Cardiology

Variation in revascularization for asymptomatic SIHD unexplained

(HealthDay)—For asymptomatic patients with stable ischemic heart disease (SIHD) and coronary artery disease (CAD), there is considerable variation in revascularization practice that is not explained by known factors, according ...

Cardiology

Calcium specks may help detect heart disease in South Asians

Specks of calcium in the heart's artery walls could be an important prognostic marker of early cardiovascular disease in South Asians and may help guide treatment in this population, according to a study by researchers at ...

Psychology & Psychiatry

When pets are family, the benefits extend into society

There is a growing global trend to consider pets as part of the family. In fact, millions of people around the world love their pets, enjoying their companionship, going for walks, playing and even talking to them. And there ...

Genetics

Genetic risk for atypical heart attack in women identified

New research published by teams from Leicester, UK and Paris, France in collaboration with international partners from the US and Australia, has found a common genetic factor that confers a significant risk of atypical heart ...

Cardiology

Does your insurance card matter when you have a heart attack?

Medicaid reimbursement to health care facilities on ST-elevation myocardial management—or STEMI, a serious form of a heart attack—is often lower when compared with the reimbursement rate of private insurance, according ...

Cardiology

Medics suggest modifications to coronary artery stenting

Bifurcation lesions are a challenge, even for an experienced cardiac surgeon. Currently, there are two surgical techniques for dealing with them, but no medical consensus on which one applies to which case. Russian scientists ...

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Coronary artery disease (CAD; also atherosclerotic heart disease) is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries that supply the myocardium (the muscle of the heart) with oxygen and nutrients. It is sometimes also called coronary heart disease (CHD). Although CAD is the most common cause of CHD, it is not the only one.

CAD is the leading cause of death worldwide. While the symptoms and signs of coronary artery disease are noted in the advanced state of disease, most individuals with coronary artery disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a "sudden" heart attack, finally arises. After decades of progression, some of these atheromatous plaques may rupture and (along with the activation of the blood clotting system) start limiting blood flow to the heart muscle. The disease is the most common cause of sudden death, and is also the most common reason for death of men and women over 20 years of age. According to present trends in the United States, half of healthy 40-year-old males will develop CAD in the future, and one in three healthy 40-year-old women. According to the Guinness Book of Records, Northern Ireland is the country with the most occurrences of CAD. By contrast, the Maasai of Africa have almost no heart disease.

As the degree of coronary artery disease progresses, there may be near-complete obstruction of the lumen of the coronary artery, severely restricting the flow of oxygen-carrying blood to the myocardium. Individuals with this degree of coronary artery disease typically have suffered from one or more myocardial infarctions (heart attacks), and may have signs and symptoms of chronic coronary ischemia, including symptoms of angina at rest and flash pulmonary edema.

A distinction should be made between myocardial ischemia and myocardial infarction. Ischemia means that the amount of blood supplied to the tissue is inadequate to supply the needs of the tissue. When the myocardium becomes ischemic, it does not function optimally. When large areas of the myocardium becomes ischemic, there can be impairment in the relaxation and contraction of the myocardium. If the blood flow to the tissue is improved, myocardial ischemia can be reversed. Infarction means that the tissue has undergone irreversible death due to lack of sufficient oxygen-rich blood.

An individual may develop a rupture of an atheromatous plaque at any stage of the spectrum of coronary artery disease. The acute rupture of a plaque may lead to an acute myocardial infarction (heart attack).

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