The following are the most important diseases or complications that may be contributed to by coronary artery disease (CAD): Cardiovascular System (I00-I99) Acute coronary syndrome – spectrum of cardiovascular disease ranging from unstable angina (UA) to the two major forms of myocardial infarction (heart attack), non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction … Coronary Artery Disease: Complications
Typical angina is present when all three of the following characteristics are met: Retrosternal symptoms/pain of short duration. Triggered by physical or psychological stress Decrease at rest and/or within a few minutes after nitrate application If only two of these three characteristics are met, it is called “atypical angina“. If only one or none of … Coronary Artery Disease: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes [in left heart failure (left ventricular failure): Neck vein congestion? [Caveat (Warning): May be absent in acute heart failure.] Cyanosis? (purplish-bluish discoloration of oral mucosa, … Coronary Artery Disease: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Fasting glucose (fasting blood glucose) (annual control) [oGTT is more appropriate as a screening parameter – see below. oGTT] HbA1c [linear association with CHD in non-diabetics; moreover, independent association of HbA1c level with disease severity (1)] Thyroid parameters … Coronary Artery Disease: Lab Test
Medical history (history of illness) represents an important component in the diagnosis of coronary artery disease (CAD). Family History Is there a history of frequent cardiovascular disease in your family? Social history What is your profession? Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic … Coronary Artery Disease: Medical History
Respiratory System (J00-J99) Bronchitis* – inflammation of the mucous membrane of the bronchi. Mediastinitis – serious disease, with inflammation of the mediastinum. Pleurisy* (pleurisy). Pneumonia* (pneumonia) Pneumothorax* – accumulation of air in the physiologically airless space between the lung and pleura. Cardiovascular system (I00-I99) Aortic aneurysm* , symptomatic – outpouching (aneurysm) of the aorta. Aortic … Coronary Artery Disease: Or something else? Differential Diagnosis
Therapeutic targets Prevention of angina pectoris symptoms. Preservation of exercise capacity Reduction of cardiovascular morbidity (e.g., heart failure (heart failure), myocardial infarction/heart attack). Reduction of CHD associated mental illness (anxiety disorders, depression). Reduction in mortality (mortality rate). Therapy recommendations Note: In patients with a high pretest probability (>85%), stenosing CAD should be assumed to be … Coronary Artery Disease: Drug Therapy
Medical device diagnostics are based on the patient’s history, any symptoms, and the results of laboratory diagnostics Mandatory Diagnostics Resting electrocardiogram (resting ECG with 12 leads) – Indications: Arterial hypertension (high blood pressure) or diabetes mellitus (class II a, C). Resting ECG may be considered (class IIb, C). [Myocardial infarction/heart attack: new pathologic Q-spikes? ST-segment … Coronary Artery Disease: Diagnostic Tests
Coronary artery disease (CAD) may be associated with the risk of deficiency of the following vital nutrients (micronutrients): Trace element selenium Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used to prevent CHD: Vitamins B6, B12, C and folic acid. Mineral magnesium Omega-3 fatty acids docosahexaenoic acid and eicosapentaenoic … Coronary Artery Disease: Micronutrient Therapy
In coronary artery disease (CAD) whose symptoms are not significantly relieved with drug therapy alone, revascularization therapy (revascularization, revascularization; removal of an obstacle to passage in occluded blood vessels) should be performed. The following surgical procedures are available for this purpose: Percutaneous coronary intervention (PCI). Aortocoronary vein bypass (ACVBV; coronary artery bypass graft, CABG/coronary artery … Coronary Artery Disease: Surgical Therapy
To prevent coronary heart disease (CHD), attention must be paid to reducing individual risk factors. The risk profile is positively influenced mainly by fat reduction, exercise, and stress management. Behavioral risk factors Diet Malnutrition and overeating, viz: Too high calorie intake High-fat diet (high intake of saturated fatty acids, trans fatty acids – found especially … Coronary Artery Disease: Prevention
The following symptoms and complaints may indicate coronary artery disease (CAD): Angina pectoris (AP; chest tightness, heart tightness). Sudden onset of retrosternal (“located behind the sternum“) pain* (of short duration; see below), left > right; usually radiating to the left shoulder-arm region or neck–lower jaw region as well as to the upper abdomen, back; pain … Coronary Artery Disease: Symptoms, Complaints, Signs