Coronary Heart DiseaseBy James GeracheAnatomy and Physiology 2 lectureBIO 2513

CausesCoronary Heart Disease is a disease in which a waxy substance

known as plaque accumulates inside the coronary arteries. (3)Data accumulated from various studies suggest that the a person

prone to CHD can be determined by certain features in their life: (2)1. Genetic factors2. Sex of individual3. High blood cholesterol level 4. Hypertension5. Diabetes 6. Smoking7. Physical inactivity8. Stress

Cause cont.

CHD starts when the inner layer of coronary arteries are damaged. Plaque begins to build up at the damaged sites and cause narrowing of the arteries. (3)

If the plaque ruptures, blood clots form and further narrow the coronary arteries, which in turn can cause heart attacks in the individual. (3)

Figure 1: Myocardial infarction(heart muscle) myocardial infarctions can happen when the coronary arteries are narrowed or blocked

from oxygen rich blood. (1)

Metabolic pathways, organelles, organs, and organ systems involved

The most widely held theory of CHD is the disturbance in lipid metabolism. (2)

The deposition of lipids and lipoproteins in the intima of the coronary artery and development of lesions on the coronary arteries may depend on 3 factors:1. The plasma content of lipids or lipoproteins2. Arterial blood pressure and other mechanical factors that filter

lipids as lipoproteins from blood plasma3. The structure and function of the arterial tissue. Permeability of

the arterial tissue also pays a role in this theory.(2) The main organs that are involved in CHD are the heart and arteries.

(1)The cardiovascular system and the muscular system both play

important roles in CHD. The cardiovascular system supplies the heart with blood thru the coronary arteries, and the muscular system uses the heart muscle to push the blood through the coronary arteries.(1)

SymptomsThe most common symptom of CHD is Angina, which is chest

pain that is caused by an insufficient supply of oxygen rich blood to the heart muscle.(3)

Another common symptom of CHD is shortness of breathe, which is brought on by left or right side heart failure or both sided heart failure.(2)

Arrhythmia is also a symptom of CHD. It is a complication in the rate, rhythm, or rhythmicity of the heart muscle. (2,3)

Figure 2: Acute Myocardial Infarction

Genetic influenceGenetics play a large role in Coronary Heart Disease.People who are siblings of persons with CHD are 4 times

higher at risk to develop CHD.(2)Three recent studies have shown that a large number of genes

are linked to CHD.(5)Cholesterol is a primary cause of CHD and it is also an

inherited trait passed down from generations.(2)

Diagnostic methodsA doctor diagnoses CHD based on using your family history,

risk factors for CHD, physical exams, and various tests.(3)Tests and procedures done to determine CHD include:

1. Electrocardiogram(EKG)-shows the rate and rhythm of the heart beating.(2)

2. Stress tests-done by performing exercise to put stress on the heart to determine its blood flow and oxygen intake.(3)

3. Echocardiography-sound waves create a picture of the heart.(3)

4. Chest x-rays(3)5. Coronary Angiography- a thin catheter is put into blood

vessels to inject a dye to show the blood flow. The dye is detected by a special x-ray machine.(2)

MorbidityCHD is the most common form of heart disease for people

over the age of 40.(2)The U.S. population is aging and CHD is becoming a dominant

cause of death.(2)“In a study of 691 autopsies of persons 20 years of age or

older…, coronary heart disease was the cause of death in 32% and accounted for 40% of the deaths in males and 20% of those in females.(2)

TreatmentWeight reduction and low calorie diet(2)Therapeutic lifestyle changes(TLC)- 3 part program:

healthy diet, physical activity, and weight management.(3)Dietary approaches to stop hypertension(DASH)- includes

diet of fruits, vegetables, whole grains, and other heart healthy foods.(3)

Stop smoking(3)Manage stress(3)Medicines-hypertension and cholesterol lowing

medicines(2)Surgery and procedures- angioplasty, coronary artery

bypass, cardiac rehab.(3)

Range of distribution

Figure 3: Ethnicity Deaths (6)

African Americans

Asians

American Indians

Hispanics

Whites

0 2040

% of deaths

% of deaths

Figure 4: Gender Deaths (7)

Series1185,000

190,000

195,000

200,000

205,000

210,000

215,000

220,000

225,000

womenmen

Bibliography1. Shier, D., Butler, J.B., and R. Lewis. (2012). Hole’s Human

Anatomy and Physiology. 13th Edition. McGraw-Hill Inc. Boston, MA

2. Friedberg, Charles K. M.D. Diseases of the Heart. Volume 1. pg. 643-693. W.B. Saunders Company.

3. http://www.nhlbi.nih.gov/health/health-topics/topics/cad/4. http://medical-dictionary.thefreedictionary.com/intima5. http://www.webmd.com/heart/news/20110308/new-geneti

c-links-to-heart-disease6. http://www.sciencedirect.com/science/article/pii/S0002914

9050202917. http://www.cdc.gov/mmwr/preview/mmwrhtml/

su6001a13.htm