Cardiovascular diseases

Cardiovascular diseases (CVD) is a class of diseases that involve heart and blood vessels. The most common cardiovascular diseases include coronary artery disease, heart failure, and cerebrovascular disorders.

Cardiovascular diseases are the most common cause of death globally: more people die annually due to cardiovascular diseases than from any other cause.

An estimated 17.7 million people died from CVDs in 2015, representing 31% of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. It has been estimated that up to 90% of cardiovascular disease may be preventable if established risk factors are avoided.

Heart attack (myocardial infarction)

A heart attack or myocardial infarction is caused by sudden oxygen deficiency in a heart muscle. Due to the deficiency of blood circulation, myocardial cells begin to suffer from oxygen deficiencies and become damaged. If the blockage cannot be opened and the oxygen deficiency persists, the injury progresses gradually within few hours and the myocardial muscle is damaged.

The underlying cause of myocardial infarction is often coronary artery disease that narrows the arteries. The myocardial infarction is formed when coronary arteries are blocked. The cause of the blockage may be rupture of the fat-containing plaque in the artery wall. In this case, a blood clot is formed to the rupture that suddenly blocks the vessel completely and the circulation to that area of heart muscle is prevented. The infarction due to plaque rupture causes cardiac death more frequently than an infarction, in which the plaque has not ruptured.

The infarction may also be due to the rupture of a plaque that has not blocked the artery and thus has not caused any previous symptoms to the patient. This explains why myocardial infarction or cardiac death may be the first symptom of coronary artery disease. However, all formed plaques are not vulnerable to rupture, it is possible that a person has so-called stable plaques, thus having a stable coronary artery disease.

Coronary artery disease

The coronary arteries are located on the heart’s surface and take care of the myocardium’s oxygen supply and nutrition. In coronary artery disease (also known as coronary heart disease) coronary arteries narrow or stricture, which may cause disturbance of the bloodstream and oxygen deficiency to the part of the heart muscle.

Coronary artery disease can be divided into stable and acute coronary artery disease. In a stable phase, the symptoms of the disease remain controlled by medication (e.g. aspirin, statin, and beta-blocker). An acute high-grade coronary heart event may be, for example, prolonged chest pain or myocardial infarction. These can be caused by plaque rupture leading to partial or complete blockage of the coronary artery caused by blood clots due to the rupture.

Stable coronary heart disease is reported when the patient’s symptoms are always of the same type and the patient has a history of myocardial oxygen deficiency or significant coronary artery disease

Treatment and prevention of coronary artery disease

In patients with coronary artery disease, treatment with aspirin is initiated to prevent the formation of blood clots. Aspirin is not suitable for everyone, so clopidogrel may be used instead. Nitroids are used for chest pain as needed. Nitroid can also be taken before any physical exertion that is thought to cause chest pain.

Other drugs that inhibit coronary artery disease include beta-blockers, long-acting nitrates and calcium channel blockers. The treatment of coronary artery disease also includes medicines for the prevention of arterial disease, of which the most common ones are the statins. If mere drug therapy is not enough then the coronary artery extension or bypass surgery may be needed.

In the treatment of coronary artery disease and the prevention of myocardial infarction, in addition to the medication, it is often helpful to do lifestyle changes. A healthy diet, smoking cessation and exercise decreases the risk of coronary artery disease and myocardial infarction. For a patient with coronary artery disease, it would be good to actively exercise at least half an hour, three days a week. In some studies intense interval training has proven to be more protective of the heart than moderate exercise.

However, physical exercise is not recommended if you are feeling unwell, have previously undiagnosed chest pain or if a cardiac patient experiences exercise induced loss of consciousness.