FEATURE
CORONARY HEART DISEASE
Coronary heart disease (CHD), also sometimes referred to as ischaemic heart disease, is the leading cause of death both in the UK and worldwide – with the number of people currently living with the condition in Northern Ireland at 74,395. [1]
By Aaron J. Courtenay MPharm MPSNI
deaths in 2014, were as a result of diseases of the circulatory system, and 1,782 deaths attributed to CHD. [2]
C As
one of the top killers, in terms of manageable chronic conditions, it is of utmost importance that Pharmacy staff are knowledgeable about the condition and able to provide advice and guidance, specifically in terms of medicines, but also regarding therapies and strategies that can be effective in managing the progression of this disease.
What is CHD? CHD is a term that describes what happens when the hearts own blood supply is interrupted or blocked. This interruption or blockage can be caused by a build-up of fatty substances in the coronary arteries (arteries which supply the heart). Over
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ardiovascular conditions play a prominent role in local mortality – in Northern Ireland 25% of all
a prolonged period of time, these arteries can become coated with fatty deposits, called atheroma - this process is known as atherosclerosis. [3]
Atherosclerosis results in the arteries becoming narrow and hard, and results in a restricted blood flow to the heart. If one of these plaques (coatings) ruptures or fragments, this can cause a blood clot. In turn, this blood clot can block the blood supply to the heart, causing a heart attack, or it can block the blood supply to the brain, causing a stroke. Atherosclerosis can be caused by other heath conditions and is heavily influenced by lifestyle factors such as:
• Smoking • High blood pressure • High cholesterol • Diabetes
The most common symptoms of CHD are chest pain (angina) and
heart attacks, however heart palpitations and irregular breathlessness can be indicators of the condition. In some instances person may be completely asymptomatic prior to receiving a diagnosis.
Angina is a condition, which develops from partially blocked arteries, and so there is reduced blood flow to the heart. This can be experienced as a mild and uncomfortable feeling, not dissimilar to indigestion. However, in severe cases of angina an extremely painful feeling of heaviness or tightness, usually across the centre of the chest, which can spread to the arms, neck, jaw, back or stomach can be experienced.
Angina can be triggered by physical activity or stressful situations – the symptoms usually pass within 10 minutes, and can be relived using a
nitrate preparation, commonly administered in the form of a sub- lingual (under the tongue) pump spray, or more affectionately “the wee pink spray”.
If the arteries supplying the heart of blood become fully blocked or obstructed, this is known as a myocardial infarction (heart attack). This is a medical emergency and medical assistance should be sought.
In 2013/2014, over 4,205 people in Northern Ireland were admitted to hospital with a heart attack, which equates to approximately 12 people each day. [4]
Heart attacks can permanently cause damage to the heart muscle, and if not treated quickly, can be fatal. Although symptoms can vary, the discomfort or pain of a heart attack is usually similar to that of angina, but
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