Coronary disease

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

Coronary disease (or coronary heart disease) refers to the failure of coronary circulation to supply adequate circulation to cardiac muscle and surrounding tissue. It is already the most common form of disease affecting the heart and an important cause of premature death in Europe, the Baltic states, Russia, North and South America, Australia and New Zealand. It has been predicted that all regions of the world will be affected by 2020.^[1]

It is most commonly equated with atherosclerotic coronary artery disease, but coronary disease can be due to other causes, such as coronary vasospasm.^[2] It is possible for the stenosis to be caused by the spasm.^[3]

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, hypertension, obesity, diabetes, high alcohol consumption, lack of exercise, inability to manage stress and hyperlipidemia.^[4]

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.^[5]

Treatment

Lifestyle changes and reversibility

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

• Healthy diet has been shown by Dr Esselstyn (along with other life-sytle oriented physicians such as Dr McDougall, and Dr Ornish) to be hugely effective as a treatment of coronary disease, and generalized atherosclerosis. However, the idea of what composes a 'healthy diet' is highly controversial. 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.^[6][7]Information recommending the reduction of animal based foods and an increase in plant based foods has been established for over 50 years.^[8][9]
• Weight control
• Smoking cessation
• Exercise
• Fish oil consumption to increase omega-3 fatty acid intake^[10]

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^[9]

Surgical intervention

• Angioplasty
• Stents (bare-metal or drug-eluting)
• Coronary artery bypass^[9]
• Heart Transplant

References

1. ^ Boon NA, Colledge NR, Walker BR and Hunter JAA (2006). Davidson's Principles & Practice of Medicine, 20th Edition. Churchill Livingstone
2. ^ Williams MJ, Restieaux NJ, Low CJ (February 1998). "Myocardial infarction in young people with normal coronary arteries". Heart 79 (2): 191–4. PMC 1728590. PMID 9538315. http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=9538315. 
3. ^ Rezkalla SH, Kloner RA (October 2007). "Cocaine-induced acute myocardial infarction". Clin Med Res 5 (3): 172–6. doi:10.3121/cmr.2007.759. PMC 2111405. PMID 18056026. http://www.clinmedres.org/cgi/pmidlookup?view=long&pmid=18056026. 
4. ^ http://www.mayoclinic.com/health/coronary-artery-disease/DS00064/DSECTION=causes
5. ^ McCann, 2001, the precocity-longevity hypothesis: earlier peaks in career achievement predict shorter lives. Personality & Social psychology bulletin, 27, 1429-1439; Rhodewalt & Smith, 1991, current issues in Type A behaviour, coronary proneness, and coronary heart disease. In C.R. Snyder & D.R.Forsyth (Eds.), Handbook of social and clinical psychology :) (pp.197-220) New York: Pergamon
6. ^ http://www.heartattackproof.com/resolving_cade.htm
7. ^ Preventive Cardiology; 2001; 4: p171-177
8. ^ morrison l m "diet in coronary artherosclerosis" JAMA 173; 1960; p884-888
9. ^ ^{a b c} http://www.mayoclinic.com/health/coronary-artery-disease/DS00064/DSECTION=treatments%2Dand%2Ddrugs
10. ^ http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html

See also

• Anomalous aortic origin of a coronary artery