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.


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.


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.


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.

Outline of cardiology

List of heart disorders
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. Aortic valve repair – Repair, instead of replacement, of the aortic valve. Aortic valvuloplasty – Repair of the valve by using a balloon catheter to force it open. Mitral valve – Disorders and treatments of the mitral valve that separates the left atrium and left ventricle. Mitral valve prolapse – Prolapse of the mitral valve into the left atrium during ventricular systole.


stentsstentingstent graft
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 in the USA was created by Richard Schatz and coworkers. Named the Palmaz-Schatz (Johnson & Johnson) it was developed in 1987. To further reduce the incidence of restenosis, the drug-eluting stent was introduced in 2003.


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


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.

List of MeSH codes (C14)

valve insufficiency. --- 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


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, certain prescription medicines, herbal remedies, and stimulants such as cocaine and methamphetamine. Arsenic exposure through drinking water has been shown to correlate with elevated blood pressure. Depression was also linked to hypertension.


ischemic strokestrokescerebrovascular accident
Carotid endarterectomy or carotid angioplasty can be used to remove atherosclerotic narrowing of the carotid artery. There is evidence supporting this procedure in selected cases. Endarterectomy for a significant stenosis has been shown to be useful in preventing further strokes in those who have already had one. Carotid artery stenting has not been shown to be equally useful. People are selected for surgery based on age, gender, degree of stenosis, time since symptoms and the person's preferences.

Myocardial infarction

heart attackheart attacksacute myocardial infarction
Atherosclerotic plaques are often present for decades before they result in symptoms. The gradual buildup of cholesterol and fibrous tissue in plaques in the wall of the coronary arteries or other arteries, typically over decades, is termed atherosclerosis. Atherosclerosis is characterized by progressive inflammation of the walls of the arteries. Inflammatory cells, particularly macrophages, move into affected arterial walls. Over time, they become laden with cholesterol products, particularly LDL, and become foam cells. A cholesterol core forms as foam cells die.


It can be caused by embolism, thrombosis of an atherosclerotic artery, or trauma. Venous problems like venous outflow obstruction and low-flow states can cause acute arterial ischemia. An aneurysm is one of the most frequent causes of acute arterial ischemia. Other causes are heart conditions including myocardial infarction, mitral valve disease, chronic atrial fibrillation, cardiomyopathies, and prosthesis, in all of which thrombi are prone to develop. The thrombi may dislodge and may travel anywhere in the circulatory system, where they may lead to pulmonary embolus, an acute arterial occlusion causing the oxygen and blood supply distal to the embolus to decrease suddenly.


The rise of the modern anti-smoking movement in the late 19th century did more than create awareness of the hazards of smoking; it provoked reactions of smokers against what was, and often still is, perceived as an assault on personal freedom and has created an identity among smokers as rebels or outcasts, apart from non-smokers: There is a new Marlboro land, not of lonesome cowboys, but of social-spirited urbanites, united against the perceived strictures of public health. The importance of tobacco to soldiers was early on recognized as something that could not be ignored by commanders.

Coronary artery bypass surgery

heart bypassbypass surgeryheart bypass surgery
Aside the latter classical approach, there are emerging techniques for construction of composite grafts as to avoiding connecting grafts on the ascending aorta (Un-Aortic) in view of decreasing neurologic complications. 9) The heart is restarted by removing the aortic cross clamp; or in "off-pump" surgery, the stabilizing devices are removed.

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.

Heart valve

heart valvesvalvesatrioventricular valves
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.

Coarctation of the aorta

aortic coarctationCoarctation of aortacoarctation
Physiologically its complete form is manifested as interrupted aortic arch. There are three types of aortic coarctations: Aortic coarctation and aortic stenosis are both forms of aortic narrowing. In terms of word root meanings, the names are not different, but a conventional distinction in their usage allows differentiation of clinical aspects. This spectrum is dichotomized by the idea that aortic coarctation occurs in the aortic arch, at or near the ductus arteriosis, whereas aortic stenosis occurs in the aortic root, at or near the aortic valve.


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.


aneurysmsaneurismruptured aneurysm
Advanced syphilis infection resulting in syphilitic aortitis and an aortic aneurysm. Tuberculosis, causing Rasmussen's aneurysms. Brain infections, causing infectious intracranial aneurysms. Berry aneurysms of the anterior communicating artery of the circle of Willis, associated with autosomal dominant polycystic kidney disease. Familial thoracic aortic aneurysms. Cirsoid aneurysms, secondary to congenital arteriovenous malformations. Lucille Ball, who died from an aortic rupture in the abdominal area days after having undergone apparently successful heart surgery for a dissecting aortic aneurysm. Laura Branigan, who died of a cerebral aneurysm.

Chronic kidney disease

chronic renal failureend-stage renal diseasechronic kidney failure
People with CKD are more likely than the general population to develop atherosclerosis with consequent cardiovascular disease. People with both CKD and cardiovascular disease have significantly worse prognoses than those with only cardiovascular disease. Vascular disease includes large vessel disease such as bilateral kidney 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.


bruitsarterial bruitsCardiac bruit
. * 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.

Lumen (anatomy)

In biology, a lumen (plural lumina) is the inside space of a tubular structure, such as an artery or intestine. It comes.


diabetes mellitusdiabeticdiabetics
Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by a high blood sugar level over a prolonged period. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.

Mitral valve stenosis

mitral stenosisMitral valvuloplastymitral atresia
M1 becomes louder in mitral stenosis. It may be the most prominent sign. If pulmonary hypertension secondary to mitral stenosis is severe, the P 2 (pulmonic) component of the second heart sound (S 2 ) will become loud. An opening snap that is a high-pitch additional sound may be heard after the A 2 (aortic) component of the second heart sound (S 2 ), which correlates to the forceful opening of the mitral valve. The mitral valve opens when the pressure in the left atrium is greater than the pressure in the left ventricle. This happens in ventricular diastole (after closure of the aortic valve), when the pressure in the ventricle precipitously drops.