Coronary heart disease is a pathological condition characterized by an absolute disturbance of the blood supply to the myocardium due to coronary artery disease. At the moment, cardiovascular diseases are in the first place in terms of morbidity and mortality all over the world, among the most common nosologies: coronary heart disease (CHD), chronic heart failure (CHF), myocardial infarction (MI), arterial hypertension (AH).
The basis of coronary heart disease (CHD) is atherosclerosis of the coronary arteries, more often there is a lesion of the anterior descending branch of the left coronary artery, congenital anomalies of coronary arteries, branching of the envelope artery from the right coronary sinus, coronary artery dissection, spontaneous detachment or due to aortic dissection are observed. In systemic vasculitis, there may be be inflammatory coronary artery disease, coronary artery embolism, radiation-induced coronary artery fibrosis, and a number of comorbidities, modifiable factors, and non-modifiable factors. Risk factors for CHD are:
1. non-modifiable:
-age (morbidity increases in men after 40-45 years old, in women – 55-60 years old)
-Male gender (men fall ill twice as often as women)
-Affluent heredity (deficiency or dysfunction of LDL receptors on the surface of hepatocytes, due to which the ability to transport HDL-C is lost inside hepatocytes).
2. Modifiable (controllable)
-arterial hypertension
-dyslipidemia
-stress
-smoking
-obesity (BMI over 30)
-hypodynamia
-disordered glucose tolerance, disordered carbohydrate metabolism
-hyperhomocysteinemia
With coronary heart disease, there are sudden pains behind the sternum, most often burning and pressing, lasting up to 15 minutes, up to 30 minutes much less. The attacks of burning and pressing pains occur against the background of intensive physical activity, which are accompanied by fear of death, shortness of breath, as well as by increased arterial pressure. Increased respiratory movements, heart rate, as well as heart rhythm disturbance are noted. In tension angina, the pain attack lasts up to 10 minutes and, as a rule, the pain is stopped by nitroglycerin within 5 minutes. Tension angina is diagnosed in the first 3 months, after the first pain attack. The attacks develop at rest, very often at night or in the early hours, and may be cyclical.
