Basic health research in 2007 showed that heart and blood vessel disease, including stroke due to narrowing of the arteries is the highest cause of death. About 25% of deaths in Indonesia are caused by this disease and will continue to increase every year. So it can be concluded that coronary heart disease is a dangerous disease that can cause the sufferer to die.
Causes of coronary heart disease
Coronary heart disease is caused by narrowing of the coronary arteries which results in obstructed blood flow to the heart. This narrowing occurs due to the buildup of cholesterol and other proteins that come from food that enter the body. Plaque buildup on the walls of the coronary arteries can cause the coronary arteries to become stiff and their channels to become narrower. This mechanism is called atherosclerosis. Besides being able to reduce blood supply to the heart, atherosclerosis also makes it easier for blood clots to form. If this happens, blood flow to the heart is completely blocked and sudden cardiac arrest can be very dangerous.
Symptoms of coronary heart disease
Early symptoms of coronary heart disease, patients complain of pain or discomfort in the middle of the chest, solar plexus, back as if pressed by a heavy object during activities for 30 seconds to 5 minutes. Symptoms are also accompanied by cold sweats, pounding dizziness and feeling like fainting. These symptoms will be reduced by rest or giving nitrate tablets under the tongue. Please note, pain or a feeling of heaviness in the chest is called angina as a warning sign of a lack of coronary blood flow.
Prevention of coronary heart disease
Coronary heart disease itself is caused by several factors, including high cholesterol, high blood pressure, diabetes mellitus, smoking, lack of activity or exercise, lifestyle and a family history of having had a heart attack at a young age (under 50 years). Actually you can prevent coronary heart disease, if you try to reduce or prevent plaque from occurring in the blood vessels by managing a healthy diet and lifestyle, such as:
- Quit smoking
- Reduce the impact of stress by means of relaxation
- Check blood pressure regularly
- Check blood sugar and control blood glucose levels if you have diabetes
- Maintain a normal weight with a diet low in cholesterol and saturated fat
- Exercise regularly
- Perform regular cardiovascular checks.
Appropriate treatment for patients with coronary heart disease
Handling of patients with coronary heart disease is adjusted to the condition of the narrowing of the heart arteries that occurs. The initial steps taken by the doctor will usually ask about the complaints that are felt and carry out tests to confirm the diagnosis and the severity. The doctor will examine the heart's electrical record (electrocardiography, EKG) and take a blood sample to see if there is damage to the heart muscle. Then, the doctor will give medicines to treat blood clots, dilate coronary arteries, reduce the burden on the heart and calm the patient.
If the narrowing of the blood vessel walls is severe enough from a catheterization examination, the doctor will perform revascularization with a Percutaneous Cardiac Intervention (PCI) procedure or a heart artery bypass bypass surgery (CABG). PCI is done by placing a stent (ring) which aims to widen the narrowed coronary artery channel. Coronary artery bypass surgery (CABG) is an operation by implanting blood vessels from other parts of the body to open new routes for blood flow to the heart so that the blood supply is sufficient. Diabetics and those with more than three narrowings of blood vessels are often advised to undergo CABG rather than PCI. Coronary heart sufferers who wish to perform PCI and CABG procedures can consult at a heart health facility (Center of Excellence Cardiology) at EMC Hospital.
This article was written by dr. Renan Sukmawan, Sp.JP(K), PhD, FIHA, FACC (Cardiologist at EMC Alam Sutera Hospital)