Coronary heart disease

Description:

Coronary heart disease (ischemic heart disease; lat. morbus ischaemicus cordis from other - Greek ἴσχω — "I detain, I constrain" and αἷμα — "blood") — the morbid condition which is characterized by absolute or relative disturbance of blood supply of a myocardium owing to defeat of coronary arteries of heart.

Coronary heart disease represents the damage of a myocardium caused by frustration of coronary circulation resulting from disturbance of balance between a coronary blood-groove and metabolic requirements of a cardiac muscle. In other words, the myocardium needs bigger amount of oxygen, than its arrives with blood. The ischemic heart disease can sharply proceed (in the form of a myocardial infarction), and also chronically (periodic attacks of stenocardia).
Classification of an ischemic heart disease by clinical forms is used, each of which has independent value in view of features of clinical manifestations, the forecast and tactics of treatment. It is recommended in 1979 by the group of experts of WHO.

  1. Sudden coronary death (primary cardiac standstill).
          * Sudden coronary death with successful resuscitation
          * Sudden coronary death (lethal outcome)
  2. Stenocardia
          * A stable angina of exertion (with the indication of a functional class).
          * Coronary syndrome of X
          * Vasospastic stenocardia
          * Unstable stenocardia
                o the progressing stenocardia
                o for the first time the arisen stenocardia
                o early postinfarction stenocardia
  3. Myocardial infarction
  4. Cardiosclerosis
  5. Ischemic heart disease Bezbolevy form

It is inadmissible to formulate the diagnosis of an ischemic heart disease without interpretation of a form as in such habit view it does not give real information on the nature of a disease. In correctly formulated diagnosis the specific clinical form of a disease follows the diagnosis of an ischemic heart disease through a colon, for example: "Ischemic heart disease: for the first time the arisen angina of exertion"; at the same time the clinical form is specified in the designation provided by classification of this form.

Also today there is more modern classification. It is classification of an ischemic heart disease of WHO with additions of VKNTs, 1984.

  1. Sudden coronary death (primary cardiac standstill)
          * Sudden coronary death with successful resuscitation
          * Sudden coronary death (lethal outcome)
  2. Stenocardia
          * Angina of exertion
                o For the first time the arisen angina of exertion
                o the Stable angina of exertion with the indication of a functional class
          * Unstable stenocardia (now it is classified by Braunvald)
          * Vasospastic stenocardia
  3. Myocardial infarction
  4. Postinfarction cardiosclerosis
  5. Disturbances of a cordial rhythm
  6. Heart failure

Symptoms of Coronary heart disease:

For justification of the diagnosis of an ischemic heart disease it is necessary to establish evidential its clinical form (from among presented to classifications) by the standard criteria of diagnosis of this disease. In most cases key value for diagnosis has recognition of stenocardia or myocardial infarction — the most frequent and most typical manifestations of an ischemic heart disease; other clinical forms of a disease meet in daily medical practice more rare and their diagnosis is more difficult.

Reasons of Coronary heart disease:

Coronary heart disease is pathology which cornerstone the damage of a myocardium caused by its insufficient blood supply (coronary insufficiency) is. Disturbance of balance between real blood supply of a myocardium and requirements it in blood supply can happen because of following circumstances:

  1. The reasons in a vessel:
          * atherosclerotic narrowings of a gleam of coronal arteries;
          * thrombosis and thrombembolia of coronal arteries;
          * spasm of coronal arteries.
  2. The reasons out of a vessel:
          * tachycardia;
          * myocardium hypertrophy;
          * arterial hypertension.

Treatment of Coronary heart disease:

There is a number of groups of drugs which can be shown to use at this or that ischemic heart disease form.
Antiagregant, in-adrenoblrkatory use, statines, nitrates, anticoagulants, diuretics, inhibitors of an angiotensin-converting enzyme, antiaritmika, surgical treatment.