The powerful heart muscle requires a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with this critical circulatory 24/7 blood supply. Without adequate and consistent blood, the heart becomes starved of oxygen and vital nutrients it requires to work properly and efficiently. Coronary artery disease or Atherosclerosis occurs when the arteries become clogged and narrowed, restricting blood flow to the heart. (Heart Attack, 2006) “The main myocardial infarction causal effects under investigation include blood pressure, hypertension, the use of antihypertensive and/or cardiovascular medication and angina pectoris.” (Caroline B. Ameling et al. 2002, p. 307)
Pathology Of The Disease
The arteries leading to the heart become narrow and blood cannot flow consistently and evenly. Fatty matter, calcium, proteins and inflammatory cells build up within the arteries to form plaques of different sizes and irregular shapes. The plaque deposits are hard on the outside and soft and mushy on the inside.
When the plaque’s deposits harden, the outer shell cracks (plaque rupture) and platelets (disc-shaped particles in the blood that aid clotting) arrive at the heart area, and blood clots form around the plaque. When the blood clot completely blocks or inhibits the artery, the heart muscle and tissue is rapidly depleted of oxygen. Within a short time, damage of the heart muscle cells occurs, causing permanent impairment. The end result, in medical terms is a myocardial infarction (MI), or heart attack. “While it is unusual, a heart attack can also be caused by a spasm of a coronary artery. During coronary spasm, the coronary arteries restrict or spasm on and off, reducing blood supply to the heart muscle (ischemia).” (Heart Attack, 2006)
Current Treatment Options
Immediate treatment options include supplemental oxygen therapy, however it is the only form of treatment that improves survival in hypoxemic patients, no clear relationship exists between improved survival and reduction in pulmonary vascular resistance with oxygen therapy. (Susan Wilansky et al. 2002, p. 629) Individuals with angina or chronic chest pains can take nitroglycerin pills to cause the pain to disappear. Because angina patients often have chest pains, the key heart attack symptoms may be lightheadedness, sweating, nausea, or shortness of breath, in addition to chest pain. (Christopher Wanjek, 2003, p. 242)
For long term treatment at a hospital, individuals are taken to the cardiac catheterization lab where a doctor will evaluate the coronary arteries to determine whether angioplasty or coronary artery bypass graft surgery is appropriate.
The traditional approach to patient education interventions requires a health educator to meet with patients individually or to provide lectures. Some educational approaches appear to be cost-effective has shown that education programs emphasizing self-management of one’s health and prevention strategies are effective in increasing patients’ self-efficacy and health status. “Therefore it appears important to measure any changes in self-efficacy and helplessness that may result from either education and/or social support interventions. Such measures make it possible to evaluate the sense of control over health decisions and outcomes that has been associated with health status and health care costs.” (Terry A. Cronan et al. 2000, p. 455)
Community referral sources
American College of Cardiology, 9111 Old Georgetown Road Bethesda, MD 20814-699 Phone: 1-800-253-4636, extension 694
WomenHeart: The National Coalition for Women With Heart Disease 818 18th Street, N.W. Suite 230 Washington, DC 20006 Phone: (202) 728-7199
American Heart Association (AHA) 7272 Greenville Avenue Dallas, TX 75231 Phone: 1-800-AHA-USA1 (1-800-242-8721) Web Address: http://www.americanheart.org
Tension and anxiety were found to be good predictors of disease and mortality even when other risk factors were controlled. More recently, it has been prospectively shown that earlier measures of anxiety were significantly related to the development of atherosclerosis disease. (Stanley Chin et al. 2004, p. 63)
Preventive life choice behavior modification includes stop smoking, controlling cholesterol through a healthy diet, managing blood pressure with exercise, relaxing and reducing stress by managing depression and anger.
Caroline B. Ameling, Hendriek C. Boshuizen, Augustinus E.M. De Hollander, Hanneke Kruize, Brigit A.M. Staatsen, Elise E.M.M. Van Kempen, 2002, The Association between Noise Exposure and Blood Pressure and Ischemic Heart Disease: A Meta-Analysis. Journal Title: Environmental Health Perspectives. Volume: 110. Issue: 3. Publication Year:. Page Number: 307+. COPYRIGHT 2002 National Institute of Environmental Health Sciences;
http://www.webmd.com/hw/heart_disease/tx2300-ConRes.asp Heart Attack and Unstable Angina Retrieved December 28, 2006
Jiang He, Gail T. Louis, Paul K. Whelton, 2003, Lifestyle Modification for the Prevention and Treatment of Hypertension. Publisher: Marcel Dekker. Place of Publication: New York. Page Number: 278.
Susan Wilansky, James T. Willerson, 2002, Heart Disease in Women. Publisher: Churchill Livingstone. Place of Publication: New York. Page Number: 629.
Christopher Wanjek, 2003, Bad Medicine: Misconceptions and Misuses Revealed, from Distance Healing to Vitamin O. Publisher: Wiley. Place of Publication: New York. Page Number: 242.
Terry A. Cronan, Erik J. Groessl, 2000, A Cost Analysis of Self-Management Programs for People with Chronic Illness Journal Title: American Journal of Community Psychology. Volume: 28. Issue: 4. Page Number: 455. COPYRIGHT 2000 Plenum Publishing Corporation;