnosis

Before CAD can be diagnosed, a series of tests and risk assessments have to be carried out for the triggers of angina to be established and to find out the nature of the chest discomfort - and whether it points towards cardiovascular disease, stroke or heart attack. According to Fuster, Topol and Nabel (2005), there are five important factors that are sourced from a patient's physical examination and family history that are useful for diagnosis of CAD. These are: the risk factors, such as diabetes, gender, history, age and Electrocardiogram (ECG) which is the test that records the hearts activities. Various tests are used in the diagnosis of CAD. Stress tests are exercises used to determine the stress levels of a patient and their causes. X-rays of the chest, lungs and the heart are used to ascertain there are no other conditions that may be causing the pain (National Health Service, 2015). The NHS also describes the Echocardiogram, which uses sound waves to enable doctors to see the picture of the heart. This test establishes how thick the heart muscle is, the pumping of blood, and the structure of the heart, as well as the movement of the heart valves. The test used to measure how narrow the coronary artery is the coronary angiography. It measures the pressure in the heart chambers to help doctors find out how well the heart is functioning (NHS, 2015). Sometimes, doctors also need to measure how strongly the heart pumps blood or to monitor how blood flows around the heart. In this case, radionuclide tests are used. Magnetic resonance imaging (MRI) and computerized tomography (CT) scans are further tests that will show the image of the heart in greater detail.