Coronary heart disease

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Heart, section through the middle

Heart, front view

Acute MI

Posterior heart arteries

Cholesterol producers

Anterior heart arteries

Coronary heart disease

Alternative Names:

Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD
Treatment:

The treatment for CHD varies depending on the symptoms and how much the disease has progressed. The general treatments include lifestyle changes, medications, and sometimes surgery.

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Lifestyle changes may include:

Losing weight
A low saturated fat, low cholesterol diet to help reduce cholesterol
Reducing sodium (salt) to keep high blood pressure under control
Regular exercise
Quitting smoking

Medications may include:

Cholesterol-lowering medication
Antiplatelet agents, such as aspirin, ticlopidine, or clopidogrel, to reduce the risk of blood clots
Glycoprotein IIb-IIIa inhibitors, such as abciximab, eptifibatide, or tirofiban, to reduce the risk of blood clots
Antithrombin drugs, such as blood-thinners (low-molecular heparin, unfractionated heparin), to reduce the risk of blood clots
Beta-blockers to decrease heart rate and�reduce oxygen use by the heart
Nitrates such as nitroglycerin to dilate the coronary arteries and improve blood supply to the heart
Calcium-channel blockers to relax the coronary arteries and all�arteries in the body,�thus reducing the workload for the heart
ACE inhibitors, diuretics, or other medications to lower blood pressure

Percutaneous Coronary Interventions (PCI's) include:

Coronary angioplasty (Balloon PTCA)
Coronary atherectomy
Ablative laser-assisted angioplasty
Catheter-based thrombolysis and mechanical thrombectomy
Coronary stenting (placing a tube in the artery to keep it open)
Coronary radiation implant or coronary brachytherapy

Coronary brachytherapy consists of delivering beta or gamma radiation into the coronary arteries. This new treatment is reserved for patients who have undergone stent implantation in a coronary artery and developed problems, such as diffuse in-stent restenosis.

Brachytherapy is a promising technique but is currently limited by certain complications. In addition, the long-term effects of radiation are unknown, as coronary brachytherapy was only approved by the FDA in late 2000. FDA approval of brachytherapy is currently restricted to treatment of stent-related problems, although in some medical centers brachytherapy is being studied as a first-line treatment of coronary disease.