Causes

The Koronare heart illness has different causes:

1. Illness of the large heart wreath/ring containers (with 90 % the KHK). Here it comes on the soil of a Arteriosklerose to deposits in the (Plaques), which lead to narrowings. Breaking of this Plaques (unstable Plaque open) with an activation of the blood clotting following on it is feared. In such a way developing Blutgerinnsel can lock and to the cardiac infarct lead the container.
2. Illness of the small containers, those of the heart wreath/ring containers branches (10 %). This kind of the KHK often steps on with sugar-ill patients, with long untreated blood high pressure or with immunologically caused container illnesses.

Both forms of the Koronaren heart illness can occur also together.

Factors of risk of the Koronaren heart illness are

1. Uncontrollable factors of risk: In addition counts the family assessment, the age (the older the person, the higher risk) and the sex of the patient (men have a higher risk than women)
2. Influenceable factors of risk: The most important are the increased Cholesterinspiegel, cigarette smoking, blood high pressure and diabetes mellitus. These become also as factors of risk 1. Order designates. The factors of risk 2. Order are predominance, lack of movement and emotional stress.

The cardiac infarct risk increases with 2 factors of risk 1. Order around the quadruple, with 3 factors of risk 1. Order even tenfold opposite a normal person.

Symptoms (disease characters and complaints)

Prominent guiding symptom of the Koronaren heart illness is the angina pectoris, a tightness feeling in the chest. The pain can radiate in the neck, lower jaw, the shoulder or the arms. Even belly pain in the Oberbauch can be released. With the fact it is substantial that the angina arises often dependent on load pectoris (physically or psychologically). Uses the heart muscle more oxygen, which did not change containers can however to the heart musculature sufficient oxygen supply. After end or by use of container-extending substances the complaints disappear to the physical load again in the period of minutes.

With the cardiac infarct against it the complaints remain existing however longer time. The patients feel air emergency (dyspnea) and fear of death, it comes to sweats and blood pressure drop.

Is important to visit promptly a physician also with the smallest suspicion. With symptoms of the cardiac infarct one informs the emergency surgeon at the best immediately.

Investigation possibilities of the Koronaren heart illness

The koronare heart illness can be proven meanwhile very exactly. The gold standard is thereby the Koronarangiografie, which is however invasiv and works with X-ray.

• Direct methods
  • Koronarangiografie
  • IVUS
  • Elektronenstrahltomografie (EBT or EBCT)
  • Coronary CT
  • Coronary NMR
• Indirect methods
  • Load electrocardiogram
  • Right heart catheter with load
  • Stressechokardiografie
  • Myokardszintigrafie

Working methods

In the case of an illness of the small containers so far no invasive working method is success-promising except the medicamentous therapy. In the case of illness of the large containers the possibility of the Aufdehnung exists the execution of a bypass operation by means of a balloon catheter or.

• The factors of risk eliminate or reduce

A current overview article of the "“German physician sheet"” (102/2005, A1889,) draws the result, which life-style changes protect "“around a repeated better"” than a combination of protektiver medicines (Cholesterinsenker + aspirin). Table modifies:

Fat-reduced food = < 20% fat portion (studies with < 30% furnished no use). "“Mediterrane"” food: Bread, vegetable, fruit, fish, insatiated fatty acids, olive oil; little meat balance sport: at least 3x/Woche 30 min. ARR = absolute risk reduction for death as well as not-deadly cardiac infarct; NNT = NUMBER needed ton treat.

• Medicines
  • Nitrate
  • Beta blocker, with symptomatic KHK and contraindication or incompatibility for beta blocker Ivabradin
  • Statine
  • Acetylsalicylic acid
  • Clopidrogel
  • Thrombolyse
• PTCA and Stents
• Bypass operation

For a uniform quality with the therapy the legal health insurance companies offer 2004 Disease management programs (DMP) since center.

Literature

Related links

• Leibniz institute for Arterioskleroseforschung at the University of
• http://www.madeasy.de/4/herz.htm#khk

Articles in category "Koronare heart illness"

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