Coronary heart disease

The creeping calcification of the coronary arteries with all their consequences is the most common heart disease in the western industrial nations - in Germany almost one third of all men and 15 percent of women are affected. It has been the number one cause of death for many years. The coronary heart disease is based on chronic deposits of circulating in the bloodstream fatty components, salts and small blood clots on the vessel walls of the coronary arteries. These increasingly narrow the vessels and thereby affect the blood circulation.

Arteriosclerosis as a sign of a general vascular disease

Deposits in the veins, also called arteriosclerosis, also occur in the blood vessels of other organs, such as the kidneys, brain, or lower extremities, depending on individual susceptibility and risk factors. Thus, coronary heart disease is only a specific expression of a general vascular disease, which in this case takes place on the blood vessels of the heart muscle.

How a coronary heart disease arises

The exact causes of coronary heart disease have not yet been scientifically clarified and in individual cases often can not be determined exactly. However, a large number of risk factors for cardiovascular diseases are known, in the presence of which there is a significantly greater probability than the normal population that coronary heart disease occurs in the course of life.

If more than one of these risk factors is present in a patient, the risk of being affected by coronary heart disease increases accordingly:

  • overweight
  • diabetes
  • Dyslipidemia
  • high blood pressure
  • gout
  • higher age
  • male gender
  • Smoke
  • Cardiovascular diseases in first-degree relatives

A not inconsiderable role in the development of coronary heart disease plays the genetic system. So it can quite happen that despite absolutely healthy diet and lifestyle and without objectively verifiable risk factors, a coronary heart disease occurs or, conversely, someone reaches an old age despite unhealthy lifestyles and risk factors.

Features of coronary heart disease

The progressive arteriosclerosis leads to a deficiency supply of the heart muscle: Due to the fatigued, verkalkten, thickened coronary vessels does not get enough blood to the heart muscle. Initially, this is usually the case only under stress conditions, so if the muscle requires more oxygen for his work, later even at rest.

Accordingly, coronary heart disease manifests itself through its effects in the form of various clinical pictures that can also occur together. Typical clinical pictures of a coronary heart disease include angina pectoris and a heart attack and their consequences.

Clinical picture angina pectoris

With increasing constriction of the coronary arteries and their blood transport capacity is increasingly limited, which can lead to a mismatch between oxygen demand and supply of the heart muscle. Only when the constrictions exceed a critical level, complaints such as chest pain radiating from the chest, shortness of breath and an oppressive tightness in the chest.

With slow progression of the disease, these symptoms are expressed in the early stages as angina pectoris during exercise. With increasing disease and the appearance of higher-grade constrictions in the coronary arteries, stress angina can become a quiescent angina - a threatening alarm symptom that can progress seamlessly into a heart attack.

Disease heart attack

The sudden closure of a previously flowed through coronary blood vessel (for example, by a clot that grafts on the calcifications and completely closes the already narrowed vessel) leads to the death of a different sized part of the heart muscle.

In the best case, this district is subsequently replaced by a connective tissue scar, which remains as a defect of the heart muscle for the rest of life and usually also a restriction of the contraction force of the heart muscle - heart failure (heart failure) or chronic cardiac arrhythmias - means. In the worst case, acute complications such as ventricular arrhythmia and sudden heart failure lead to death.

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