Coronary Artery Disease (Ischemic Heart Disease)
What Is Ischemia?
Cardiac ischemia
occurs when plaque and fatty matter narrow the inside of an artery to a
point where it cannot supply enough oxygen-rich blood to meet your
heart's needs. Heart attacks can occur - with or without chest pain and other symptoms.
Ischemia is most commonly experienced during:
- Exercise or exertion
- Eating
- Excitement or stress
- Exposure to cold
Coronary artery disease can progress to a point
where ischemia occurs even at rest. And ischemia can occur without any
warning signs in anyone with heart disease, although it is more common
in people with diabetes.
What Are the Symptoms of Coronary Artery Disease?
The most common symptom of coronary artery disease is shoulder,
or chest pain. Angina can be described as a heaviness, pressure,
aching, burning, numbness, fullness, squeezing or painful feeling. It
can be mistaken for indigestion or heartburn. Angina is usually felt in the chest, but may also be felt in the left shoulder, arms, neck, back, or jaw.
Other symptoms that can occur with coronary artery disease include:
- Shortness of breath
- Palpitations (irregular heart beats, skipped beats, or a "flip-flop" feeling in your chest)
- A faster heartbeat
- Weakness or dizziness
- Nausea
-
Sweating
Main Root Causes of Coronary Heart Disease
Half a century ago, coronary heart disease killed an even greater percentage of those who suffered from it, but fortunately today doctors are adept at using various treatments to control heart disease symptoms. Some of these are effective at lowering blood pressure, triglycerides and cholesterol, but many simply target symptoms and don’t focus on the bigger picture.
CHD is ultimately a result of inflammation from fatty material and other substances forming a buildup of plaque that accumulates within the walls of your arteries. Because these arteries have the crucial role of bringing blood and oxygen to your heart, reduced blood flow can slow down or stop your heartbeat, causing “cardiac arrest.” For this reason, medical professionals use a combination of lifestyle changes, medicines and medical procedures to slow, stop or reverse the buildup of plaque. This can help lower the risk of blood clots forming and a heart attack taking place because it widens clogged arteries.
Heart disease is sometimes called the “quintessential disease of civilization” because it was rare before 1900, and it still remains much less common in pre-industrialized populations. By midcentury, coronary heart disease was the nation’s biggest killer, and today all forms of cardiovascular diseases — including conditions of the heart and blood vessels like angina, congestive heart failure and stroke — are still the leading causes of death in many Western nations. Combined, all cardiovascular diseases kill more than 1 million Americans a year — men and women pretty much equally.
In the first stage of heart disease, called angina, blood flow to the heart is restricted. When blood flows stops, there’s a myocardial infraction, also known as a heart attack. The combination of these two conditions is what many doctors are referring to when they say “coronary heart disease.”
Arteriosclerosis, which is the hardening of the walls of arteries, is said to be “partly a function of aging.” Over time the smooth, elastic arterial cells become more fibrous and stiff. Calcium, cholesterol particles and fatty acids accumulate on arterial walls and form a swelling called an atheroma. Atheroma are capable of bursting, causing blood clots, and leading to heart attacks or strokes. In populations that eat an unprocessed diet, far less inflammation-caused arteriosclerosis and heart disease is present.
We now know that inflammation and heart disease symptoms are tied to free radical damage (also called oxidative stress) and antioxidant levels in the body.
When antioxidant levels are lower than those of free radicals due to poor nutrition and other lifestyle factors, oxidation wreaks havoc in the body — damaging cells, breaking down tissue, mutating DNA and overloading the immune system. Environmental pollutants, alcohol, smoking, unhealthy fats and a lack of sleep can also generate a high level of free radicals.
How Is Coronary Artery Disease Diagnosed?
Your doctor can tell if you have coronary artery disease by: - Talking to you about your symptoms, medical history, and risk factors.
- Performing a physical exam.
- Performing diagnostic tests, including an electrocardiogram (ECG or EKG), exercisestress tests, electron beam (ultrafast) CT scans, cardiac catheterization,
and others. These tests help your doctor evaluate the extent of your
coronary heart disease, its effect on the function of your heart and the
best form of treatment for you.
How Is Coronary Artery Disease Treated?
Treatment for coronary artery disease involves making lifestyle changes, taking medicationsWhat to Do If You Have a Coronary Emergency, possibly undergoing invasive and/or surgical procedures, and seeing your cardiologist for regular checkups. - Reduce your risk factors. If you smoke, quit. Avoid processed foods and adopt a low-trans-fat, low-salt, and low-sugar diet. Keep your blood sugar in control if you have diabetes. Exercise regularly (but talk to your doctor before you starting an exercise program).
- Medications. If making lifestyle changes isn't enough to manage your heart disease, medications may be needed to help your heart work more efficiently and receive more oxygen-rich blood. The drugs you are on depend on you and your specific heart problem.
- Surgery and other procedures. Common procedures to treat coronary artery disease include balloon angioplasty (PTCA), stent placement, and coronary artery bypass surgery. All of these procedures increase blood supply to your heart, but they do not cure coronary heart disease. You will still need to decrease your risk factors to prevent future disease.
Doctors are also studying several innovative ways to treat heart disease. Here are a couple of the more promising ones:
- Angiogenesis. This involves giving substances, such as stem cells and other genetic material, through the vein or directly into damaged heart tissue to trigger the growth of new blood vessels to bypass the clogged ones.
- EECP (Enhanced External Counterpulsation). Patients who have chronic angina but are not helped by nitrate medications or who do not qualify for various surgeries and procedures may find relief with EECP. The outpatient procedure involves using treatment cuffs placed on the legs that inflate and deflate, increasing the blood supply that feeds coronary arteries.
What to Do If You Have a Coronary Emergency
Learn to recognize your heart disease symptoms
and the situations that cause them. Call your doctor if you begin to
have new symptoms or if they become more frequent or severe. If you or
someone you are with experiences chest discomfort, especially if there
is shortness of breath, heart palpitations, dizziness, a fast heart
beat, nausea or sweating, don't wait longer than a few minutes to call 911 for help.
If you have angina and have been prescribed nitroglycerin,
call your doctor or have someone take you to the nearest emergency room
if pain persists after taking two doses (taken at five-minute
intervals) or after 15 minutes.
Emergency personnel may tell you to chew an aspirin to help break up a possible blood clot, if there is not a medical reason for you to avoid aspirin.
Home Remeies To Treat Coronary Atery Diseases
Diet and lifestyle play a huge role in this
strategy, and the dietary component of this approach includes several herbs and
supplements that may benefit in the fight against atherosclerosis, the
underlying cause of most heart disease.
Natural Treatments for Coronary Heart Disease
Adjusting your diet, reducing stress levels and regularly exercising are fundamental to controlling inflammation and, therefore, naturally treating and preventing coronary heart disease.Many doctors place people on a treatment plan that includes both prescription medications and lifestyle changes. Depending on which healthcare professional you choose, your symptoms and how severe the disease is, you might be prescribed one or more medicines to treat your high blood pressure or high cholesterol or to prevent complications like diabetes.
However, many people are able to prevent CHD and recover from it naturally by maintaining a healthy lifestyle: changing their diet, stopping smoking, getting good sleep and adding in supplements on top of some other things we’ll discuss below.
Foods That Make Heart Disease Worse
Following a healthy, whole-foods–based diet can reduce inflammation, high blood pressure and unhealthy high cholesterol. Of course, eating well will also help you maintain a healthy weight and have more energy to be active, both of which are important for preventing coronary heart disease.When most people think of foods that increase chances of heart disease, fatty cuts of meat and fried food probably come to mind. For many years the public was led to believe that cholesterol-rich foods and saturated fats of all kinds increased the risk for developing coronary heart disease. “The cholesterol hypothesis,” as it’s called, rested on the assumption that saturated fats raise cholesterol and that cholesterol clogs arteries.
However, a number of researchers today have demonstrated that this is not necessarily true, and that while this theory has been widely accepted, it has never been proven. Cholesterol is actually an essential component of healthy cells and organisms, and we all need to maintain a certain level to thrive.
According to a 2009 study published in the International Journal of Clinical Practice,
It is now acknowledged that the original studies purporting to show a linear relation between cholesterol intake and coronary heart disease (CHD) may have contained fundamental study design flaws, including conflated cholesterol and saturated fat consumption rates and inaccurately assessed actual dietary intake of fats by study subjects.The belief today is that elevated blood cholesterol is a symptom, not a cause, of heart disease. Whether or not someone’s blood cholesterol level is increased by eating a certain food depends on that person’s individual cholesterol makeup, and each person is different. Several recent studies have shown that the dynamics of cholesterol homeostasis and of development of CHD are extremely complex and multifactorial and that the previously established relationship between dietary cholesterol and heart disease risk was likely largely overexaggerated.
In the majority of people, the real cause of heart disease is inflammation. Foods that promote inflammation include:
- Corn and soybean oils
- Pasteurized, conventional dairy
- Refined carbohydrates
- Conventional meat
- Sugars of all kinds
- Trans fats
When it comes to saturated fats raising cholesterol, the topic needs some explaining. Saturated fat does, in fact, do this, but not in what’s considered an unhealthy or unsafe way for most people. Certain saturated fats, when compared with polyunsaturated fats, do usually raise total cholesterol levels in most people, but we now know that total cholesterol is a poor predictor of heart disease in general.
In fact, saturated fats raise HDL cholesterol, which is known as the “good cholesterol,” while polyunsaturated fats lower this type — low cholesterol might even be worse than high!
Despite the existing evidence that eating cholesterol isn’t the cause of heart disease, most government-funded health associations, including the National Heart, Lung and Blood Institute, still recommend limiting saturated fats. As part of a treatment plan called “Therapeutic Lifestyle Changes” (TLC) used to control high blood cholesterol through a healthy diet, physical activity and weight management, the Institute recommends that less than 7 percent of daily calories come from saturated fats found in meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
The TLC diet is purposefully low in saturated fat, trans fat and dietary cholesterol. No more than 25–35 percent of your daily calories are intended to come from all fats, including saturated, trans, monounsaturated and polyunsaturated fats.
Going forward, we can expect guidelines like this to be updated to reflect the most recent study findings. Over the last decade, many countries and health promotion groups have modified their dietary recommendations to reflect the current evidence and, in fact, now address the negative consequence of ineffective dietary cholesterol in someone’s diet.
So if the truth about saturated fat means that fatty foods aren’t the issue, what is the real cause of inflammation? The real key is eliminating all sources of inflammation from your diet: rancid oils, sugary foods and refined carbs, conventional meats, pasteurized dairy, trans fats and packaged goods in general.
Foods That Heal Heart Disease
Instead of focusing on foods that reduce fat and cholesterol, we would be much better off making the goal to reduce inflammation. Heart disease is really caused by the inflammation of arteries, and yet modern medicine focuses on treating symptoms, not addressing the root cause of the issue.The healthiest anti-inflammatory foods for fighting coronary heart disease are those beaming with antioxidants and phytonutrients that lower your immune system’s overactive response. These help fight free radical damage and target the problem where it starts by lowering oxidative stress. How do you know what the top antioxidant foods are? Anything loaded with fiber, grown directly from the earth and brightly colored is a good place to start!
Healthy fats and animal proteins have a place among other whole foods in a heart-healthy diet, too. When it comes to including healthy fats, the general effect of quality saturated fats in someone’s diet is to help balance the ratio of HDL to LDL cholesterols. Regarding HDL cholesterol, some feel “the higher, the better,” but we know that the ratio of cholesterol is important too. Coconut oil, for example, raises HDL if it’s low and lowers LDL if it’s high. Other foods that help with this balance include grass-fed beef and cocoa — which contain stearic acid — and also butter, which contains palmitic acid.
If you look at evidence from many people living a traditional diet, saturated fats do not cause coronary heart disease. Foods containing saturated fats — such as full-fat dairy, organ meats, beef, eggs, lard and butter — are actually found in high levels in many of the healthiest, longest-living people that have been studied.
Begin incorporating one new anti-inflammatory food to your diet each day. Don’t be afraid to try new things and keep it interesting!
Foods that help reduce inflammation and, therefore, the risk of CHD include:
- Fiber-rich and antioxidant-rich foods of all kinds
- Vegetables (all kinds, including beets, carrots, cruciferous vegetables like Brussels sprouts, broccoli, cabbage, cauliflower and kale, dark leafy greens, artichokes, onions, peas, salad greens, mushrooms, sea vegetables and squashes)
- Fruits (all kinds, especially berries and citrus)
- Herbs and spices, especially turmeric (curcumin) and raw garlic (also basil, chili peppers, cinnamon, curry powder, ginger, rosemary and thyme)
- Traditional teas like green tea, oolong or white tea
- Legumes and beans
- Healthy fats found in nuts, seeds, avocados, wild-caught fish, coconut oil and extra virgin olive oil
- Raw, unpasteurized dairy products, cage-free eggs and pasture-raised poultry
- Red wine in moderation
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