Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... ·...
Transcript of Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... ·...
![Page 1: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/1.jpg)
Coronary Heart Disease in Young Adults
Ezam Emran
Raja Isteri Pengiran Anak Saleha Hospital
![Page 2: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/2.jpg)
Which of these gentleman could have heart disease?
![Page 3: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/3.jpg)
Mr AH
19 year old gentleman, university student
Smokes occasionally
Childhood asthma
On and off chest discomfort for 2 days – needed to take paracetamol and used thermal patches
![Page 4: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/4.jpg)
Mr AH
Severe chest pain and profuse sweating whilst in the movie theatre
Taken straight to RIPAS Hospital
Pronounced dead by doctors 45 mins later
Cause of death: Myocardial infarction (“Heart attack”)
![Page 5: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/5.jpg)
What this case highlights
Coronary heart disease although rare, does occur in young individuals
Late recognition of symptoms can be FATAL
![Page 6: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/6.jpg)
THE HUMAN HEART
![Page 7: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/7.jpg)
The Heart
![Page 8: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/8.jpg)
The Human Heart
Small but majestic organ
Roughly the size of your fist (250-350g)
Located inside your chest in close proximity to the lung and other major blood vessles
Never rests
![Page 9: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/9.jpg)
The heart’s function
Essentially a PUMP -> 5-7 litres of blood/minute (7600 litres/day)
Our body relies on oxygen and nutrient to function properly
These are transported to/fro the various organs by our blood via blood vessels (arteries, capillaries and veins)
The heart is the pump that ensures optimal flow of blood
![Page 10: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/10.jpg)
The heart’s function
Able to adjust according to needs, for example:
- Faster heart rate during exercise
- Slower heart rate during sleep
Heavily influenced by other factors such as hormones and drugs
![Page 11: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/11.jpg)
WHAT IS CORONARY HEART DISEASE?
![Page 12: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/12.jpg)
Anatomy of the heart
![Page 13: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/13.jpg)
Coronary artery
![Page 14: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/14.jpg)
Coronary artery
The heart is mostly muscle
Needs nutrients and therefore adequate blood supply to function properly
This is supplied via the coronary arteries
There are 3 main coronary arteries supplying the heart
![Page 15: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/15.jpg)
Coronary heart disease
Usually refers to blockage of the coronary artery
This leads to impediment in blood flow to the heart muscle
Vicious cycle as heart will have to work harder
![Page 16: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/16.jpg)
Coronary heart disease
![Page 17: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/17.jpg)
Progression of coronary heart disease
![Page 18: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/18.jpg)
Risk factors for coronary heart disease
Non-modifiable:
- Age
- Male gender
- Family history
- Race
![Page 19: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/19.jpg)
Risk factors for coronary heart disease
Modifiable:
- Obesity
- Dietary factors
- Sedentary lifestyle
- Smoking
- Drugs and substance abuse
- Diabetes
- High cholesterol levels
![Page 20: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/20.jpg)
Epidemiology
Cardiovascular disease contributes to 17.5 million deaths worldwide
Heart disease (without stroke) is the second leading cause of death in Brunei behind cancer. It contributed to 12.9% of deaths in 2016
Worrying trend in Brunei -> young adults with cardiovascular diseaser
![Page 21: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/21.jpg)
![Page 22: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/22.jpg)
Symptoms of coronary heart disease (stable state)
Chest pain – mainly on exertion or exercise
Breathlessness – on exertion
Easy fatigue
Chest pain after heavy meals
![Page 23: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/23.jpg)
Symptoms in unstable situation/ heart attack
Severe chest pain at rest – may radiate to neck or arms Profuse unexplained sweating Nausea Upper abdominal pain Escalation of usual stable symptoms
![Page 24: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/24.jpg)
SEEK URGENT MEDICAL ATTENTION!!
![Page 25: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/25.jpg)
Where to seek medical attention?
Nearby health clinics if symptoms are stable and infrequent
If symptoms appear unstable -> go to nearest Emergency Department
Time is muscle!!!
![Page 26: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/26.jpg)
What is typically done by your doctors
Detailed history
-> This helps categorize severity/urgency of symptoms
Examination
- Examining your pulse
- Listening to your heart sounds
Send you for investigations
![Page 27: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/27.jpg)
CARDIAC INVESTIGATIONS
![Page 28: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/28.jpg)
ECG
![Page 29: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/29.jpg)
Blood tests
To establish a baseline
To rule out other diseases
To check whether you have had a heart attack/damage to heart muscle
![Page 30: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/30.jpg)
Echocardiogram
![Page 31: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/31.jpg)
Stress test (treadmill)
![Page 32: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/32.jpg)
Coronary CT scan
![Page 33: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/33.jpg)
Coronary angiogram
![Page 34: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/34.jpg)
Coronary angiogram
![Page 35: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/35.jpg)
Coronary angiogram
Anabolic steroid user
![Page 36: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/36.jpg)
WHAT ABOUT MEDICATIONS?
![Page 37: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/37.jpg)
Medications
Depends on clinical situation
May be put on several different types of medications
Medications for coronary heart disease are usually taken lifelong
Lifestyle adjustments will be necessary
![Page 38: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/38.jpg)
WHAT HAPPENS IF I LEAVE IT ALONE?
![Page 39: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/39.jpg)
Untreated coronary heart disease
FATAL
Could lead of permanent muscle damage and weakened heart (“heart failure”) Repeated episodes of heart attack Irregular heart rhythms Affects patient as well as loved ones
![Page 40: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/40.jpg)
Key take home messages
Coronary artery disease does occur in the young
Be weary of supplements and anabolic steroids
Healthy lifestyle important
Follow medical advice and take medications as prescribed
Early recognition and treatment may prevent long-term sequelae
![Page 41: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/41.jpg)
Thank you
![Page 42: Coronary Heart Disease in Young Adultsmoh.gov.bn/Shared Documents/My Heart Your Heart... · Cardiovascular disease contributes to 17.5 million deaths worldwide Heart disease (without](https://reader033.fdocuments.net/reader033/viewer/2022042811/5fa105b09c14a96282457ed4/html5/thumbnails/42.jpg)