Coronary disease

Coronary heart disease
Classification and external resources
ICD-9	414.00
MeSH	D003327

Coronary heart disease is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis (sometimes called “hardening” or “clogging” of the arteries) is the buildup of cholesterol and fatty deposits (called plaques) on the inner walls of the arteries. These plaques can restrict blood flow to the heart muscle by physically clogging the artery or by causing abnormal artery tone and function.

Without an adequate blood supply, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. This can cause chest pain called angina. If blood supply to a portion of the heart muscle is cut off entirely, or if the energy demands of the heart become much greater than its blood supply, a heart attack (injury to the heart muscle) may occur.

It is most commonly equated with atherosclerotic coronary artery disease, but coronary disease can be due to other causes, such as coronary vasospasm, where the stenosis to be caused by spasm of the blood vessels of the heart it is then usually called Prinzmetal's angina.

Causes

Coronary artery disease, the most common type of coronary disease, which has no clear etiology, has many risk factors, including smoking, radiotherapy to the chest, chest pains, hypertension, obesity, diabetes, high alcohol consumption, lack of exercise, inability to manage stress, and hyperlipidemia.

Also, having a type A behavior pattern, a group of personality characteristics including time urgency and competitiveness, is linked to an increased risk of coronary disease.

Treatment

Lifestyle changes and reversibility

Lifestyle changes have been shown to be effective in reducing (and in the case of diet, reversing) coronary disease:

• A plant-based diet has been shown by Caldwell Esselstyn and T. Colin Campbell among others to be hugely effective as a treatment of coronary disease, and generalized atherosclerosis. In numerous peer reviewed studies the progression of heart disease has been shown to halt, and in some cases, the disease process may be reversed. Information recommending the reduction of animal based foods and an increase in plant based foods has been established for over 50 years.
• Weight control
• Smoking cessation
• Avoiding the consumption of trans fats (in partially hydrogenated oils)
• Exercise
• Fish oil consumption to increase omega-3 fatty acid intake

Medications to treat coronary disease

• Cholesterol lowering medications, such as statins, are useful to decrease the amount of "bad" (LDL) cholesterol.^{[citation needed]}
• Nitroglycerin
• ACE inhibitors, which treat hypertension and may lower the risk of recurrent myocardial infarction^{[citation needed]}
• Calcium channel blockers and/or beta-blockers
• Aspirin

Surgical intervention

• Angioplasty
• Stents (bare-metal or drug-eluting)
• Coronary artery bypass
• Heart transplant

See also

• Anomalous aortic origin of a coronary artery