The function of the coronary arteries
Each of us has two coronary arteries. They arise from the large body arteries. One coronary artery goes to the right heart, the other to the left heart, where it is divided into two branches. The coronary arteries provide blood to the heart, and are therefore a source of oxygen and nutrients.
What is coronary artery calcification or narrowing of the heart's blood vessels?
If one or more coronary arteries narrow (stenosis), the part of the heart muscle that depends on it will no longer be absorbed appropriately. Lack of oxygen (ischemia) occurs. The heart then sends a distress signal that is pain.
Such a narrowing (one or more) of the coronary arteries usually occurs because certain particles are circulating in the blood - red and white blood cells, nutrients, cholesterol and other fatty substances settle over time in the walls of the coronary arteries. This process is called artery calcification or atherosclerosis. Cholesterol deposition, also called plaque, can accumulate over time. As a result, blood vessels harden and constrict the walls of more and more arteries, which inhibit blood flow.
What is thrombosis?
Sometimes blood flow in the coronary arteries is completely blocked, especially when the veins are completely closed. Part of the heart muscle that is no longer supplied by blood then dies. Thrombosis causes heart attacks (infarction means dead organs, in this case the heart).
Coronary artery and cerebral artery
When blockage of blood flow due to clots occurs in some vital organs, such as heart, brain or kidney, can cause serious and even life-threatening complications. For example, blockage in the coronary artery circulation can cause a heart attack (or myocardial infarction), and thus the death of a part of the heart muscle. The blockage in the cerebral artery can then cause a stroke (cerebral thrombosis).
What is acute coronary syndrome?
Cardiac cramps and myocardial infarction
Acute coronary syndrome is a collective name for unstable angina pectoris heart disease (heart cramps) and acute myocardial infarction.
In the case of stable angina pectoris, symptoms of feeling pressure and chest pain occur after exertion or emotion, but disappear again at rest. If the symptoms appear without a direct cause and if the feeling does not go away by itself, there is an unstable angina pectoris.
Angina pectoris is unstable
In unstable angina pectoris, impaired coronary artery blood flow is inhibited because plaque, the accumulation of cholesterol particles in the arterial wall, has ruptured and consequently a blood clot has developed in the coronary artery in question. These clumps partially block the supply line in the coronary arteries, resulting in less oxygen reaching the heart's portion that communicates with this coronary artery, and temporary oxygen deprivation. In other words, the heart muscle does not die, but it looks like another muscle that does not get enough oxygen and energy. Unstable angina pectoris may be a sign of acute myocardial infarction.
Acute myocardial infarction
If the clot completely covers the blood supply in the coronary arteries, an acute myocardial infarction occurs, also known as a heart attack. When the blood supply is completely turned off in a coronary artery or one of its branches, the heart tissue no longer receives oxygen and dies: this is an acute myocardial infarction.
The heart muscle cells desperately need oxygen and therefore quickly die if there is no more oxygen. Cell death can occur within 20 minutes after the blood supply stops
Acute coronary syndrome: narrowing of the heart's blood vessels
The complaint was decisive
In the case of coronary suffering, complaints are crucial for the urgent. Stable angina pectoris has no urgency. The following form of unstable angina pectoris and myocardial infarction (heart attack) and require immediate treatment. It is therefore important to distinguish between the symptoms of stable angina pectoris and symptoms of acute coronary syndrome:
Unstable angle and infarction are acute coronary syndromes, and usually occur in the same form. Hospitalization is required in both cases.
Time is the muscle
In myocardial infarction (heart attack), time factor is very important. American cardiologist Eugene Braunwald says "time is muscle" 35 years ago. It means that myocardial infarction is a growing process and that the consequences are heavily dependent on the size of the infarct. In short, the sooner the blood flow is restored, the more heart muscle will be spared. In medical literature, 'golden hour' to start reperfusion therapy is a maximum of 120 minutes. Ideally, it begins with therapy a maximum of 1 hour after the onset of symptoms. So there's no time to doubt going to a doctor. Patients should be immediately taken to the hospital.
Test for heart attack
Blood tests can reveal so-called heart markers. These are proteins and enzymes that are released into the blood by damaged heart cells. These 'markers', such as troponin T or I (very sensitive and specific for myocardial necrosis, allow doctors to determine if the patient has had a heart attack, in their normal state is absent in the blood, or in the case of an unstable angiogram. typical abnormalities in the electrocardiogram and no increase in blood markers, it can be concluded that it is not a heart attack but unstable.
Of course, these results can not be expected to start treatment. There is a consensus among doctors that reperfusion should be initiated if there is clinical evidence of acute coronary syndrome and / or if the electrocardiogram shows ischemia. The sooner the treatment begins, the less likely it is for permanent damage to the heart.
What is the function of coronary CT scan?
In a coronary CT scan (computed tomography), doctors get a picture of the coronary arteries, surrounding structures, heart valves and heart muscle by means of fluid contrast and X-rays. CT scan angiography is faster than classical coronerography because no catheter is inserted.
But even with the most advanced equipment still can not visualize the entire vascular vessel coronary. In classical coronarography, there is a correct diagnosis of smaller blood vessels. In addition, the classical form not only can diagnose but also treat, which is not possible with a CT scan.
Ultrasound to check for heart function
With ultrasound, the possibility of anomalies in cardiac wall contractions and other mechanical complications can be determined: problems with heart valves, blood clots, torn in walls, etc. More important, is that with ultrasound the function of the heart can be evaluated, in other words the heart's ability to pump blood to the lungs and the whole body. The latter is very important in the diagnosis. With ultrasound, other disorders can also be excluded which can cause chest pain. In addition, the technique is fast, widely distributed, easy to do and non-invasive (no cuts to be done on the skin). Therefore, cardiac ultrasound is always indicated when the acute coronary syndrome is suspected. Cardiac ultrasound is a rapid and non-invasive method for evaluating cardiac function.