Coronary heart disease
What is coronary heart disease and how to identify it?
Coronary heart disease is the most common heart disease that causes chest pain. In coronary heart disease, the coronary artery supplying blood to the heart has become occluded. Coronary artery occlusion causes an oxygen deficiency in the heart, and thereby chest pain. Cardiac chest pain typically becomes more severe during exercise, whereas resting alleviates the symptoms.
How do you examine and treat coronary heart disease?
The patient is given a clinical stress test to investigate the cause of the chest pain. In the test, the patient rides an exercise bicycle while the doctor monitors his or her blood pressure and ECG changes. If the exercise causes an oxygen deficiency in the heart, it will show on the ECG. This way, the doctor can assess whether the patient has coronary heart disease and begin medical treatment as necessary. The clinical stress test can also be used to assess whether pharmacotherapy is sufficient or further examinations are required, such as coronary angiography. The medical treatment of coronary heart disease comprises treatment in accordance with the prognosis, including aspirin, and statins to lower cholesterol. Beta blockers may also be used. They are used to alleviate the symptoms. If the patient has had a myocardial infarction or has heart failure, beta blockers also improve the prognosis. The patient may also be given ACE inhibitors or AT inhibitors if he or she suffers from heart failure. Nitrate is another medical substance that alleviates the symptoms of a patient with coronary heart disease. If chest pain interferes with everyday coping in spite of proper pharmacotherapy, other forms of treatment may be considered after coronary angiography. Other forms of treatment include angioplasty of the coronary artery occlusion and coronary artery bypass.
The most common risk factors for coronary heart disease
The risk factors are always identified at the doctor’s surgery. The most significant risk factors for coronary heart disease are smoking, diabetes, hypertension, high cholesterol levels and family history. Family history means that a first‑degree relative (parents or siblings) has had myocardial infarction or has undergone angioplasty or a coronary artery bypass at under 55 years of age (men) or under 65 years of age (women).
Monitoring of a coronary heart disease patient
In spite of the method of treatment of coronary heart disease (pharmacotherapy, angioplasty or coronary artery bypass), the most important thing is to ensure that the patient is regularly monitored at the surgery of a heart specialist. The sufficiency and suitability of medical treatment is checked during each appointment. If the symptoms return or become more difficult, the physician will assess the need for coronary angiography.
When to see a doctor?
The cause of chest pain conjunction with exertion must always be examined. If the symptoms subside a few minutes after the exertion stops and the patient does not experience chest pain while inactive, the examination can be conducted in the next few weeks. Patients can then seek treatment trough their personal doctor or a cardiologist.