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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 world.

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.


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 death.

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