Coronary artery disease

coronary heart diseaseischemic heart diseaseischaemic heart disease
A more controversial link is that between Chlamydophila pneumoniae infection and atherosclerosis. While this intracellular organism has been demonstrated in atherosclerotic plaques, evidence is inconclusive as to whether it can be considered a causative factor. Treatment with antibiotics in patients with proven atherosclerosis has not demonstrated a decreased risk of heart attacks or other coronary vascular diseases. Since the 1990s the search for new treatment options for coronary artery disease patients, particularly for so called "no-option" coronary patients, focused on usage of angiogenesis and (adult) stem cell therapies.

Heart

cardiachuman heartapex of the heart
Coronary artery disease, also known as ischaemic heart disease, is caused by atherosclerosis – a build-up of fatty material along the inner walls of the arteries. These fatty deposits known as atherosclerotic plaques narrow the coronary arteries, and if severe may reduce blood flow to the heart. If a narrowing (or stenosis) is relatively minor then the patient may not experience any symptoms. Severe narrowings may cause chest pain (angina) or breathlessness during exercise or even at rest. The thin covering of an atherosclerotic plaque can rupture, exposing the fatty centre to the circulating blood.

Angioplasty

balloon angioplastyangioplastiespercutaneous transluminal angioplasty
Carotid artery stenosis is treated with angioplasty in a procedure called carotid stenting for patients at high risk for carotid endarterectomy. Atherosclerotic obstruction of the renal artery can be treated with angioplasty with or without stenting of the renal artery. Renal artery stenosis can lead to hypertension and loss of renal function. Angioplasty is occasionally used to treat venous stenosis, such as stenosis of the subclavian vein caused by thoracic outlet syndrome. Angioplasty requires an access vessel, typically the femoral or radial artery or femoral vein, to permit access to the vascular system for the wires and catheters used.

Outline of cardiology

Aortic stenosis – Narrowing of the aortic valve opening that reduces blood flow through the valve. Stenosis commonly occurs from calcification of the valve, which happens prematurely in those with a bicuspid aortic valve. Stenosis of the aortic valve produces a harsh systolic murmur that classically radiates in the carotid arteries as well as pulsus parvus et tardus. Aortic valve replacement – Replacement of the aortic valve due to aortic regurgitation, aortic stenosis, or other reasons. A special kind of replacement called percutaneous aortic valve replacement is done through catheters are does not require open-heart surgery.

Stent

stentsstent graftstenting
It was used as a scaffold to prevent the vessel from closing and to avoid restenosis in coronary surgery—a condition where scar tissue grows within the stent and interferes with vascular flow. Shortly thereafter, in 1987, Julio Palmaz (known for patenting a balloon-expandable stent ) and Richard Schatz implanted their similar stent into a patient in Germany. Though several doctors have been credited with the creation of the stent, the first FDA-approved stent was invented by Cesare Gianturco and Gary S. Roubin and approved in 1993. To further reduce the incidence of restenosis, the drug-eluting stent was introduced in 2003. Bioresorbable stent. Bronchoscopy. Colonoscopy.

Angina

angina pectorischest painstable angina
Myocardial ischemia can result from: Atherosclerosis is the most common cause of stenosis (narrowing of the blood vessels) of the heart's arteries and, hence, angina pectoris. Some people with chest pain have normal or minimal narrowing of heart arteries; in these patients, vasospasm is a more likely cause for the pain, sometimes in the context of Prinzmetal's angina and syndrome X. Myocardial ischemia also can be the result of factors affecting blood composition, such as reduced oxygen-carrying capacity of blood, as seen with severe anemia (low number of red blood cells), or long-term smoking. Angina results when there is an imbalance between the heart's oxygen demand and supply.

Aortic valve

aorticaortic valvesaortic semilunar valve
It can also become necessary for the treatment of aortic aneurysm, or less frequently for congenital aortic stenosis. Aortic valve replacement is a surgical procedure in which a patient's aortic valve is replaced by a different valve. The aortic valve can be affected by a range of diseases and require aortic valve replacement. The valve can become either leaky (regurgitant or insufficient) or stuck partially shut (stenotic). Aortic valve replacement traditionally required open heart surgery. A new alternative is transcatheter aortic valve replacement (TAVR), which delivers a mechanical valve to the site of the diseased valve through a catheter.

Hypertension

high blood pressurehypertensivearterial hypertension
Hypertension can also be caused by endocrine conditions, such as Cushing's syndrome, hyperthyroidism, hypothyroidism, acromegaly, Conn's syndrome or hyperaldosteronism, renal artery stenosis (from atherosclerosis or fibromuscular dysplasia), hyperparathyroidism, and pheochromocytoma. Other causes of secondary hypertension include obesity, sleep apnea, pregnancy, coarctation of the aorta, excessive eating of liquorice, excessive drinking of alcohol, and certain prescription medicines, herbal remedies, and illegal drugs such as cocaine and methamphetamine. Arsenic exposure through drinking water has been shown to correlate with elevated blood pressure.

List of MeSH codes (C14)

C14
. --- aortic valve stenosis. --- aortic stenosis, supravalvular. --- williams syndrome. --- aortic stenosis, subvalvular. --- cardiomyopathy, hypertrophic. --- discrete subaortic stenosis. --- heart murmurs. --- heart valve prolapse. --- aortic valve prolapse. --- mitral valve prolapse. --- tricuspid valve prolapse. --- mitral valve insufficiency. --- mitral valve stenosis. --- pulmonary atresia. --- pulmonary valve insufficiency. --- pulmonary valve stenosis. --- leopard syndrome. --- pulmonary subvalvular stenosis. --- tricuspid atresia. --- tricuspid valve insufficiency. --- tricuspid valve stenosis. --- coronary disease. --- angina pectoris. --- angina, unstable. --- angina pectoris, variant

Angiography

angiogramarteriographyarteriogram
The presence or absence of atherosclerosis or atheroma within the walls of the arteries cannot be clearly determined. Coronary angiography can visualize coronary artery stenosis, or narrowing of the blood vessel. The degree of stenosis can be determined by comparing the width of the lumen of narrowed segments of blood vessel with wider segments of adjacent vessel. To detect coronary artery disease, a CT scan is more satisfactory than an MRI scan. The sensitivity and specificity between CT and MRI were (97.2 percent and 87.4 percent) and (87.1 percent and 70.3 percent), respectively.

Peripheral artery disease

peripheral vascular diseaseperipheral arterial diseaseperipheral artery occlusive disease
Renal artery stenosis can cause renovascular hypertension. Carotid artery disease can cause strokes and transient ischemic attacks. Risk factors contributing to PAD are the same as those for atherosclerosis: Peripheral arterial disease is more common in the following populations of people: Upon suspicion of PAD, the first-line study is the ankle–brachial index (ABI), which is the ratio of blood pressure in the ankle to blood pressure in the upper arm. When the blood pressure readings in the ankles is lower than that in the arms, blockages in the arteries which provide blood from the heart to the ankle are suspected. An ABI range of 1.00 to 1.40 is considered normal.

Fibromuscular dysplasia

In cases of renal stenosis and indications for intervention, percutaneous balloon angioplasty may be recommended. Many studies have assessed the success rate of percutaneous transluminal angioplasty (PTA) in these cases, and have found relief of hypertensive symptoms. Duplex ultrasonography should be performed soon after this procedure to ensure adequate renal velocities. Stents have a restenosis rate of 10-20%, and may make surgical revascularization more difficult. Surgical revascularization may be necessary if aneurysms develop within the affected artery or if PTA does not resolve the issue.

Cardiology

cardiologistcardiologistscardiovascular medicine
This procedure can also be done proactively, when areas of the vascular system become occluded from Atherosclerosis. The Cardiologist will thread this sheath through the vascular system to access the heart. This sheath has a balloon and a tiny wire mesh tube wrapped around it, and if the cardiologist finds a blockage or Stenosis, they can inflate the balloon at the occlusion site in the vascular system to flatten or compress the plaque against the vascular wall. Once that is complete a Stent is placed as a type of scaffold to hold the vasculature open permanently. Helen B. Taussig is known as the founder of pediatric cardiology.

Artery

arteriesarterialarterial system
Theodor Kocher reported that atherosclerosis often developed in patients who had undergone a thyroidectomy and suggested that hypothyroidism favors atherosclerosis, which was, in 1900s autopsies, seen more frequently in iodine-deficient Austrians compared to Icelanders, who are not deficient in iodine. Turner reported the effectiveness of iodide and dried extracts of thyroid in the prevention of atherosclerosis in laboratory rabbits. * Vein * Human arterial system

Congenital heart defect

congenital heart diseaseheart defectcongenital heart defects
Common defects include pulmonic stenosis, aortic stenosis, and coarctation of the aorta, with other types such as bicuspid aortic valve stenosis and subaortic stenosis being comparatively rare. Any narrowing or blockage can cause heart enlargement or hypertension. The septum is a wall of tissue which separates the left heart from the right heart. Defects in the interatrial septum or the interventricular septum allow blood to flow from the right side of the heart to the left, reducing the heart's efficiency. Ventricular septal defects are collectively the most common type of CHD, although approximately 30% of adults have a type of atrial septal defect called probe patent foramen ovale.

Percutaneous coronary intervention

coronary angioplastyPCIpercutaneous transluminal coronary angioplasty
PCI is used primarily to open a blocked coronary artery and restore arterial blood flow to heart tissue, without requiring open-heart surgery. In patients with a restricted or blocked coronary artery, PCI may be the best option to re-establish blood flow as well as prevent angina (chest pain), myocardial infarctions (heart attacks) and death. Today, PCI usually includes the insertion of stents, such as bare-metal stents, drug-eluting stents, and fully resorbable vascular scaffolds (or naturally dissolving stents). The use of stents has been shown to be important during the first three months after PCI; after that the artery can remain open on its own.

Hypercholesterolemia

high cholesterolhigh blood cholesterolhypercholesterolaemia
Newer methods, such as "lipoprotein subclass analysis", have offered significant improvements in understanding the connection with atherosclerosis progression and clinical consequences. If the hypercholesterolemia is hereditary (familial hypercholesterolemia), more often a family history of premature, earlier onset atherosclerosis is found. The U.S. Preventive Services Task Force in 2008 strongly recommends routine screening for men 35 years and older and women 45 years and older for lipid disorders and the treatment of abnormal lipids in people who are at increased risk of coronary heart disease.

Coronary artery bypass surgery

heart bypassbypass surgeryheart bypass surgery
Other heart surgery factors related to mental damage may be events of hypoxia, high or low body temperature, abnormal blood pressure, irregular heart rhythms, and fever after surgery. Nonunion of the sternum; internal thoracic artery harvesting increases the sternum devascularization risk. Myocardial infarction due to embolism, hypoperfusion, or graft failure. Late graft stenosis, particularly of saphenous vein grafts due to atherosclerosis causing recurrent angina or myocardial infarction. Acute renal failure due to embolism or hypoperfusion. Stroke, secondary to embolism or hypoperfusion. Vasoplegic syndrome, secondary to cardiopulmonary bypass and hypothermia.

Coarctation of the aorta

aortic coarctationcoarctation of aortaSevere coarctation of the aorta
Treatment of recoarctation is usually successfully done without the need for open heart surgery. Recoarctation is increasingly less common in the modern era. Late hypertension does also seem to be much less of a problem if the coarctation repair was performed not later than within the 5 first tear of life. Life expectancy and quality of life are therefore same as if very close to that of the normal population, but check ups are recommended so that those few percent who need further treatment, get it on time.

Bruit

bruitsunusual blood soundshumming noise
. * American Heart Organization Peripheral vascular disease; femoral artery stenosis. Renal artery stenosis. Stroke, carotid artery stenosis. Aortic aneurysm. Tinnitus – a symptom which may be caused by a cranial artery bruit. Arteriovenous malformation. Coarctation of the aorta. Hepatocellular carcinoma. Alcoholic hepatitis. Atherosclerosis (atheroma or plaque) (cholesterol deposition in artery wall). Median arcuate ligament syndrome, celiac artery stenosis – external compression. Arteriovenous (AV) fistula – pathologic or surgically created. Graves' disease, goitre. Paget's disease. Polymyalgia rheumatica. Giant cell arteritis. Fibromuscular dysplasia. IgG4-related disease. Carotid bruit.

Chronic kidney disease

renal insufficiencychronic renal failureend-stage renal disease
Vascular disease includes large vessel disease such as bilateral renal artery stenosis and small vessel disease such as ischemic nephropathy, hemolytic-uremic syndrome, and vasculitis. Glomerular disease comprises a diverse group and is classified into:. Primary glomerular disease such as focal segmental glomerulosclerosis and IgA nephropathy (or nephritis). Secondary glomerular disease such as diabetic nephropathy and lupus nephritis. Congenital disease such as polycystic kidney disease. Tubulointerstitial disease includes drug- and toxin-induced chronic tubulointerstitial nephritis, and reflux nephropathy.

Heart valve

heart valvesvalvescardiac valve
This is a result of the valve becoming thickened and any of the heart valves can be affected, as in mitral valve stenosis, tricuspid valve stenosis, pulmonary valve stenosis and aortic valve stenosis. Stenosis of the mitral valve is a common complication of rheumatic fever. Inflammation of the valves can be caused by infective endocarditis, usually a bacterial infection but can sometimes be caused by other organisms. Bacteria can more readily attach to damaged valves. Another type of endocarditis which doesn't provoke an inflammatory response, is nonbacterial thrombotic endocarditis. This is commonly found on previously undamaged valves.

Aneurysm

aneurysmsaneurismruptured aneurysm
The heart, including coronary artery aneurysms, ventricular aneurysms, aneurysm of sinus of Valsalva, and aneurysms following cardiac surgery. The aorta, namely aortic aneurysms including thoracic aortic aneurysms and abdominal aortic aneurysms. The brain, including cerebral aneurysms, berry aneurysms, and Charcot–Bouchard aneurysms. The legs, including the popliteal arteries. The kidney, including renal artery aneurysm and intraparechymal aneurysms. Capillaries, specifically capillary aneurysms. Fatigue. Loss of perception. Loss of balance. Speech problems. Double vision. Severe headaches. Loss of vision. Double vision. Neck pain or stiffness. Pain above or behind the eyes.

Aorta

aorticaortic archventral aorta
Aortic stenosis. Aortitis, inflammation of the aorta that can be seen in trauma, infections, and autoimmune disease. Atherosclerosis. Ehlers–Danlos syndrome. Marfan syndrome. Trauma, such as traumatic aortic rupture, most often thoracic and distal to the left subclavian artery and often quickly fatal. Transposition of the great vessels, see also dextro-Transposition of the great arteries and levo-Transposition of the great arteries.

Coronary catheterization

coronary angiographycoronary angiogramcardiac catheterization
Specifically, coronary catheterization is a visually interpreted test performed to recognize occlusion, stenosis, restenosis, thrombosis or aneurysmal enlargement of the coronary artery lumens; heart chamber size; heart muscle contraction performance; and some aspects of heart valve function. Important internal heart and lung blood pressures, not measurable from outside the body, can be accurately measured during the test. The relevant problems that the test deals with most commonly occur as a result of advanced atherosclerosis – atheroma activity within the wall of the coronary arteries. Less frequently, valvular, heart muscle, or arrhythmia issues are the primary focus of the test.