CORONARY ATHEROSCLEROSIS IN ENGLISH

                                                    

                          CORONARY ATHEROSCLEROSIS IN ENGLISH

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CORONARY ATHEROSCLEROSIS-

CAD-

     Coronary artery disease (CAD) is the most prevalent type of cardiovascular disease in adults. Coronary arteries are the arteries  which  supply oxygenated blood supply to the heart muscles and any problem in coronary arteries directly affect function of heart muscles.

ATHEROSCLEROSIS-

     Atherosclerosis  is  the main coronary artery disease. an abnormal accumulation of lipid, or fatty substances, and fibrous tissue in the lining of arterial blood vessel walls. These substances block and narrow the coronary vessels in a way that reduces blood flow to the myocardium.

CAUSATIVE FACTORS-

Ø  The development of atherosclerosis over many years involves an inflammatory response, which begins with injury to the vascular endothelium.

Ø  The injury may be initiated by smoking, hypertension, and other factors.

Ø  These deposits, called atheromasor plaques, protrude into the lumen of the vessel, narrowing it and obstructing blood flow

Ø  Elevated low-density lipoprotein (LDL) cholesterol and  decreased level  of High density lipoprotein (HDL) cholesterol are also included in the risk  factors   of  atherosclerosis.

     Other factors  include

     Hyper-lipidemia

     Cigarette smoking,

     tobacco use

     Hypertension

     Diabetes mellitus

     Metabolic syndrome

     Obesity

     Physical inactivity

     CLINICAL MANIFESTATIONS-

     Atherosclerosis produces symptoms and complications according to the location and degree of narrowing of the arterial lumen, thrombus formation, and obstruction of blood flow to the myocardium. Clinical manifestations includes-

     Pain in the chest (due to myocardial ischemia)

     Shortness of breath.

     Dyspnea,

     Nausea,

     Angina pectoris,

     Myocardial Infarction and

     sudden cardiac death

DIAGNOSTIC INVESTIGATIONS-

Ø  History and Physical examination. (presence of clinical manifestations of coronary atherosclerosis)

Ø  ECG.

Ø  Lipid profile test.

Ø  CRP.

Ø  Cardiac angiography

 

MANAGEMENT-

Ø  The goal of management of atherosclerosis is to prevent further progression of disease and prevent complications such as angina and MI.

Ø   The main step in this regard is to modify cholesterol abnormalities. All adults 20 years of age or older should have a fasting lipid profile (total cholesterol, LDL, HDL, and triglyceride) performed at least once every 5 years and more often if the profile is abnormal.

Ø  Target should be to keep-

Ø  LDL cholesterol less than 100 mg/dL (less than 70

mg/dL for very high-risk patients)

Ø  Total cholesterol less than 200 mg/dL

Ø  HDL cholesterol greater than 60 mg/dL

Ø  Triglyceride less than 150 mg/dL

Ø  Lipid-lowering medications can reduce CAD mortality in patients with elevated lipid levels and in at-risk patients.

Ø  Diet modification is very important in preventing coronary atherosclerosis such as ingestion of vegetables and fish and restricting  meat and fatty foods etc. Soluble dietary fiber may help reduce cholesterol levels.

Ø  Management of an elevated triglyceride level also involves life style modification such as-

Ø  focuses on weight reduction and

Ø  Brisk walking.

Ø  Regular, moderate physical activity increases HDL levels and reduces LDL. And

Ø  Cessation of cigarette smoking.