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Did you know that coronary heart disease (CHD) is one of the major causes of death in the UK?
CHD is caused by fatty deposits (called atheroma) building up inside the arteries supplying the heart. Over time, this reduces the blood flow through the arteries, resulting in the heart muscles becoming deprived of oxygen. The heart needs glucose and oxygen to respire. Through respiration, energy is released which is used to contract the heart muscle, allowing blood to be pumped around the body. Without glucose and oxygen, heart cells might eventually die, possibly leading to a heart attack.
There are many possible factors that can lead to CHD, such as a poor diet that is high in saturated fat, stress and smoking, which increases blood pressure. Often, certain lifestyle changes can be made in order to lower the risk of getting CHD, such as changing the types of food eaten and by giving up smoking cigarettes.
For someone who has CHD, there are different ways to treat it. Let's look at this further below.
Statins
Statins are a group of medicines that work to lower the level of cholesterol in your blood. Too much cholesterol in your blood can lead to fatty deposits building up in your arteries.
Advantages:
Taking statins is a relatively easy way to lower cholesterol.
Disadvantages:
Statins might cause unwanted side effects such as headaches, muscular pain and nausea.
Statins have to be taken on a long-term basis.
Stents
A stent is a small mesh tube that is used to widen arteries that are narrowed, blocked or weakened. The collapsed stent is put into the artery with a balloon inside it. The balloon is then inflated and the stent increases in size, so that the blood flow through the artery is increased.
Advantages:
The success rate is high.
Stents lower the risk of a heart attack.
They last for a long time.
Disadvantages:
There can be complications such as bleeding, irregular heartbeat and infection.
Arteries sometimes reclose.
Drugs need to be taken to stop blood clotting.
Coronary artery bypass
Coronary artery bypass is a surgical procedure that can be used to treat CHD. Often, the procedures mentioned above would be tried first before resorting to bypass surgery.
In a coronary artery bypass, blood is diverted around the blocked arteries so the rest of the heart gets a good supply of oxygen. Often, a blood vessel from another part of the body is attached near to the blocked artery supplying the heart. Having a bypass might reduce the chances of having a heart attack.
Advantages:
It can reduce symptoms such as chest pain or breathlessness.
Disadvantages:
There is a risk of complications during surgery.
Heart Valve Disease
Veins have valves to stop the blood flowing in the wrong direction, so the blood flows in the correct direction in the heart. If the valve doesn't close properly, blood will move back into the heart. This can put great strain on the heart, as it then has to work harder to pump the much-needed blood around the body. Sufferers may feel unusually tired and constantly out of breath.
Some people might be born with heart valve disease, while others might have it as a side effect of a heart attack. The faulty valves can be replaced with mechanical valves made from man-made material,such as titanium and carbon, or biological valves which are made from human or animal tissue such as pigs, cows or horses.
Advantages:
The success rate is high - they can prolong the life of patients.
The new valve can last up to 20 years.
Patients with biological valves don't need to take blood-thinning medication.
Disadvantages:
It might be necessary to take blood thinners to prevent clotting.
Biological valves often need replacing after 10 - 20 years.
There is always a risk of serious complications with surgery.
Heart failure
Heart failure is a serious condition that tends to get worse over time and can lead to death. It's often the result of many different problems affecting the heart, like those mentioned above. The heart often becomes very weak and can no longer pump blood around the body. In these cases, a donor heart can be transplanted. This means a healthy heart from a person who's recently died will replace the patient's damaged heart. However, a heart transplant is very risky and there are many complications. The patient's immune system might not recognise the transplanted heart and reject it. Even if the transplant is successful, the transplanted heart may not work properly.
Artificial hearts have been used temporarily to keep people alive while they wait for a heart transplant. The artificial heart is not living so needs a power source - early power sources were so large that the patient had to stay in hospital. New advances mean that the patient can now use a portable power supply and can go home.
Advantages:
The artificial heart is not rejected by the body.
It keeps the patient alive while waiting for a transplant.
Disadvantages:
Surgery can lead to bleeding and infection.
Blood does not flow as easily and can lead to clots, so blood thinners need to be taken.
Parts of the heart can wear out or stop working.
In the following activity, you will compare different coronary heart disease treatments.
