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© Borgis - Postępy Nauk Medycznych 6/2018, s. 358-360 | DOI: 10.25121/PNM.2018.31.6.358
Maria Kasprzyk1, *Beata Wudarczyk2, Rafal Czyz3, Lukasz Szarpak4, Beata Jankowska-Polanska5
Ischemic heart disease – definition, epidemiology, pathogenesis, risk factors and treatment
Choroba niedokrwienna serca – definicja, epidemiologia, patogeneza, czynniki ryzyka i postępowanie
1Graduate of Wroclaw Medical University, Poland
2Department of Nursing, Faculty of Medicine and Health Science, University of Zielona Gora, Poland
3Department of Emergency Medicine, Wroclaw Medical University, Poland
4Lazarski University, Warsaw, Poland
5Department of Internal Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland
Streszczenie
Choroba niedokrwienna serca (ChNS) jest rezultatem ograniczonego dopływu krwi do mięs?nia sercowego. W ponad 95% przypadko?w przyczyną ChNS jest zmniejszenie przepływu wien?cowego spowodowanego miażdzycą tętnic wien?cowych, dlatego celem opisu tego zespołu chorobowego często zamiennie stosuje się termin „choroba wien?cowa”. Choroba niedokrwienna serca w ocenie S?wiatowej Organizacji Zdrowia jest nadal najczęstszą przyczyną s?mierci tak w Polsce, jak i na s?wiecie. Z powodu przewlekłej choroby niedokrwiennej serca cierpi w Polsce 2,5% populacji, tj. ok. 1 miliona osób, spośród których 100 tys. rocznie zapada na zawał serca. Na przestrzeni ostatnich dwóch dekad w Polsce wzrosła umieralność z powodu choroby niedokrwiennej serca u osób poniżej 65. roku życia. Pomimo szerokiej polityki istnieje problem pomiędzy obecnymi wytycznymi postępowania a kontynuowaniem zalecen? przez pacjenta. Dobra komunikacja między personelem medycznym a pacjentem z chorobą niedokrwienną serca oraz zwiększenie nacisku na edukację stanowią gwarancję sukcesu terapeutycznego, co przełoży się na sferę zdrowia zaro?wno w kwestii społecznej, jak i ekonomicznej. Celem artykułu było podsumowanie zagadnien? dotyczących definicji, epidemiologii, patogenezy, czynniko?w ryzyka i leczenia choroby niedokrwiennej serca.
Summary
Ischemic heart disease (IHD) is the result of a limited blood supply to the heart muscle. In more than 95% of cases, the cause of IHD is coronary blood flow reduction caused by coronary artery atherosclerosis, therefore the term “coronary heart disease” is often used to describe this syndrome. Ischemic heart disease in assessment of the World Health Organization is still the most common causes of death in Poland and in the world. Due to chronic ischemic heart disease in Poland, 2.5% of the population suffers, i.e. about 1 million people, of whom 100,000. She has a heart attack every year. Over the last two decades in Poland, mortality from ischemic heart disease has increased in people under 65 years of age. In spite of wide prevention, there is a problem between the current guidelines and the patient's continuing of recommendations. Good communication between medical staff and patient with ischemic heart disease and increasing the pressure on education is a guarantee of therapeutic success, which will be reflected in the health, social and economic sphere. The aim of the article is to summarize the issues of definition, epidemiology, pathogenesis, risk factors and treatment of ischemic heart disease.
Introduction
One of the most serious problems of modern times are cardiovascular diseases. Ischemic heart disease is still the most common cause of death in Poland and in the world. Number of deaths due to this disease will increase from 7 200 000 in 2002 to 11 000 000 in 2020 (1, 2).
The aim of this study is to draw attention to still present problems of patients with ischemic heart disease by presenting current definition, epidemiology of disease, pathogenesis, risk factors and treatment methods.
Description of knowledge
In the available literature can be found various definitions and descriptions of the ischemic disease form. It should be emphasized here that the contemporary definition includes stable coronary disease and acute coronary syndromes (3). According to the European Society of Cardiology (ESC) coronary artery disease (CAD) is defined as an episode of a reversible incommensurability between the nutrient needs of the cardiac muscle and its demand that is associated with ischemia or hypoxia. Stable CAD also includes a stable, often asymptomatic phase of the disease after having an acute coronary syndrome (ACS) (4). Acute coronary syndromes are a group of diseases characterized by changes in coronary circulation, according to ESC, it includes acute myocardial infarction (MI). The unstable angina is defined by the European Cardiac Society as ischemia of the myocardium at rest or with minimal effort, in which there is no necrosis of cardiomyocytes (4).
Epidemiology
Due to the high occurrence frequency of risk factors as well as the aging of the population, ischemic heart disease is still the most frequent cause of deaths in Poland and in the world. According to the World Health Organization (WHO), the number of deaths due to ischemic heart disease will increase from 7 200 000 in 2002 to 11 000 000 in 2020 (2). The incidence of angina pectoris in men between 45 and 54 increases from 2% up to 5% and in 56-, 74-year-olds grow from 11 to 20%. In women, they are at the level of 0.5-1% and 10-14%, respectively. After the age of 75, the frequency of diagnosing ischemic heart disease is comparable in both genders (2, 5). Epidemiological studies show that the elimination of harmful risk factors such as smoking, alcohol abuse, lack of physical activity, unhealthy and irregular nutrition, stress, lack of sleep, influences the behavior of health to a greater extent than genetic factors, quality of medical care or environmental conditions (6).
Pathogenesis
Ischemic heart disease is a pathophysiological condition caused by the disproportion between the myocardial oxygen demand and its supply. Nutrition of the myocardium depends on the oxygen capacity of the blood and the amount of coronary flow (7). Ischemia is caused by an myocardial oxygen demand at the time of the provision of coronary artery spasm or intravascular blood clotting at the site of ruptured atherosclerotic plaque. This results in limiting the coronary flow. It is possible to combine all of those mechanisms at one time. In general, the pathology relates to large coronary arteries in which stenosis reduces the coronary reserve in proportion to the degree of vasoconstriction. Stenosis may be accompanied by spasm amplifying the size of it. Ruptured atherosclerotic plaque often becomes a substrate for intravascular clotting leading to acute coronary events (2). During acute ischemia oxygen deficiency impairs oxidation of glucose and free fatty acids (FFA), so the main source of energy becomes enzymatic cytoplasmic glycolysis. Secreted catecholamines (epinephrine and norepinephrine) intensify the hydrolysis of fats, which reach to the heart. As a result of the reduced supply of glucose promotes the oxidation of free fatty acids while becoming the only source of energy during which the oxygen consumption is increased, and the reserve decreases rapidly, thereby forcing the cell to move to the anaerobic glycolysis. This causes accumulation of lactates and hydrogen ions. Several seconds of ischemia impairs contractility and relaxation of the myocardium. Lack of return of the myocardium reperfusion for 45-60 minutes’ leads to necrosis of the heart cells, i.e. a heart attack (5).
Risk factors

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Piśmiennictwo
1. Lippi G, Franchini M, Cervellin G: Diagnosis and management of ischemic heart disease. Semin Thromb Hemost 2013; 39(2): 202-213.
2. Frycz-Kurek AM, Buchta P, Szkodziński J: Stabilna choroba wieńcowa – epidemiologia, diagnostyka, wybór postępowania. Choroby Serca i Naczyń 2008; 5(3): 125-133.
3. Adamson PD, Newby DE, Hill CL et al.: Comparison of International Guidelines for Assessment of Suspected Stable Angina: Insights From the PROMISE and SCOT-HEART. JACC Cardiovasc Imaging 2018; 11(9): 1301-1310.
4. Pająk A: A new model of secondary prevention of cardiovascular disease in patients after acute coronary syndrome. Kardiol Pol 2016; 74(4): 399-402.
5. Jankowski P, Czarnecka D, Badacz L et al.: Practice setting and secondary prevention of coronary artery disease. Arch Med Sci 2018; 14(5): 979-987.
6. Abderrahman HA, Al-Abdallat IM, Idhair AK: Age threshold for proper definition of premature coronary artery disease in males. J Forensic Leg Med 2018; 58: 45-49.
7. Vollmer-Conna U, Cvejic E, Granville Smith I et al.: Characterising acute coronary syndrome-associated depression: Let the data speak. Brain Behav Immun 2015; 48: 19-28.
8. Ahmed N, Kazmi S, Nawaz H et al.: Frequency of diabetes mellitus in patients with acute coronary syndrome. J Ayub Med Coll Abbottabad 2014; 26(1): 57-60.
9. Katz P, Leiter LA, Mellbin L et al.: The clinical burden of type 2 diabetes in patients with acute coronary syndromes: prognosis and implications for short- and long-term management. Diab Vasc Dis Res 2014; 11(6): 395-409.
10. Wessler JD, Kirtane AJ: Patients who require non-cardiac surgery in acute coronary syndrome. Curr Cardiol Rep 2013; 15(7): 373.
11. Roffi M, Patrono C, Collet JP et al.: 2015 ESC Guidelines for the Management of Acute Coronary Syndromes in Patients Presenting Without Persistent ST-segment Elevation. Rev Esp Cardiol (Engl Ed) 2015; 68(12): 1125.
12. Kubica J, Adamski P, Paciorek P et al.: Treatment of patients with acute coronary syndrome: Recommendations for medical emergency teams: Focus on antiplatelet therapies. Updated experts’ standpoint. Cardiol J 2018; 25(3): 291-300.
13. Kubica J, Adamski P, Paciorek P et al.: Anti-aggregation therapy in patients with acute coronary syndrome – recommendations for medical emergency teams. Experts’ standpoint. Kardiol Pol 2017; 75(4): 399-408.
14. Prejean SP, Din M, Reyes E et al.: Guidelines in review: Comparison of the 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. J Nucl Cardiol 2018; 25(3): 769-776.
15. Lempereur M, Moonen M, Gach O et al.; European Society for Cardiology: 2011 ESC guidelines for the management of acute coronary syndromes without ST segment elevation. Rev Med Liege 2012; 67(1): 8-10.
16. Roerecke M, Rehm J: Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. BMC Med 2014; 12: 182.
17. Quiles J, Miralles-Vicedo B: Update: Acute coronary syndromes (IX). Secondary prevention strategies for acute coronary syndrome. Rev Esp Cardiol (Engl Ed) 2014; 67(10): 844-848.
18. Deter HC, Weber C, Herrmann-Lingen C et al.; SPIRR-CAD-Study Group: Gender differences in psychosocial outcomes of psychotherapy trial in patients with depression and coronary artery disease. J Psychosom Res 2018; 113: 89-99.
otrzymano: 2018-11-12
zaakceptowano do druku: 2018-12-03

Adres do korespondencji:
*Beata Wudarczyk
Department of Nursing Faculty of Medicine and Health Science University of Zielona Gora
28 Zyty Str., 65-046 Zielona Gora, Poland
Phone: +48 506 997 749
E-mail: src.emergency@gmail.com

Postępy Nauk Medycznych 6/2018
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