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Cardiovascular Disease (CVD) includes dysfunctional conditions of the heart, arteries, and veins that supply oxygen to vital life-sustaining areas of the body like the brain, the heart itself, and other vital organs. If oxygen doesn’t arrive the tissue or organ will die.

Ischemic Heart Disease is the technical term for obstruction of blood flow to the heart. In general this results because excess fat or plaque deposits are narrowing the veins that supply oxygenated blood to the heart. Excess buildup of fat or plaque are respectively termed arteriosclerosis and atherosclerosis. Equally significant would be inadequate oxygen flow to the brain, which causes a stroke.

High Blood Pressure (hypertension) often results from this excess fat or plaque buildup because of the extra effort it takes to circulate blood. Even though the heart works harder, blockages still shortchange the needed blood supply to all areas of the body. The body’s amazing survival systems will mask the subtle damage that is occurring from this extra wear and tear, but not forever. High blood pressure is called “The Silent Killer” because the first warning sign is an angina attack or a deadly heart attack or a stroke.

Kidney disorders (which leave extra fluids, sodium, and toxins in the body), obesity, diabetes, birth control pills, pregnancy, smoking, excess alcohol, stress, and thyroid and adrenal gland problems can also cause and exacerbate a high blood pressure condition.

Damage to the heart tissues from CVD or from heart surgery will disrupt the natural electrical impulses of the heart and result in cardiac arrhythmia (an abnormally high or abnormally low heart rate). Individuals often don’t realize the aftermath and side effects that invasive surgical procedures leave. Sudden fluctuations in heart rate can cause noticeable palpitations, with an associated faintness, or dizziness, and if severely abnormal could interfere with blood flow and even initiate a heart attack.

Proper ranges of cholesterol are also important in the prevention of heart attack or stroke. Total blood cholesterol above 200 mg/dl, LDL cholesterol above 130 mg/dl, HDL cholesterol below 35 mg/dl; and lipoprotein(a) level greater than 30 mg/dl are indicators of problematic cholesterol. Cholesterol is not actually a damage mechanism but is more an indicator of compromised liver function, and increased risk of heart attack.

Infection of the heart, carditis and endocarditis, is an additional complication that can occur as a result of a weak immune system, liver problems, heart surgery, or from an autoimmune disorder like rheumatic fever. Endocarditis is quite common in persons with compromised immune systems from HIV or AIDS. If not appropriately handled, permanent heart muscle damage can occur from the infection.

Treatment of chronic occlusive disease is aimed at opening or bypassing the occluded vessel; however, vessels can also be replaced surgically via several techniques. In the carotid circulation, atherosclerotic plaques can be directly removed from vessels to reestablish open blood flow via a procedure called atherectomy, in which a tiny knife inserted into a vessel through a catheter is used to shave fatty deposits off the vessel wall. Occlusion of the coronary arteries is treated using coronary artery bypass surgery. This procedure relocates native vessels, such as the saphenous vein (from the leg) or the internal mammary artery (in the chest), to the heart, where they serve to bypass the flow of blood around the occlusion. Replacement of the large arteries and the aorta with Dacron™ (synthetic fibre tubing) grafts is quite common.

Noninvasive methods have been developed to open chronic atherosclerotic occlusions using a catheter in a procedure called angioplasty. A balloon near the end of the catheter is inflated, thereby dilating the vessel and allowing blood to flow around the obstruction. This procedure is often followed by the insertion of an expandable stent (a wire mesh tube) that becomes permanently embedded in the wall of the artery to be sure that the vessel stays open. Today many stents have special coatings that gradually release drugs to prevent reclosure of the vessel (restenosis).

Acute closure of vessels in the coronary circulation is treated in several ways. Proteolytic enzymes (enzymes that break down proteins) or drugs that activate the proteolytic process are often used for clot dissolution. The most commonly used therapeutic agent is tissue plasminogen activator (t-PA), which is given intravenously and acts rapidly to dissolve clots. Acute coronary thrombosis can also be treated by angioplasty, almost always accompanied by insertion of a stent and resulting in rapid and complete restoration of blood flow. However, since the blood clotting mechanism is compromised by the use of thrombolytic agents, such as t-PA, there is a substantial incidence of bleeding during and following stent implantation that can be fatal. This complication has led to a relative reluctance to utilize these procedures in older patients because of the possibility of producing hemorrhagic stroke. Regardless of the method, time is a critical factor in the success of restoring proper blood flow, and early recognition of symptoms has become a major health education goal.

In patients at risk for thrombotic events, antiplatelet or anticoagulant drugs can be used to decrease platelet aggregation and to prevent the formation of thrombi. Statins can also reduce the incidence of acute arterial events through an anti-inflammatory mechanism, although this is not well understood. In addition, several dietary habits have been associated with lower incidence of acute thrombotic events, including high intake of vitamin E and fish oil and drinking red wine; however, extensive studies are needed to confirm these effects.