Cardiology

Vigorous activity weekly may improve outcomes in stable CAD

Performing vigorous physical activity once or twice a week compared with sedentary behavior or light physical activity may improve long-term cardiac health in patients with stable coronary artery disease, according to a study ...

Diabetes

HbA1c variability linked to cardiovascular disease risk

(HealthDay)—For patients with newly diagnosed type 2 diabetes, visit-to-visit hemoglobin A1c (HbA1c) variability is associated with increased risks for cardiovascular disease and microvascular complications, according to ...

Cardiology

Blood transfusion practices should be revisited

Restricting blood transfusion guidelines may save both lives and money, according to a study presented at CHEST 2019, the annual meeting of the American College of Chest Physicians, held from Oct. 19 to 23 in New Orleans.

Genetics

New genomic regions linked to common vascular disorder

Blood clotting in veins, a disorder called venous thromboembolism (VTE), is a common vascular disease like heart attack and stroke, but hasn't been as well studied. Genetics are known to be involved, but only about a dozen ...

Health

Women find it more difficult to quit smoking

Women are half as likely to quit smoking as men, according to research presented at the 2019 Canadian Cardiovascular Congress (CCC). Affordability of smoking cessation medications was another barrier to success.

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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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