PUBLIC HEALTH

Public Health



Public Health

Coronary heart disease (CHD) is also known as ischemic heart disease. Coronary artery disease is the most common manifestation of cardiovascular disease and represents more than half of overt heart failure in the general population. Coronary artery disease is a progressive disease, initiated by damage to the walls of the vessels supplying the heart (coronary arteries). These lesions trigger a complex process of remodelling and atherosclerosis which causes thickening of the arterial wall and therefore a decrease in blood flow to the heart.

This process leads to the atherosclerosis (fatty deposits), the narrowing or obstruction (blockage) of coronary arteries that supply blood carrying oxygen to the heart muscle. Consequently, the heart muscle cannot function properly and may even stop completely (Rosamond, 2007, 33-90).

Some key points regarding coronary heart disease:

• CHD moved gradually through the accumulation of fatty deposits and other blood waste on the inner lining of arteries. This is a gradual process called atherosclerosis.

• The progression of atherosclerosis leads to the formation of plaques whose size may grow to reduce the blood flow in the artery and reducthe bloodod flow to the heart muscle.

• Therefore, the decreased blood flow to the heart and the lack of oxygen resulting can cause angina (heart pain).

•When an artery is completely blocked, an entire area of the heart muscle is deprived of oxygen and dies, the heart attack.

•The key problem of CHD is that since many people remain asymptomatic, they are unaware of suffering from this disease before the onset of heart attack.

Initially, the plaques (platelets) are composed of cholesterol. The accumulation of plaques can be accelerated by smoking, high blood pressure, high cholesterol and diabetes. Elderly patients may also be at risk for development of the platelet (males over 45, women over 55). Cause of early cardiovascular system can be and hereditary predisposition (Navarro, 2007, 23-70).

Atherosclerotic process is the cause of the substantial narrowing of the lumen in one or more coronary arteries. When narrowing of the coronary arteries more than 50 - 70%, blood flow beyond the plaque becomes so weak that it cannot meet the increased oxygen demand during exercise. Cardiac muscle in these arteries lacks oxygen (becomes ischemic). On admission of oxygen in the blood of an insufficient quantity of patients often experience chest pain (angina pectoris, or angina). Up to 25% of patients did not experience chest pain, despite the lack of detectable blood flow and reduced oxygen supply. In these patients, there is the so-called "latent" form of angina, but the risk of heart attacks among them no less than people with obvious angina. When a blood clot is formed on top of the plaque artery, then it will be completely blocked which will lead to a heart attack.

A rigid rest angina or angina (unstable angina) is formed when the artery is narrowed by more than 90 - 99%. Unstable angina may also occur due to periodic clogging of the artery thrombus, which eventually collapses (Witt, 2006, ...