CORONARY HEART DISEASE Introduction Whitaker (2

Whitaker (2002) reports that every year, approximately 500,000 people die due to coronary heart disease. Moreover, about one-third of these deaths occur in people under 55 years of age. This paper provides a brief but comprehensive overview of coronary heart disease, its pathophysiology, clinical manifestations, diagnosis, management, complications and nursing interventions.

According to Whitaker (2002), coronary heart disease or CHD is the most common form of heart disease involving a reduction in the blood supply to the heart muscle by narrowing or blockage of the coronary arteries. CHD can be associated with direct damage to the heart muscle of a degree sufficient to interfere with the function of the heart. This may result from a marked reduction in blood flow to the heart muscle as a result of narrowing due to coronary artery disease, or from complete blockage of the artery that occurs during a heart attack (myocardial infarction). If the amount of damage or area of impaired function is not too large, it may not interfere with the total function of the heart. If there is extensive damage to the heart muscle (usually from multiple heart attacks), the heart may become so weak that heart failure will develop.

Gould (2000) states that there are several known remediable risk factors associated with coronary heart disease. These are said to include: hypertension, high levels of low density lipoprotein cholesterol (LDL-C), low levels of high density lipo

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practices indicate a risk for coronary heart disease, patients should have at least two or more of several other tests. These include: electrocardiograms (ECGs); an exercise stress test; echocardiograms; computer tomography scans; radionuclide imaging; and other noninvasive imaging techniques such as magnetic resonance angiography. Specific tests are also important in people who may have risk factors or symptoms of diabetes. Other tests being investigated for indications of risk include blood tests for homocysteine, the protein albumin, and blood clotting factors, especially fibrinogen. Routine Management Jairath (1999) states that management of any degree of coronary heart disease involves lifestyle changes; however, depending upon the severity of the condition, medication and/or surgery may also be required. Jairath states routine management involves: Aspirin and anti-angina drugs; blood pressure medication and beta-blockers; the use of cholesterol-lowering agents (typically statins) and cessation of cigarette smoking; diet control; and exercise and education about the condition. Complications Complications associated with CHD include heart attack, unstable angina and sudden death (Jairath, 1999). In the case of heart att

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