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Course: SBI OAO


3 Introduction
4 The Human Heart
5 Symptoms of Coronary Heart Disease
5 Heart Attack
5 Sudden Death
5 Angina
6 Angina Pectoris
6 Signs and Symptoms
7 Different Forms of Angina
8 Causes of Angina
9 Atherosclerosis
9 Plaque
10 Lipoproteins
10 Lipoproteins and Atheroma
11 Risk Factors
11 Family History
11 Diabetes
11 Hypertension
11 Cholesterol
12 Smoking
12 Multiple Risk Factors
13 Diagnosis
14 Drug Treatment
14 Nitrates
14 Beta-blockers
15 Calcium antagonists
15 Other Medications
16 Surgery
16 Coronary Bypass Surgery
17 Angioplasty
18 Self-Help
20 Type-A Behaviour Pattern
21 Cardiac Rehab Program
22 Conclusion
23 Diagrams and Charts
26 Bibliography

In today's society, people are gaining medical knowledge at
quite a fast pace. Treatments, cures, and vaccines for various
diseases and disorders are being developed constantly, and yet,
coronary heart disease remains the number one killer in the

The media today concentrates intensely on drug and alcohol
abuse, homicides, AIDS and so on. What a lot of people are not
realizing is that coronary heart disease actually accounts for
about 80% of all sudden deaths. In fact, the number of deaths
from heart disease approximately equals to the number of deaths
from cancer, accidents, chronic lung disease, pneumonia and
influenza, and others, COMBINED.

One of the symptoms of coronary heart disease is angina
pectoris. Unfortunately, a lot of people do not take it
seriously, and thus not realizing that it may lead to other
complications, and even death. THE HUMAN HEART

In order to understand angina, one must know about our own
heart. The human heart is a powerful muscle in the body which is
worked the hardest. A double pump system, the heart consists of
two pumps side by side, which pump blood to all parts of the
body. Its steady beating maintains the flow of blood through the
body day and night, year after year, non-stop from birth until

The heart is a hollow, muscular organ slightly bigger than a
person's clenched fist. It is located in the centre of the chest,
under the breastbone above the sternum, but it is slanted
slightly to the left, giving people the impression that their
heart is on the left side of their chest.

The heart is divided into two halves, which are further
divided into four chambers: the left atrium and ventricle, and
the right atrium and ventricle. Each chamber on one side is
separated from the other by a valve, and it is the closure of
these valves that produce the "lubb-dubb" sound so familiar to
us. (see Fig. 1 - The Structure of the Heart)

Like any other organs in our body, the heart needs a supply
of blood and oxygen, and coronary arteries supply them. There are
two main coronary arteries, the left coronary artery, and the
right coronary artery. They branch off the main artery of the
body, the aorta. The right coronary artery circles the right side
and goes to the back of the heart. The left coronary artery
further divides into the left circumflex and the left anterior
descending artery. These two left arteries feed the front and the
left side of the heart. The division of the left coronary artery
is the reason why doctors usually refer to three main coronary
arteries. (Fig. 2 - Coronary Arteries) SYMPTOMS OF CORONARY HEART DISEASE

There are three main symptoms of coronary heart disease:
Heart Attack, Sudden Death, and Angina.

Heart Attack

Heart attack occurs when a blood clot suddenly and
completely blocks a diseased coronary artery, resulting in the
death of the heart muscle cells supplied by that artery.
Coronary and Coronary Thrombosis2 are terms that can refer to a
heart attack. Another term, Acute myocardial infarction2, means
death of heart muscle due to an inadequate blood supply.

Sudden Death

Sudden death occurs due to cardiac arrest. Cardiac arrest
may be the first symptom of coronary artery disease and may occur
without any symptoms or warning signs. Other causes of sudden
deaths include drowning, suffocation, electrocution, drug
overdose, trauma (such as automobile accidents), and stroke.
Drowning, suffocation, and drug overdose usually cause
respiratory arrest which in turn cause cardiac arrest. Trauma may
cause sudden death by severe injury to the heart or brain, or by
severe blood loss. Stroke causes damage to the brain which can
cause respiratory arrest and/or cardiac arrest.


People with coronary artery disease, whether or not they
have had a heart attack, may experience intermittent chest pain,
pressure, or discomforts. This situation is known as angina
pectoris. It occurs when the narrowing of the coronary arteries
temporarily prevents an adequate supply of blood and oxygen to
meet the demands of working heart muscles. ANGINA PECTORIS

Angina Pectoris (from angina meaning strangling,