Coronary

Coronary's disease overview

What is

coronary artery disease?

Coronary artery is a nourishing blood artery for the heart, including anterior ventricular artery, the hat artery comes from the body of the left coronary artery and the right coronary artery. coronary artery disease is a pathology of these arteries, mainly caused by atherosclerosis that causes coronary artery narrowing, which can lead to dangerous events such as myocardial infarction. Coronary artery disease is a disease of the present era with the incidence and the number one mortality rate worldwide (ranked on cancer, brain stroke, etc.). Currently, with many advances in cardiovascular intervention as well as medications, it has greatly improved in the mortality rate of coronary disease.

Coronary artery disease is divided into two main groups: acute rim syndoms (myocardial infarction with st differentiation, non -stable myocardial infarction, unstable chest pain) and stable angina (vascular disease stable rim).

Causes of Coronary's disease

Ceremony of coronary artery disease

  • Coronary artery blockage caused by atherosclerotic plaques: The atherosclerotic plaques that cause coronary artery narrowing to a certain extent will cause myocardial ischemia, symptoms of chest pain on forestry Sound. If atherosclerosis suddenly cracks, the blood clotting process starts, creating thrombosis that covers the coronary heart, then the heart attack will occur.
  • Local spasms or coronary arteries
  • Coronary dysfunction

    • Symptoms of Coronary's disease

    Symptoms of coronary artery disease are mainly manifested by angina pain

    Coronary angina is described with 3 characteristics:

  • Feeling of pain like strangling, pain like angina or heavy, behind the breastbone, spreading to the chin, on the left shoulder and spreading to the left arm
  • Appears of a rule, increasing after exertion, strong emotions, cold, ... lasting 3-15 minutes
  • Chest pain when resting or using nitroglycerin

    • If there are all 3 characteristics, called typical angina, if only 2/3 of the standard is called a typical pain, if only 1 or 1 or There is no criteria, then find another cause not coronary artery

  • Chest pain consists of the above characteristics called stable chest pain. If the chest pain appears suddenly, appears even at rest, or appears when performing activities that normally without chest pain is called unstable chest pain. Severe chest pain, lasting for more than 20 minutes to think of myocardial infarction.

    • For high -age patients or especially diabetes, chest pain may not be typical or unclear, faint. Patients can go to the hospital with heart failure without knowing the previous chest pain, surveying the coronary artery is narrowed in a significant way. Such cases are called silent myocardial ischemia

    People at risk for Coronary's disease

  • Men

    • Old age

  • Smoking

    • obesity

    Diabetes

    Blood lipid disorders

    Hypertension

  • Static, sedentary lifestyle

    • Prevention of Coronary's disease

  • Quit smoking

    • Weight loss if overweight

    Exercise regularly: at least 30 minutes a day, 5 days per week

  • Healthy diet: Many green vegetables, fruits, limit animal fat instead of vegetable oil, limit animal organs, reduce salt in food, do not eat other Salt foods like pickles, salted tomatoes ...
  • Control blood pressure by changing the diet with oral medication regularly
  • Control blood sugar, blood lipid

    • Diagnostic measures for Coronary's disease

    For acute breast pain: St difference, ST will go down to the mirror in other relations, or high -pointed t waves at the dark stage

    Blood test: Troponin Temple or Troponin I is the sign of myocardial necrosis, which is the standard for diagnosis to determine acute myocardial infarction

    Emergency echocardiography: In unclear cases, may need an emergency detrimental ultrasound to find myocardial movement disorders Cases of chronic, stable chest pain:

  • Electrimidism: is the first means to be done first to diagnose coronary disease. On the ECG can see the difference of ST horizontal, t soundwaves, necrotic Q waves of old myocardial infarction. In addition, if those electrocardiograms appear in the pain, the more anemia is confirmed.

  • Electrolyte effort (with rugs, bicycles ..): Record the continuous electrocyte when the patient is active, seeking an electrocardiogram while trying to be exertion Performed when suspected patients with coronary artery disease and electrocardiogram during normal leave, no signs of suggestions

    • Echocardiography and echocardiography: On the heart doppler ultrasound can see regional movement disorders, reduce or lose movement of the myocardial area according to the blood level of the artery rim. If normal echocardiography can perform an echocardiography, the patient will be transmitted to the myocardial contraction (Dobutamin). If there is a dynamic dysfunction when doing exertion ultrasound, there is also a diagnosis of anemia heart disease.

  • Multi -sequence of computers: Evaluate coronary artery images, narrow level, narrow position. However, it may not be accurate in cases
  • Coronary angiography through the skin: is an invasive measure, high technology. The catheter will be taken through blood vessels to capture coronary arteries. It is possible to determine the degree of narrow, coronary artery reserves through ultrasound (IVUS) and FFR measurement.
  • Testing: heart enamel (troponin t or troponin I, CK, CK-MB) to eliminate acute rims, cholesterol tests, triglycerides, LDL-C, HDL-C , Glucose, HBA1C, liver, kidney function, .. to diagnose diseases and risk factors attached

    • Coronary's disease treatments

    Treatment of coronary artery disease divided into two groups: acute myocardial infarction and coronary artery disease

  • Acute myocardial infarction with st differentia: acute myocardial infarction has a difference, to 12 hours from the onset, need emergency intervention. Interventions by putting the tube through peripheral vascular (rotary artery, femoral artery) into the coronary injury and then placing coronary stent. If it is late after 12 hours, within 48 hours can still intervene regularly.
  • Myocardial infarction has no difference and unstable chest pain: The risk stratification is based on the Grace scale to determine the time of intervention.

    • General medical treatment for both myocardial infarction and stable coronary artery disease will be specified by a doctor in each case.

    Communication in patients with stable coronary coronary artery: When optimal medical treatment without improving the symptoms can re -pass through the skin through the skin or the Northern surgical surgery depends on the case of each case. specifically. It is also possible to re-connect coronary arteries in patients with 2-3 coronary pathology, stenosis of the left coronary coronary artery> 50%, with heart failure ... to improve prognosis.

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