The causes of Coronary Heart Disease
In many countries, including Indonesia, coronary heart disease (PKJ) is the number one killer. Disease that occurs due to narrowing of the coronary arteries is triggered by many factors. Unhealthy lifestyle is one of the factors that trigger this disease.
According to Prof. Dr. Dr. Budhi Setianto SpJP, heart disease experts from heart Hospital Harapan Kita, Slipi, West Jakarta, is the coronary blood vessels or arteries. Its function is to feed the heart muscle so that the heart can function well. “Coronary heart disease caused by a narrowing of the coronary blood vessels that drain blood to the heart muscle,” he said.
Narrowing of blood vessels due to accumulation of fat in the blood vessel wall. This process is called atherosclerosis. When an artery or blood vessel blockage, blood flow will decrease, causing a heart attack. “A heart attack is caused by vasokontriksi or narrowing of blood vessels due to contraction of the muscle blood vessels,” he continued.
Causes and Symptoms
There are several factors causing the occurrence of coronary heart disease. In general there are two parts, the causative factor that can be changed and the factors that cause not changed.
Causative factor that can not be changed is heredity and gender. If parents or grandparents suffer from coronary heart disease, most likely his son suffered from coronary heart disease, most likely his son suffered from this disease are male. Many men aged 30 years suffering from this disease.
While the factors that can be changed related to lifestyle. Obesity, hypertension (high blood), diabetes mellitus (diabetes), smoking habits, and levels of high blood fat can trigger the occurrence of coronary heart disease.
Similarly stress. At the time of stress, an imbalance occurs in the heart of the work. Heart work increases, so the heart muscle requires a lot of blood intake.
There are several symptoms that appear. Typical symptoms are chest pain or pain and like dutusuk sharps. This pain usually lasts 20 minutes. This sense, pain, should really be identified to determine whether the taste was caused by heart disease or by a muscle disorder or disturbance in respiratory function.
Cardiac chest pain is usually like a crushed chest and body weight on bone pain or chest called the sternum. The pain may spread up to the neck and the back of the right and left. “Chest pain also occurred because the patient is doing activities such as working too hard,” he explained.
If such symptoms appear, patients should go or be taken to the hospital to receive medical treatment. Patients will directly didentifikasi by cardiologists whether coronary heart attack or not. “Usually the doctor directly provide drugs pelebar coronary blood vessels or nitrate. If it’s true a heart attack, it will be further addressed by a cardiologist,” he continued.
Examination and Treatment
First of all is the anamnesis of the patients answered questions about the typical chest pain was. Then there are checks with an ECG (Electro cardiogram). “This test is done at bedtime or the so-called static,” he said.
Furthermore, examination by means of nuclear cardiology, which is a form of examination that uses a radioactive substance to see the heart muscle blood flow, evaluate cardiac pump function, see the extensive and the location of the damaged heart muscle and see the heart muscle perfusion.
In addition to nuclear cardiology, there is also a nuclear scan of heart, which is a form of tests done to detect the early presence or absence of coronary heart disease, to determine which coronary artery ischemia effect in patients who had performed a heart catheterization, to evaluate the situation before and after performed balloon angioplasty and coronary bypass surgery, and prognostic stratification. “When large nuclear perfusion disturbances, then the life expectancy and incidence of heart attack in front of the worse,” he said.
Medical
There are several types of drugs normally given to people with coronary heart disease is. First is the statins. These drugs reduce levels of fat serves to prevent the formation of blood cholesterol or bad cholesterol, especially low-density lippoprotein (LDL). “It also has the effect of reducing inflation pleotropik plaque that is not easily broken. If the plaques rupture, heart attacks can happen,” explained Dr. Budhi.
Statins are taken only once a day. Usually at night for a long period of time. Side effects of these drugs is the occurrence of liver disorders. “Therefore, the need to do liver function tests periodically. After several months of usage, usually muscle pain,” he continued.
Second, asetosal. Asetosal function inhibits platelets or collection of platelets and prevent heart attacks by 20 percent. But this can not asetosal consumed patients suffering from stomach pain. Instead, clopidrogel can be consumed for 1 month to a year.
Other drugs that can be given a beta insulation. “This drug works lowering heart rate and dilate coronary or vasodilatation,” added Dr. Budhi. But people with asthma, people with chronic obstructive pulmonary disease (COPD), or to block the heart rhythm should not take this drug. Instead, be given class of calcium antagonists such as diltiazem.
Other drugs are also given modifier angiotensinogen enzyme inhibitors. These drugs prevent changes in the structure and reduce the burden on the heart. “Provision of angiotensinogen modifier enzyme itself in the long term and have side effects that the patient is susceptible to interference and can be replaced cough with angiotensin receptor inhibitor class,” he explained.
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