Coronary heart disease: Early prevention helps
It is one of the most common causes of death in industrialized nations: coronary heart disease (CHDThe cause is usually arteriosclerosis - commonly known as "hardening of the arteries" - which causes the coronary arteries to narrow.
It is one of the most common causes of death in industrialized nations: coronary heart disease (CHD). The cause is usually arteriosclerosis (popularly known as “hardening of the arteries”), which causes the coronary arteries to narrow. Deposits of fat and connective tissue adhere to the inner walls of the vessels and make the coronary arteries stiff and uneven. Such deposits (“plaque”) consist of cholesterol, calcium and other substances from the blood.
Over time, they lead to a narrowing (stenosis) of the coronary arteries, i.e. the vessels that supply the heart muscle with oxygen and nutrients. "The diameter of the affected blood vessel shrinks until the supply of oxygen no longer covers the demand for oxygen. Such a process can develop over years," explains Dr. Reinhold Lunow, medical director of the practice clinic BornheimThis leads to local blood loss (ischemia) with inadequate oxygen supply to the heart (coronary insufficiency).
The reduced blood flow causes temporary chest pain (angina pectoris): a tightness in the chest with dull, pressing, constricting and often burning pain behind the breastbone (retrosternal). Typical symptoms include pain in the chest, shoulder, back or arm, shortness of breath, extreme exhaustion when moving, swelling of the feet. When such warning signals occur, the blockage is often already serious or even life-threatening.
“The first symptoms are often noticed during major exertion of the heart, for example SportsBut they can also occur when you are resting without any physical activity,” says Dr. Lunow, describing the symptoms. If you notice such signs, you should have a thorough medical examination. If the coronary heart disease progresses further, you risk serious illnesses such as cardiac arrhythmia and heart failure, eventually even acute, life-threatening complications such as Heart attack and sudden cardiac death.
Identifying and Treating Personal Risk Factors
The investigation by the Doctor reveals the personal risk factors for suffering from coronary heart disease. A distinction is made between uncontrollable or constitutional risks, such as genetic predisposition, gender and age. The typical risk groups include men over 45 years of age, women after menopause and women over 55 years of age.
In contrast, there are risk factors that can be influenced, such as lipid metabolism disorders. This includes elevated cholesterol levels (hypercholesterolemia) with high LDL and low HDL cholesterol levels, as well as obesity, arterial hypertension, Diabetes mellitus, smoking, lack of exercise and psychosocial factors. "It is important to note that the individual risk factors not only have an effect as a whole, but that their mutual relationships disproportionately increase the cardiovascular risk," says Dr. Lunow.
In the treatment of coronary heart disease, drugs such as nitrates, beta-blockers, calcium channel blockers, aspirin or cholesterol lowering agent (statins) are used to counteract the corresponding risk factors at an early stage. If the narrowing in the coronary artery is already advanced, however, intervention is carried out directly there: with a stent. "In contrast to coronary balloon angioplasty, in which a small balloon is inserted through the skin to widen the artery in order to ensure blood flow, a stent remains permanently in the coronary artery and keeps it open," explains Dr. Lunow.
Stents keep the artery open
A stent is a small, expandable mesh tube made of medical stainless steel or a cobalt alloy. It is pushed through a body artery to the narrowed area using a catheter. The stent is attached to a small balloon, which is then expanded in the artery. This compresses the plaque against the artery wall and restores blood flow. The stent then unfolds in this position. Like a scaffold, it stabilizes the artery and allows blood to flow through. The balloon is then relieved and removed. In practice, uncoated, so-called "bare metal stents" are used, as well as coated stents in which an applied medication prevents the artery from narrowing again.
Stenting has now become established: over 2 million people have a stent implanted every year. By changing your lifestyle, you can do a lot to prevent it from happening in the first place. "In order to avoid coronary heart disease, it is necessary to identify your personal risks. Then you can take gentle countermeasures early on," says Dr. Lunow. "A change in your diet often helps. Nutrition and regular exercise. An early check-up is a prerequisite to prevent serious heart disease from occurring in the first place."
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