Whitaker (2002) reports that every year, approximately 500,000 people die due to coronary heart disease. Moreover, about one-third of these deaths occur in people under 55 years of age. This paper provides a brief but comprehensive overview of coronary heart disease, its pathophysiology, clinical manifestations, diagnosis, management, complications and nursing interventions.
According to Whitaker (2002), coronary heart disease or CHD is the most common form of heart disease involving a reduction in the blood supply to the heart muscle by narrowing or blockage of the coronary arteries. CHD can be associated with direct damage to the heart muscle of a degree sufficient to interfere with the function of the heart. This may result from a marked reduction in blood flow to the heart muscle as a result of narrowing due to coronary artery disease, or from complete blockage of the artery that occurs during a heart attack (myocardial infarction). If the amount of damage or area of impaired function is not too large, it may not interfere with the total function of the heart. If there is extensive damage to the heart muscle (usually from multiple heart attacks), the heart may become so weak that heart failure will develop.
Gould (2000) states that there are several known remediable risk factors associated with coronary heart disease. These are said to include: hypertension, high levels of low density lipoprotein cholesterol (LDL-C), low levels of high density lipoprotein cholesterol (HDL-C), diabetes, sedentary lifestyle, obesity, and cigarette smoking. Gould further states that other factors play a mechanistic role in the disease, either directly or as part of a complex set of host characteristics and risk factor interactions. In this regard, homocysteine levels, insulin resistance, lipoprotein factors such as the density of the LDL particle and apolipoproteins, Lp(a), insulin resistance, and some identified genetic polymorphisms have a...