Coronary artery and its branches provide the myocardium whit needed oxygen and nutrients,specially glucose,otherwise the heart muscle will suffer of ischemia(local anemia),and the risk of developing ischemia heart disease.
Causesof Myocardial ischemia:
-diminished blood flow in coronary artery
-diminished flow of oxygenated blood to myocardium
-increased oxygen requirement of myocardium
Risk factors:
Coronary atherosclerosis is the main cause of coronary heart disease and others.
classification of risk factors:
-unmodified factors:personal factors of age,gender,genetic and inheritance(family history).
-modified factors:potential factors that can be changed whit treatment.
Major factors:
-hyperlipidamia(serum cholesterol level)
-cigarette smoking
-hypertention
-diabetesor impaired glucose tolerance
Contributing factors:
-physical inactivity,lack of exercise
-heavy consumption of alcohol
-obesity
-personality type,mental stress and worry
-oral contraception
-socioeconomic circumstances
Characteristics:
In case of asymptomatic type the obstruction of blood flow in the coronaries is light at the beginning of disease and gives no symptoms.
In case of angina pectoris the obstraction and impaired blood flow are progressing,causing hypoxia of glucose,myocardium.
Types of angina:
-Classical angina:anginal pain appears on physical exertion and may be provoked by excitement,psychological upset and unger,exposure to cold or after heavy meals.
The attack is transient,for few minutes and disappears on rest.
-Nonclassical angina:this type arises under certain circumstances other then exertion,for exemple nocturnal angina due to coronary spasm during sleep,angina at rest,without any obvious provoking factors.
Acute myocardial infarction may arise from complete obstruction of involved vessels.
Prevention of coronary heart disease is based on prevention and control of determined risk factors:
1.Diet control:
-no excess of calories,fat and common salt
-dietary carbohydrates must be largely of the complex form: from grain and their products
-no excess of rafined sugar
-consumption of vegetable oil,rather then animal fat and margarine
-restriction of solid fats.
Marine fat oils(omega 3 tryglycerides)contain large amount of two highly unsaturated fatty acids and have potenital role in prevention of coronary heart coronary.
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