Heart Disease – College Essay Example

resulting in the death of heart muscle tissue leads to acute myocardial infarction. Cardiac arrest is another possible symptom of coronary artery disease that can cause sudden death. Other causes include drowning, suffocation, drug overdose, trauma (like car accidents), and stroke.

People with coronary artery disease may experience angina pectoris which is characterized by intermittent chest pain caused by narrowing of the coronary arteries. Angina occurs when the blood and oxygen supply to the working heart muscles is temporarily limited. The term "angina" was coined by Dr.William Heberden during a lecture in 1768 to describe a sensation of strangling rather than pain. Those experiencing angina may feel pressure or discomfort behind their breastbone and it can spread to the arms, neck, and upper back before subsiding intermittently.Angina does not cause permanent damage to the heart muscle but serves as an indication that the heart is not receiving enough oxygen for increased demands. If preventive measures are not taken, underlying coronary heart disease will continue to progress. Symptoms of angina vary among individuals and include chest pressure, distress, heaviness, burning feeling, constriction, tightness, and more. Other discomforts associated with angina can include mild chest discomfort in the center that spreads to the left shoulder or arm; a dull ache or pins and needles sensation in the arms (typically more severe in the left arm); pain resembling severe indigestion; a heavy or tight feeling; dull ache; intense pressure; burning sensation; or constriction in the chest, throat , or upper abdomen. Additional symptoms may include extreme tiredness , shortness of breath or a choking sensation , a sense of foreboding or impending death along with chest discomfort , jaw

, gums , teeth , throat or earlobe pain , and back or shoulder blade pain. The severity of angina attacks can range from causing fear to being ignored . These attacks typically last from one to two minutes up to about four to five minutes . Rest usually relieves symptoms within a couple of minutes or at most ten minutes. There are two forms of angina: stable angina and unstable angina. Stable angina is characterized by brief pain that occurs during exertion and subsides with rest.Unstable angina is a type of angina that occurs during rest and is characterized by severe symptoms and significant narrowing of the coronary arteries. Individuals with unstable angina are at a higher risk of developing heart attacks. They may experience pain multiple times a day, even waking up after a disturbing dream.

On the other hand, atypical or variant angina differs from both stable and unstable angina as it happens when the person is resting or asleep instead of during physical activity. This type of angina is caused by coronary artery spasm that leads to arterial narrowing due to cramping.

The main cause of angina lies in the narrowing of coronary arteries. In healthy individuals, these arteries have smooth and elastic inner walls that allow for constriction and expansion based on demand. However, as people age or have damaged linings from smoking or high blood pressure, fatty deposits accumulate on artery walls leading to plaque formation. This narrows the arteries and restricts blood flow causing atherosclerosis.

Generally speaking, angina does not occur until around two-thirds of an artery's diameter is blocked. Besides atherosclerosis, there are other heart conditions that can result in

oxygen deprivation within the heart leading to angina.

The brain plays a role in regulating emotions and managing artery widening and narrowing through nerve supply and control over the arteries via the hypothalamus.The pressures of modern life, such as aggression, hostility, deadlines, competition, unrest, and insecurity can activate a control mechanism. Emotions can cause chemicals like adrenaline, noradrenaline, and serotonin to constrict coronary arteries even more. The pituitary gland is influenced by the hypothalamus and can signal adrenal glands to produce stress hormones like cortisol and adrenaline. Artery muscle contractions can temporarily limit blood flow, causing platelets to stick together in a process known as coronary spasm. Platelets are crucial for clotting and repairing damaged arterial walls which aggregate more easily when chemicals released during arousal are present (such as cortisol). This aggregation causes further constriction of blood vessels if an artery is already narrowed. High levels of stress often lead to overbreathing or breath-holding resulting in shallow irregular rapid breathing.

This text discusses the effects of a certain type of breathing on the body specifically related to oxygen levels and blood alkalinity. This type of breathing leads to excessive elimination of carbon dioxide from the body, which results in an overabundance of oxygen in the blood. While this may initially seem beneficial, it actually hinders the release of oxygen to the heart thereby reducing its availability. Additionally, this excessive elimination of carbon dioxide causes blood alkalinity and can result in spasms occurring in blood vessels especially those found within the brain and heart.
The text then goes on to discuss a condition called atherosclerosis, where coronary arteries become clogged with plaques consisting of connective tissue, fats, and

smooth muscle cells. These plaques obstruct blood flow by protruding into the artery passageway. In healthy arteries, smooth muscle cells are found in the middle layer of their walls. However, during atherosclerosis, these cells migrate into the inner layer.

There are two theories explaining the cause of atherosclerosis. The first theory proposed by Rudolf Virchow suggests that fatty materials like cholesterol enter arterial walls and irritate them, leading to cell outpouring and plaque formation. The second theory presented by Karl von Rokitansky suggests that atherosclerotic plaques form as a result of blood clot organization (thrombosis). According to this theory, clots stick to the intima and gradually transform into tissue masses that eventually become plaques.

Evidence supporting the second theory includes finding platelets, fibrin, cholesterol crystals, and lipid-rich cells in atherosclerotic plaques. This indicates that thrombosis may contribute to atherosclerosis and the development of more complex plaques. Moreover, high levels of blood lipids can speed up arterial narrowing.

Within the plaque itself exists a yellow substance resembling porridge made up of blood lipids such as cholesterol and triglycerides. Lipids in the bloodstream combine with specific proteins to form lipoproteins.Lipoprotein particles are composed of varying proportions of cholesterol, triglycerides, phospholipids, and proteins. The largest type of lipoprotein is chylomicra, which mainly consists of triglycerides. Pre-beta-lipoproteins and beta lipoproteins follow in size order with decreasing concentrations of triglycerides and increasing cholesterol content. Pre-beta-lipoproteins are also known as low density lipoproteins (LDL), while beta lipoproteins are called very low-density lipoproteins (VLDL). These different types of lipoproteins play a significant role in the development of atheroma formation.

The smallest lipoprotein particles are referred to as alpha lipoproteins or high-density lipoproteins (HDL), which have higher

protein levels and lower concentrations of cholesterol and triglycerides. It is believed that these particles protect against the development of atherosclerotic plaque. Unlike other lipoproteins, these lipoproteins are transported to the liver instead of the blood vessels. It is believed that these lipoproteins pass through artery lining cells and some accumulate underneath, excluding chylomicra due to their size.

Enzymes break down the protein in these lipoproteins, leaving behind cholesterol and triglycerides. These fats cause inflammation when trapped, while alpha particles that do not react with enzymes are returned to circulation.

There are several risk factors for atherosclerosis and angina including family history, diabetes, hypertension, cholesterol levels, and smoking.Family history is a factor in heart disease, with around 50 genes influencing the function and structure of the heart and blood vessels. This genetic influence can lead to a higher risk of heart disease that can be passed down through generations. People with diabetes, particularly women, have an increased risk of developing angina compared to those without diabetes. Diabetes damages the lining of arteries and causes issues in the smaller blood vessels that nourish medium-sized arteries, including the coronary arteries. This damage results in blockages and deterioration of larger arteries known as atherosclerosis.

High blood pressure directly harms the lining of arteries through different mechanisms. The elevated pressure compresses small vessels that supply blood to the artery wall, causing structural changes such as microscopic fracture lines. Atherosclerosis occurs when compressed and injured cells on arterial walls allow fatty deposits to accumulate in inner walls, compromising their effectiveness as barriers against cholesterol and other substances.

Reducing cholesterol intake can directly lower the risk of heart disease. People are now more aware of

their food choices and their diet's impact on cholesterol levels. Cholesterol levels tend to rise during middle age.

Despite warnings from health officials like the surgeon general, smoking has been proven to shorten lifespan. Cigarette smoke contains harmful substances such as carbon monoxide, nicotine, and radioactive polonium.Both carbon monoxide and nicotine have significant effects on cardiovascular health. Nicotine stimulates the nerves in the heart and blood vessels, leading to an increase in adrenaline secretion, resulting in a rise of approximately 10% in blood pressure and heart rate for an hour per cigarette. In simple terms, nicotine causes the heart to beat more forcefully. On the other hand, carbon monoxide disrupts the normal transportation systems of cell membranes lining coronary arteries. This deterioration exposes them to damaging effects from circulating blood containing clotting factors and cholesterol. The presence of multiple risk factors can have a multiplying effect on individuals as shown in the Risk Factors chart.

To accurately diagnose a condition, it is crucial for patients to honestly communicate their symptoms to doctors. It is important for doctors to be aware of any additional symptoms that can help distinguish angina from other conditions such as esophagitis, pleurisy, costochondritis, pericarditis, a broken rib, a pinched nerve, a ruptured aorta, lung tumor gallstones ulcers pancreatitis collapsed lung or even nervousness because each of these conditions can cause chest pain.

During a physical examination, the doctor may measure pulse and blood pressure and use a stethoscope to listen to the heart and lungs while also checking weight. An experienced cardiologist can usually quickly differentiate between cardiac and noncardiac situations.Routine tests such as urine and blood tests can be used to determine body

fat levels and check for anemia, which is done by measuring hemoglobin levels. Low levels of hemoglobin can restrict blood supply to the heart. Kidney function can also be assessed through these tests by measuring salts and waste products like urea and creatinine in the blood. Ideally, these levels should be low. Other factors that may be tested include salt level, blood fat level, and sugar level. A chest x-ray provides information about the size of the heart, which could enlarge if overworked over time.

The electrical activity of the heart during each beat and relaxation is recorded using an electrocardiogram (ECG), which traces received signals. The ECG pattern consists of alternating plateaus and sharp peaks that indicate irregularities in the heart's beating or pace or if high blood pressure has strained the heart. It can also detect unnoticed heart attacks.

Another version of this test is called veterocardiogram (VCG) which shows loops or vectors representing the heart's electrical activity on a screen, paper printout, or photograph. This provides a three-dimensional view of a single heartbeat and makes it superior to ECG.

For drug treatment, angina patients commonly receive various prescribed drugs such as nitrates, beta-blockers, and Calcium antagonists to improve blood flow and reduce strain on the heart. However, it should be noted that these drugs only relieve pain but do not address the underlying disorder.Nitrates, such as nitroglycerine, can relax the smooth fibers of blood vessels, allowing arteries to dilate. However, this dilation can cause flushing and headaches throughout the body, including in the head.

Glyceryl trinitrate is a tablet that is taken under the tongue for fast absorption through capillaries. This helps relieve pain within minutes.

Trinitrates are also available as ointments or transdermal patches that are applied to the skin.

Dinitrates and mononitrates are medications used to prevent angina attacks instead of providing immediate pain relief. They have a slower onset but longer-lasting effect and are typically taken regularly throughout the day.

On the other hand, beta-blockers regulate heart rate and blood pressure by reducing oxygen levels required by these functions. These drugs block stress hormones at beta receptors in the heart and blood vessels, resulting in decreased heart rate and blood pressure. However, they may also have potential side effects such as reducing the pumping action of the heart, which can lead to heart failure in individuals with pre-existing heart disease. Other side effects include cold hands and feet due to constriction of peripheral blood vessels, vivid dreams, sleep disruption,
depression,
skin rashes,
dry eyes,
and increased levels of blood cholesterol
and triglycerides.

In contrast to beta-blockers, calcium antagonists work differently by removing calcium from artery walls.This text discusses the effects and side effects of medications used to treat angina, as well as surgical options and lifestyle changes. The medications cause arterial relaxation and dilation, improving blood flow and oxygen supply to the heart. They also enhance the utilization of oxygen and nutrients by the heart muscle. However, larger doses of calcium antagonists can lower blood pressure but may lead to dizziness and fluid retention with swollen ankles. Another medication option for severe angina attacks is Pexid, which has side effects like pins and needles sensation or numbness in limbs, muscle weakness, liver damage, potential diabetes, and retina damage.

If medications and other treatments fail to control angina effectively, surgery is considered as an option. There are two

types of surgical procedures available: Coronary Bypass and Angioplasty. Coronary Bypass is more commonly performed while Angioplasty is a relatively new minor operation. It's important to note that surgery should only be used as a last resort for relief since it does not provide a permanent cure for the underlying disease.

In addition to medical interventions, lifestyle changes are crucial in controlling the disease. Coronary Bypass surgery involves using a vein from another part of the body (usually the leg) to create a detour around the blocked coronary artery in order to restore blood flow to the heart muscle. Despite sounding risky, its death rate remains below 3 percent.If the disease is widespread or if the heart muscle is already weakened, there is a higher risk involved. The blocking of the grafted artery after the operation can result in complications such as a heart attack. The number of bypasses required during this procedure depends on how many coronary arteries are affected; one, two, or all three arteries may be impacted by coronary artery disease. If multiple arteries are affected, the patient will need multiple grafts. About 20 percent of patients being considered for surgery have only one diseased vessel. In 50 percent of patients, two arteries are affected, and in 30 percent, all three arteries are affected. These patients are diagnosed with triple vessel disease and will require triple bypass surgery. Triple vessel disease and left main coronary artery disease are considered to be the most severe conditions.

The surgical procedure involves making an incision on the breastbone to expose the heart. During the surgery, a heart-lung machine is used to support the patient's heart and lungs.

Additionally, a small incision is made in the leg to remove a section of vein that is then attached to the heart. One end of the vein is sewn into the aorta while the other end is sewn intothe affected coronary artery beyondthe blocked segment.This newly grafted vein acts as an alternative route for blood flow,bypassingthe original blocked artery.The procedure can be lengthy, especially when multiple bypasses are necessary,and it may take several hours to complete.
Patients recover in intensive care units (ICUs) after undergoing a procedure to relieve angina pain. This operation does not provide a permanent cure for the underlying disease, and its effects may diminish over time. To prevent the recurrence of angina, individuals must make lifestyle changes. One innovative technique, called transluminal balloon coronary angioplasty, can compress plaque caused by atherosclerosis using balloons. A thin balloon catheter is inserted into an artery in the arm or leg under general anesthesia, guided by x-ray imaging. The catheter is directed past the narrowed coronary artery and filled with fluid to compress fatty deposits against the artery walls. Once completed, the deflated balloon is removed. This procedure offers a simpler and more cost-effective alternative to bypass surgery with shorter hospitalization time required for patients. The length of the operation varies depending on the severity and location of narrowing in the artery. If plaques cannot be compressed sufficiently, a bypass may be necessary, especially if limited to the left anterior descending artery where it is most effective. However, it is crucial for individuals to understand that continuous strain on their heart can lead to an untimely demise unless lifestyle changes are combined with medications and available

surgical options.To improve heart health, individuals can follow several pieces of advice. First, they should limit physical exertion to avoid episodes of angina. Additionally, adjusting workload by delegating tasks and reassessing priorities is crucial. It is also important to learn how to pace oneself accordingly.

If work demands become unmanageable, changing jobs should be considered. Regular exercise is beneficial for overall health but should be done within personal limitations. For treating narrowed coronary arteries, a minimally invasive procedure with a balloon catheter can be an effective alternative to bypass surgery and requires less hospitalization time.

Maintaining a healthy heart condition over time involves making necessary lifestyle changes such as limiting exertion levels and engaging in regular exercise within one's limits. There are two categories of exercises: isotonic and isometric exercises. Individuals with angina should stick to isotonic exercises like leisurely walking, swimming, and yoga while more intense activities include cycling and jogging.

Reducing excess weight can lessen the strain on the heart and potentially lower blood pressure. This can be achieved by consuming fewer calories, particularly by decreasing intake of fatty and sugary foods that lack nutrients but are high in calories.

Overall diet plays a significant role in maintaining overall health.It is recommended to consume fewer animal fats and foods high in cholesterol, such as fatty meat, lard, butter, cream, hard cheese, eggs, prawns, and offal. It is also important to reduce salt intake and increase consumption of fiber-rich foods like wholegrain cereals, pulses, fresh fruits, and vegetables. Moderate alcohol consumption does not harm but may slow down weight loss due to its calorie content. Mineral water, fruit juice, herb tea, and ordinary tea can be consumed without

restrictions; however coffee intake should be limited to two cups a day. Smoking cigarettes has no beneficial effects on the body; instead it increases heart rate, constricts blood vessels,and strains the heart. Quitting smoking may be challenging but worthwhile. Stress is often overlooked as a significant risk factor; therefore it's important to avoid situations that raise blood pressure and trigger stress hormones.If unable to avoid these situations,sucking on an angina tablet beforehand may help.To relax when feeling tense,sit or lie down quietly with closed eyesand take slow deep breaths through the nose with long steady exhalations.Getting enough sleep each night is always essential for overall health.While sexual intercourse may induce an angina attack , abstaining from sex can lead to chronic frustration and further tensionIf engaging in sexual intercourse triggers symptoms of angina, there are two options: either suck on an angina tablet a few minutes beforehand or allow your partner to take on a more active role. In the industrialized societies of the twentieth century, there has been a noticeable increase in coronary heart disease, possibly due to the rewarding of individuals who exhibit quick, aggressive, and competitive behavior. Both males and females with Type-A personalities display traits such as an intense drive towards ambiguous self-selected goals, a strong desire to compete, persistent ambition for recognition and advancement, and continuous engagement in multiple tasks with strict time constraints. This personality type also tends to habitually speed up both physical and mental functions, demonstrating exceptional alertness in both aspects. Furthermore, these individuals often experience feelings of aggression and hostility which further fuel their competitiveness.