Arteriosclerosis / coronary heart disease

HOW DOES CORONARY HEART DISEASE DEVELOP?

In coronary heart disease, the coronary vessels are narrowed and the heart muscle is no longer supplied with blood properly. The cause is calcification (arteriosclerosis) of the blood vessels.

Due to the lack of blood supply, the heart is not supplied with enough oxygen and there is a risk of a heart attack.

The following factors favour the development and progression of coronary artery calcification:

  • Smoking
  • Raised blood pressure (hypertension)
  • Elevated blood lipid levels (especially increased levels of LDL cholesterol and decreased levels of HDL cholesterol)
  • Diabetes mellitus
  • Hereditary predisposition to arteriosclerosis
  • Old age
  • Obesity
  • Lack of exercise
  • Increased blood levels of fibrinogen and C-reactive protein (CRP), among others, which reflect inflammatory changes in the vessels

The risk of coronary heart disease increases with the number of risk factors.

WHAT ARE THE SYMPTOMS OF CORONARY HEART DISEASE?

The typical symptom of coronary heart disease is so-called angina pectoris ("chest tightness"), which occurs with varying degrees of severity:

  • Pain or burning in the heart area, usually behind the breastbone
  • Tightness in the chest (angina pectoris)
  • Restricted breathing, the feeling of shortness of breath
  • Radiation of the pain into the upper abdomen, left or both arms, lower jaw, shoulder blades and shoulder
  • Often severe anxiety or fear of suffocation

A common trigger for angina pectoris is physical exertion and/or stress.

The severity of the symptoms depends on how much blood can still flow through the coronary vessels. If the symptoms also occur at rest, there is a risk of a heart attack.

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HOW IS CORONARY HEART DISEASE DIAGNOSED?

Our cardiology department offers all modern invasive and non-invasive diagnostic procedures. These include:

  • History-taking, physical examination
  • Laboratory tests
  • ECG (electrocardiogram): provides information about damage to the heart or old heart attacks
  • Exercise ECG (ergometry): shows changes that only occur under stress
  • Echocardiogram (ultrasound): shows parts of the heart muscle that no longer move properly due to insufficient blood supply (over the chest and through the oesophagus)
  • Stress echocardiography (stress ultrasound): can indicate disturbed blood flow to the coronary arteries
  • Magnetic resonance imaging of the heart (cardiac MRI) to measure blood flow to the heart, heart function, stress due to inflammation and to check for heart valve defects
  • Cardiac catheter examination (coronary angiography): with the help of a contrast medium, it is possible to assess which coronary vessels are constricted and to what extent. The affected coronary vessel can be treated during the procedure (balloon/stent)

HOW IS CORONARY HEART DISEASE TREATED?

Depending on the severity of the coronary heart disease, we first treat it with medication. We also strongly advise a healthier lifestyle.

If drug therapy is not sufficient, we will perform balloon dilation in our cardiac catheterisation laboratory. In this procedure, a very thin and flexible wire is pushed through the artery to the diseased area using a catheter. The narrowed coronary vessel is dilated with a balloon and, if necessary, a stent is inserted. The stent consists of a metal mesh that is intended to prevent further narrowing.

PROSPECTS: LIVING WITH A DISEASE

In addition to these medical measures, stent therapy or sometimes bypass surgery and drug therapy, the patient can make a decisive contribution to recovery through a healthy lifestyle.

Also crucial is support from family, life partners and friends, all of whom are indirectly affected.

In order to help people with chronic diseases of the cardiovascular system or following a heart attack to make the necessary lifestyle changes, the Havelhöhe Heart School also offers a comprehensive programme.

In group therapy, patients and their partners learn about heart-healthy lifestyles and realise that giving up negative habits very quickly leads to a better quality of life.

You can find more information at: www.herzschule.org