HEART DISEASES: CORONARY HEART DISEASE
Under this heading, I discuss diseases of the coronary arteries— the vital blood vessels of the heart. Arteriosclerosis (hardening) of the coronary arteries impairs the heart because it affects the arteries that supply blood to the heart muscle. It narrows their diameter, making it difficult for the blood to flow through. It also causes irregularities in the otherwise smooth lining of the arteries. When the flow of blood has been slowed down, and there are tiny grooves in the channel, blood is apt to settle in these places and form clots.
Arteriosclerosis of the coronary arteries can cause pain over the heart (angina pectoris). These brief attacks are due to the fact that the heart muscle is not getting enough oxygen from the blood.
Coronary occlusion and coronary thrombosis A blood clot may form within a coronary artery and block off the blood supply to part of the heart muscle. This coronary thrombosis, sometimes called coronary occlusion, may injure or destroy part of the heart muscle. Blood clots are the cause of heart attacks characterized by severe and prolonged pain. Since this kind of attack is most dangerous, hospitalization will be required, with at least four weeks of bed rest.
Why is a hospital important for the victim of a heart attack? Because only at a good hospital can he get all the necessary items of therapy, such as oxygen, expert nursing care, and anti-blood-clotting medicines. Hospitals also have the latest lifesaving equipment for patients with heart diseases. Resting at home invites the temptation of having friends visit, which may excite the person. When the hospital says ‘No visitors,’ you can be sure the rule will be enforced.
Should the critically ill person be moved? This decision should be made only by a doctor. In most instances, transportation to a hospital is safe in an ambulance, with skilled attendants or a doctor or nurse to care for the patient en route.
First aid for a coronary heart attack.
What future is there for a person who has recovered from a coronary heart attack? There are many cases on record of complete recovery after a coronary thrombosis. Usually some symptoms will remain, but these can be controlled by co-operation on the patient’s part in the schedule of activity and medicines prescribed by the doctor.
Anticoagulants (medicines that lower the blood’s tendency to clot) are used for some heart disease patients. More and more, doctors are prescribing exercise, not only as a preventive measure but as therapy after a heart attack. In addition, the weight must be kept down and smoking held to a minimum. The reduction of emotional tensions is important, for these can be an especially severe strain.
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