Coronary Artery Disease 1

Running head: CORONARY ARTERY DIESEASE

Coronary artery Disease

Hassan Rizvi

CTU Online

Jennifer Lame

BIO121

10-31-2008
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Coronary artery Disease

ANATOMY AND PHYSIOLOGY OF THE CARDIO VASCULAR SYSTEM:

Heart is a vital organ located in the middle mediastinum, enclosed by double layer

of tissue called the pericardium. The visceral pericardium is attached to the heart whereas

the parietal layer is separated from the visceral layer by a thin layer of fluid called the

pericardial fluid. It consists of four chambers; upper 2 are called the atria and the lower

two are the ventricles. There are four valves which control the flow of blood through the

heart. They are Mitral, Tricuspid, Aortic and Pulmonary valves.

The ventricles are composed of specialized muscle fibers called the Purkinje

fibers. These specialized fibers are responsible for the uniform distribution of the cardiac

impulse resulting in a smooth ventricular contraction.

The heart receives and pumps blood to and from the body through specific veins

and arteries respectively. The blood coming to the heart from different tissues is low in

oxygen and enters the right side through veins called Superior and Inferior Vena cava.

This blood after being oxygenated by the lungs is pumped from the left side of the heart

by an artery called as the Aorta.

The cardiac cycle consists of a systolic phase during which the ventricles contract

and force the blood into the arteries, while during the diastole phase the atria and
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ventricles are filled with blood for the next contraction. During this cycle there are

different phases of contraction and relaxation that control the opening and closing of the

valves, hence regulating effective blood flow.

MYOCARDIAL INFARCTION (MI) OR "HEART ATTACK":

MI means ischemia of the heart. This happens because the heart cannot function

effectively because of the increasing workload. The result is infarction or death of the

heart muscle.

Important causes of MI are:

Hypertension or High Blood Pressure: This is responsible for majority of the

cases of MI. Elevated blood pressures damage the endothelial lining of the blood vessels

this causes the platelets to be activated. These platelets attach to the damaged area

causing a thrombus to form and hence jeopardizing the blood supply of the heart leading

to MI.
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Hyperlipidemia: Increased lipids in the body, especially the bad lipids like LDL
(low density lipoprotein) causes plaque formation in the blood vessels cutting off the
blood supply. Cigarette smoking causes increase in the carbon monoxide concentration
within the blood. Carbon monoxide has a strong affinity for the oxygen binding sites on
the hemoglobin molecule. As a result oxygen is displaced and hypoxia occurs. Smoking
also has lot of other toxic agents which directly damage the blood vessels and decrease
the amount of oxygenated blood within the body.

Treatment of MI consists of
lifestyle modifications,
drug therapy and
interventional procedures. Having
a diet low in salt and cholesterol
and rich in HDL
cholesterol provides a protective
effect on the heart. Regular exercises, avoidance of
cigarette smoking is other important examples. Drug therapy consists of Aspirin, Nitrates,
Thrombolytic drugs, Heparin unless contraindicated, ACE inhibitors and Beta blockers.
The main aim is to improve the blood supply of the heart and decrease the workload.
Interventional procedure includes coronary artery angioplasty in which a blocked artery
is opened and a stent is placed. The stinted artery may still restenose; hence regular
follow up should be maintained. Surgical procedure for MI is coronary artery by pass
surgery (CABG). The blocked artery is simply bypassed with a healthier branch of the
aorta and connected distal to the site of obstruction in order to maintain blood flow. It is
quite clear from different clinical double blind research studies, Meta analysis, systematic
reviews that MI is avoidable and treatable. By simply adopting healthier living habits a
person can save himself from this deadly condition. Talking to your physician and
keeping regular appointments may help in formulating an individualized plan for the
management of MI.

It is also important to have a considerable amount of extra time during your

appointments so that you can be given more updates on prevention of a subsequent MI by

the health care personnel.

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References

Cardio Vascular System. Retrieved October 29, 2008, from Clarian Health web site:

http://www.clarian.org

Heart Attack. Retrieved October 29, 2008, from Cleveland Clinic web site:

http://my.clevelandclinic.org/disorders/Heart_Attack/hic_Heart_Attack.aspx

Visavadiya, N.P, & Narasimhacharya, A.V. (2007, August, 27) Evid based complement

alternat med. Retrieved October 30, 2008, from pumed web site:

http://www.pubmed.gov/18955232