Coronary Heart Disease Treatment

Coronary Heart Disease Treatment

Depending on the stage of the disease, the following measures can be considered, which can be used individually or in combination:

  • Control of risk factors
  • medication
  • Expansion of coronary artery constrictions using special cardiac catheters
  • Bypass operation

Control of risk factors

The basis of any treatment for coronary heart disease is the consistent control of risk factors to prevent the disease from progressing as far as possible and, in the best case, to achieve a regression of the calcification in the heart. Specifically, this means:

  • Weight regulation in overweight
  • Alcohol and nicotine abstinence
  • Dietary measures for diabetes
  • medical treatment of the dyslipidemia or gout
  • Reduction of psychological stress factors
  • adequate physical activity

If the measures described and, if necessary, the treatment of the other diseases are not sufficient, supportive heart medication is prescribed. A heart attack is also followed by tablet treatment to control blood pressure, improve blood flow and make work easier for the weakened heart muscle.

 

Coronary heart disease surgery

Direct interventions on the coronary arteries in the case of chronic circulatory disorders or the event of an acute heart attack are possible as part of a heart catheter examination. Using special inflatable balloons at the tip of cardiac catheters inserted into the coronary arteries, individual constrictions can be expanded, and the blood flow normalized.

Unfortunately, in about 20 to 30 per cent of the primarily successfully treated cases, narrowing occurs again (restenosis) in the same place, which can, however, be expanded again with balloon catheters. To reduce the high risk of re-narrowing, stents, such as expandable, mesh-like tubes made of stainless steel that keep the vessel open, are often used. Some of them also release medication slowly.

In the case of severe calcification of all important coronary arteries, in some cases, only a bypass operation can be considered. In this significant heart operation, veins from other parts of the patient’s body (usually the lower leg) are sewn over the narrowed coronary arteries to form vascular bridges. Due to the increasing surgical risk, new bypass operations are only performed in a few individual cases if the bypasses initially created are not functional.

treatment of the complications

Of the complex manifestations of coronary heart disease, chronic consequences of circulatory disorders in the heart muscle or previous heart attacks also have to be treated specifically. As a result of acute or chronic circulatory disorders, a wide variety of arrhythmias can occur in patients with coronary heart disease, which can be associated with a heart rhythm that is too slow or too fast.

  • Chronic, recurring arrhythmias from the ventricles present a particular problem, the development of which is favoured by infarction scars. Since, according to current knowledge, it is unfortunately not possible to treat these cardiac arrhythmias with medication that is 100% safe, implantable automatic defibrillators the size of a cigarette case have been developed since the mid-1980s, which are inserted under the pectoral muscle on the left above the heart. Although these do not prevent arrhythmias, they can treat them effectively by administering an electric shock in an emergency.
  • Heart failure after one or more heart attacks is usually treated with medication and, in severe cases, with a heart transplant.
  • Functional disorders of the heart valves caused by blood flow require drug treatment or the surgical replacement of the damaged heart valve with artificial valve prostheses.
  • Suppose there are acute or chronic circulatory disorders of the heart muscle, coagulation disorders or blood clots that have spread into the coronary arteries. In that case, blood-thinning medication must be taken for life.

 

preventive measures

It is well known that the best cure for a disease is its prevention. In the case of coronary heart disease, there is a whole range of options for significantly reducing the probability of disease by controlling individual risk factors, as described above.

Above all, it is essential to develop an awareness of the fact that our modern, sedentary lifestyle and our Western eating habits significantly promote vascular diseases in general and coronary heart disease in particular. If there are risk factors such as a genetic load, special attention should be paid to additional avoidable or treatable risks.

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