Coronary Heart Disease Treatment in South Africa

Coronary heart disease (CHD) is a disease which develops when plaque (a waxy substance) build up inside the coronary arteries.

What are the symptoms of CHD?

• Chest pain: Also called angina. It is characterized by tightness or pressure I the chest. It is usually triggered by emotional or physical stress.
• Shortness of breath: When the heart cannot pump enough blood to the body it results in extreme fatigue or shortness of breath.
• Heart attack: This may occur when a coronary artery becomes completely blocked.
• Other symptoms include sweating, neck pain, jaw pain, and fatigue.

Treatment

Although the disease cannot be cured, treatment options are available that help manage the symptoms and reduce the risk of complications. These include lifestyle changes, medications, and surgery.

Lifestyle changes

These include stopping smoking. This can reduce the risk of having a heart attack. Making dietary changes t ensure that meals are well-balanced and healthy is also very important. In addition, you should ensure that you exercise regularly.

Medication

Medicines aim at either widening the arteries or reducing blood pressure. Some medicine may have side effects so it may take some time in finding the one that works right for you. Medication should not be stopped suddenly as this may worsen the symptoms. Medications used to treat coronary heart disease include:

• Antiplatelets: This help reduce the risk of heart attack by thinning your blood to prevent clotting.
• Statins: These are cholesterol lowering medications that your doctor may prescribe. They block the formation of cholesterol and increase the number of LDL receptors in the liver which helps remove cholesterol from your blood.
• Beta-blockers: They are used to treat high blood pressure and prevent angina. They slow down the heart beat and improve blood flow.
• Nitrates: These relax your blood vessels allowing more blood to flow through. They lower blood pressure and widen the blood vessels.
• ACE (angiotensin-converting enzyme) inhibitors: They improve blood flow by blocking the activity of a hormone called angiotensin II that causes blood vessels to narrow.
• Angiotensin II receptor antagonists: This one lowers blood pressure by blocking angiotensin II.
• Calcium channel blockers: They relax the heart’s wall muscles and lower the blood pressure.
• Diuretics: They are used to flush excess water and salt from the blood through urine.

Side effects of medications

• Dry cough
• Headaches
• Facial flushing

If the symptoms cannot be controlled by lifestyle changes or medications your doctor may recommend surgery. Surgical procedures include:

• Coronary angioplasty: It is also referred to as percutaneous transluminal coronary angioplasty (PTCA), percutaneous coronary intervention (PCI), or balloon angioplasty. It involves inserting a small balloon which pushes the fatty tissue in the narrow arteries outwards. This allows for inv=creased blood flow. A metal stent is then placed in the artery to hold it open.
• Coronary artery bypass graft (CABG): It is also referred to as heart bypass, bypass surgery or coronary artery bypass surgery. It involves inserting a blood vessel between the aorta and a part of the coronary artery beyond the blocked or narrow area. This allows blood to bypass the affected arteries.
• Heart transplant: This is done when the heart is too damaged and all other options are ineffective. It involves replacing the heart that is damaged or not working properly with a healthy heart donated.