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Coronary Heart Disease/Coronary Artery Disease (CAD)/Ischemic Heart Disease/Coronary Atherosclerosis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Coronary arteries are the blood vessels that deliver oxygenated blood to the heart. Coronary atherosclerosis, also commonly known as coronary artery disease and coronary heart disease, is a > 50% narrowing of any coronary artery. When cholesterol, fat, and calcium plaque builds up and hardens within the innermost layer (intima) of the coronary arteries, the wall becomes thicker and more stiff. This reduces or blocks the flow of rich oxygenated blood that can reach the heart. The resulting myocardial ischemia can lead to shortness of breath, palpitations, chest pain (angina), heart attack, arrhythmias, and heart failure.
Actual Patient Cases of CHD and MI from My Practice
Published in Mark C Houston, The Truth About Heart Disease, 2023
I suspected that she had “coronary artery spasm” based on her history and the tests. This is a relatively common cause of chest pain in women due to constriction and spasm of the coronary arteries, but there is no plaque or blockage in the arteries.
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Fatty streaks are non-pathological lesions in the coronary arteries; they are present in most people around the age of 20 and are thought to be the precursors of atheromatous plaques. The progression into pathological lesions is influenced by both genetic and lifestyle factors (Mageed 2018). During the early stages of this disease, lipids are deposited into the sub-intimal space where they combine with monocytes to form large bulky cells called foam cells. As the cells proliferate, the amount of space needed for them is reduced, and they slowly start to force the endothelial layer of the arterial wall out into the lumen of the artery. As a result, the diameter of the lumen becomes slowly more narrow (stenosis) (see Figure 6.17). The patient might be asymptomatic throughout the early phases of atherosclerosis build-up. By the time that symptoms of chest pain (angina) and breathlessness occur during activity, the disease will already be quite advanced in the coronary arteries.
Risk factors for a broken heart: understanding drug-induced causes for Takotsubo syndrome and pharmacological treatment options
Published in Expert Review of Clinical Pharmacology, 2022
Gao Jing Ong, Thanh Ha Nguyen, Sven Y Surikow, John D Horowitz
On patient discharge, a detailed communication should be established with the patient’s usual medical practitioner, and arrangements made to review the patient after 3 months or less. It should be explained to the patient that:- This was not a ‘heart attack’, and has nothing to do with blocked coronary arteries: nor are either aspirin or statins indicated for its treatmentAlthough there will be rapid improvement in echocardiographic appearances, the patient is likely to take at least 3 months to feel better, and there is a chance that some scarring will occur within the heart, resulting in a degree of permanent exercise limitation.There is a small risk of recurrence in future.
The forgotten specific ECG sign of idiopathic dilated cardiomyopathy: Goldberger’s triad revisited
Published in Acta Cardiologica, 2022
Yalcin Velibey, Emrecan Parsova, Gokcem Ayan, Ozge Guzelburc
A 61-year-old man with no prior medical history presented with progressive shortness of breath and oedematous legs over the prior two weeks. He had no history of hypertension, diabetes mellitus, cigarette smoking and coronary artery disease. On admission, his arterial blood pressure was 120/70 mmHg and his heart rate was 90 beats per minute. Physical examination was notable for crackles in the lower half of the both lungs, elevated jugular venous pressure, and severe lower-extremity edoema. Electrocardiography (ECG) revealed the characteristic Goldberger’s triad which is 90% specific for detecting severe left ventricular (LV) systolic dysfunction (Figure 1). Chest radiography showed mild cardiomegaly with cardiothoracic ratio of 0.55 and evidence of pulmonary edoema. Routine laboratory tests showed normal electrolyte levels, renal, liver and thyroid functions. Serum biomarkers of myocardial injury such as Troponin I and CK-MB were also normal. Transthoracic echocardiography (TTE) demonstrated severe global LV hypokinesis, dilated left heart chambers, severe mitral and moderate tricuspid regurgitation, elevated (45 mmHg) pulmonary artery systolic pressure and reduced LV systolic function with EF of 15%. Coronary angiography revealed normal coronary arteries. Treatment with intravenous diuretic (furosemide), oral metoprolol, perindopril, spironolactone was initiated. Patient was discharged from the hospital after resolution of his symptoms.
Nanotechnological approach to delivering nutraceuticals as promising drug candidates for the treatment of atherosclerosis
Published in Drug Delivery, 2021
Sindhu C. Pillai, Ankita Borah, Eden Mariam Jacob, D. Sakthi Kumar
Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is performed by opening narrowed coronary arteries to place a stent thus improving the blood flow to the heart and mitigating chest pain. Coronary artery bypass grafting (CABG) involves the grafting of a new artery to bypass the narrowed coronary arteries while boosting blood flow and preventing heart attacks. In the list of surgical methods, carotid endarterectomy is a common surgical process that involves the correction of the internal carotid artery by removing plaque build-up eventually restoring the blood flow to the brain. Surgical procedures of the blood vessel-blockade have achieved clinical success for many years, yet are also associated with numerous complications such as restenosis, in-stent restenosis, and late-stage clotting to name a few (Giannini et al., 2018).