Coronary Heart Disease

                                 Coronary Heart Disease

In coronary heart disease atherosclerosis develop in coronary arteries causing them to becoming narrow and block this leads to decrease or stop blood supply to the heart muscles.

Etiology :-

1. Non modifiable :-

• Genetic Heredity :- Children whose parents had heart disease are at a higher risk of C.H.D.
• Race :- The African & American have 45% greater chances of developing CHD.
• Age:- with increasing age risk & severity of CHD are increases.
• Gender :- males of younger age and females after menopause are at high risk of CHD.

     2. Modifiable factor :-

• Elevated serum lipid level
• Habitual diet high in fat and cholesterol
• Obesity 
• Cigarette smoking 
• Heavy alcohol consumption  
• Personality types
• Sedatory live
• Psychological strem
• Improper life style

Pathophysiology :-

• Due to etiological factor
• Localized accumulation of lipid, fibrous tissue, or thrombus
• Arterial narrowing or occulusion
• vascular changes occur that affect the functional ability or coronary arterial
• Deficit in myocardial oxygen supply
• Angina pectoris M.I. / cardiac arrest 
• Death

Types :-

• Type 1 st :- fatty, streaks lipid deposit in the int em of arteriol wall.
• Type 2 nd :- Inflammatory response takes macrophage to ingest lipid.
• Type 3rd :- Smooth muscle cell proliferate and form a fibrous capat are the deal fatty cell.
• Type 4th :- Fibrotic layer and plaque formation.
• Type 5th :- Distributed internal structure along with moderate disease that cause decrease in                         the size of lumen.
• Type 6th :- Rupture of plaque producing cavity thrombus with partial occlusion of lumen.

Clinical Manifestation :-

• Disrhythmia 
• Restlessness
• Fatigue
• Malase

Complication :-

• \Heart Failure
• Heart block
• Angina pectoris

Diagnostic Evaluation :-

• ECG
• 2D Echo
• Angiography
• Blood Investigation
• LFT

Management :-

1. Reduce Risk Factor :-

• Primary and secondary prevention cause are use for all major risk factor.
• Health professionals provide guidance & counselling related to disease condition.
• Health profession team motivate the client to stop smoking and alcohol consumption.
• maintain ideal body weight through the physical exercise
• Dietary modification according to disease condition & according to dietitian prescription.
• Encourage the client to perform physical activity and participate in exercise.
• Behavioral therapy or diversional therapy to reduce stress.

     2. Restore blood supply :-

• PTCA
• PCA
• Intra coronary stent
• laser ablation

    3. Pharmacological management :-

• Analgesics to relieve pain
• Vasoldilatiors
• ACE inhibitors