Coronary Heart Disease

The coronary arteries supply blood to the heart muscle. When they became narrowed or blocked (usually by fatty deposits and or blood clots), the heart muscle can be damaged. This is coronary heart disease. Two conditions of coronary heart disease are “angina pectoris” (See angina on page 164), and acute myocardial infarction (heart attacks). Every day, about 4,000 Americans have heart attacks, one every 20 seconds. And each year, nearly 600,000 people die of coronary artery disease, making it the nation’s number one killer. Fortunately, heart disease claims fewer and fewer lives each year, thanks to advances in medical treatment of heart disease and growing public awareness of the benefits of exercise and good nutrition. Prevention is of utmost importance.

Prevention

To avoid coronary heart disease, the American Heart Association suggests the following steps:

Have your blood pressure checked regularly. High blood pressure can increase the risk of atherosclerosis. To control high blood pressure, follow your doctor’s advice.
If you smoke, quit. Nicotine constricts blood flow to the heart, decreases oxygen supply to the heart, and seems to play a significant role in the development of coronary artery disease.
Be aware of the signs and symptoms for diabetes, which is associated with atherosclerosis. Follow his or her advice if you have diabetes. (See Diabetes on page 170).
Maintain a normal body weight. (People who are obese are more prone to atherosclerosis, high blood pressure, and diabetes, and therefore coronary heart disease).
Eat a diet low in saturated fats and cholesterol. (Saturated fats are found in meats, dairy products with fat, hydrogenated vegetable oils and some tropical oils, like coconut and palm kernel oils). High-saturated fat, high-cholesterol diets contribute to the fatty sludge that accumulates inside artery walls.
Reduce your intake of salt if you are “salt-sensitive.” Salt sensitive persons’ blood pressure goes up if they eat too much salt.
Get some form of aerobic exercise at least three times a week for 20 minutes at a time. Sitting around hour after hour, day after day, week in and week out with no regular physical activity may cause circulation problems later in life and contributes to atherosclerosis. Start new exercise programs gradually. Report symptoms of chest pain and/or shortness of breath to your doctor.
Reduce the harmful effects of stress by practicing relaxation techniques and improving your outlook on daily events. Stress has been linked to elevated blood pressure, among other health problems.
Get regular medical checkups.
Know the signs of a heart attack so you can get immediate medical attention if necessary, before it’s too late. The signs of a heart attack are:
- Chest discomfort or pressure lasting several minutes or longer.
- Discomfort or pressure that spreads to the shoulder, neck, arm, and jaw.
- Nausea or vomiting associated with chest pain.
- A cold sweat.
- Difficulty breathing.
- Faintness or dizziness.
- Stomach upset.
- A sense of impending disaster.

Treatment and Care

If you think you’re having a heart attack, get to a hospital as quickly as possible. A clot dissolving injection can be given to reduce the risk of mortality and severity of damage to the heart muscle if given within four hours. Other emergency procedures can also prevent damage to the heart muscle.

The type of care following a heart attack will depend on the amount of damage done to the heart muscle which can be assessed by specific medical tests and procedures. Your doctor will determine the course of treatment. This could include any or many of the following:

Medication (cardiac, blood pressure, cholesterol lowering medicines, etc.).
Hospitalization for treatment and recovery from the heart attack.
Cardiac rehabilitation for lifestyle changes including: Smoking cessation, weight loss, low-fat, cholesterol-controlling diet, behavior modification and stress management relaxation techniques.
Surgery if indicated: Angioplasty, coronary artery bypass grafts, etc.
Long-term maintenance and medical follow-up.
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