Factors that lead to Coronary Heart Disease

Coronary heart disease primarily caused by abnormalities of myocardial blood flow due to coronary insufficiency due to atherosclerosis which is a degenerative process, besides many other factors. Therefore with increasing human life expectancy, the incidence will increase and become an important disease, let alone frequently cause sudden death.
Seven types of heart disease the most important are:
1. Coronary heart disease (causes 80% of deaths due to heart disease)
2. Heart disease due to hypertension (9%)
4. Congenital heart disease (2%)
5. Bacterial endocarditic (1-2%)
6. Syphilitic heart disease (1%)
7. Cor Pulmonale (1%),
8. and others (5%) (4).

Atherosclerosis is a condition of large and small arteries are characterized by deposits of fat, platelets, macrophages and leukocytes in all layers of the tunica intima and finally into the tunica medium. It is known that atherosclerosis is not a continual process, but a disease with a phase of stable and unstable phases are alternated. Changes in clinical symptoms of sudden and unexpected presumably related to plaque rupture, although the rupture is not always followed by clinical symptoms. Often the rupture soon recovered; presumably this is how the process takes place plaque.

Now atherosclerosis is no longer considered an aging process alone. The emergence of "fat spots" on the walls of the coronary artery is a natural phenomenon ever since childhood and do not always have to be of atherosclerotic lesions; there are many interrelated factors that can accelerate the atherogenic process. It has been known for some of the factors that increase the risk of coronary atherosclerosis in certain individuals.



RISK FACTORS
There are four biological risk factors that cannot be changed, namely: age, gender, race, and family history. The risk of coronary atherosclerosis increases with age; serious illness rarely occurs before age 40 years. But the relationship among age and incidence of disease may simply reflect the much longer length of exposure to atherogenic factors. Women seem relatively immune to this disease until menopause, and then become as vulnerable as men; suspected by the presence of the protective effect of estrogen. African Americans are more susceptible to atherosclerosis than white men. Positive family history of coronary heart disease (siblings or parents who suffer from this disease before age 50 years) increases the possibility of premature atherosclerosis. The importances of genetic and environmental influences are still unknown. Genetic component can be expected in some tangible form of atherosclerosis, or the rapid its development, as in familial lipid disorders. However, family history may also reflect a strong environmental component, such as a stressful lifestyle or obesity.

Other risk factors can still be changed, so that potentially could slow the atherogenic process. These factors are elevated levels of serum lipids, hyper-tension, smoking, impaired glucose tolerance and a diet high in saturated fat, cholesterol, and calories.

Heart disease due to insufficiency of coronary blood flow can be divided into 3 types which are similar.
- Heart disease arteriosclerotic
- Angina pectoris
- Myocardial Infarction

CONCLUSION
1. Coronary heart disease is caused by abnormalities of myocardial blood flow of coronary insufficiency by arteriosclerosis which is a degenerative process although influenced by many factors.
2. The cause of coronary heart disease is the constriction of blood flow to the heart muscle caused by the thickening layers of the tunica intima and plaque rupture followed by thrombus formation.
3. At the heart of arteriosclerosis in the know two things Put oxygen demand imbalance that is happening hypoxemia because vascular abnormalities and hypoxia due to lack of oxygen in the blood.
4. There are four hypotheses that endothelial damage causes high serum cholesterol, high blood pressure, viral infections, and high levels of iron.
5. Endothelial cells damaged by the oxidation of cholesterol and triglyceride that settle in the tunica intima to the tunica medium.
6. Chest pain is almost the same place and quality, the difference is the length of the occurrence. In angina pectoris is usually 1-5 minutes while the myocardium infarction more than 20 minutes.
7. At the time of the attack ECG will show ST segment depression and T waive can be negative.
8. To distinguish weather angina pectoris or myocardial infarction CPK enzyme examination, SGOT, LDH is elevated in myocardial infarction.

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