Coronary Artery Disease (CHD) and Rehab

Coronary artery disease: overview

Coronary artery disease, known by physicians for short as CHD, arises with the progressive narrowing of the coronary arteries. It is defined as an expression of calcification of the coronary arteries. There is a lack of blood flow to the heart muscle and thus a lack of oxygen in the cells. At the latest when the patient puts strain on his body, the performance of the heart is no longer sufficient and symptoms such as chest pain and cardiac arrhythmia appear. A heart attack can follow.

Coronary artery disease: general

With approximately 17 percent, the KHK with its consequences is the most common cause of death in USA and other industrialized countries. Around two percent of people suffer from so-called silent CAD without symptoms. A CHD affects men twice as often as women, and the risk of being affected increases with age. Typical signs of CHD are the so-called angina pectoris, a tightness in the chest, which is accompanied by dull burning pain behind the breastbone. The pain often radiates into the left arm. Possible surgical measures are the expansion of a narrowed coronary artery in the cardiac catheter or a bypass operation. Significant complications of CAD are cardiac arrhythmia, heart attack and heart failure (heart failure).

Coronary artery disease: causes

Atherosclerosis, simply called vascular calcification, develops on the floor of small inflammation spots in the walls of the coronary arteries. Fats such as cholesterol, cells and other blood components are deposited on the herds. So-called plaques develop, which can significantly narrow the affected blood vessel over time. If the heart is no longer adequately supplied with blood and oxygen, a CHD has developed. Physical and mental exertion and stress can lead to angina (pain and tightness in the chest). At this point the disease is still stable. However, if a blood clot suddenly forms on a plaque, this can completely close the vessel. An unstable angina pectoris follows without effort and possibly a heart attack.

CHD risk factors

  • gender
  • age
  • overweight
  • nicotine consumption
  • increased cholesterol
  • high blood pressure
  • diabetes mellitus
  • bleeding disorders

Coronary artery disease: appearance/symptoms/course of the disease

CHD is a chronic disease that usually cannot be cured. However, the patient can have a positive influence on the course. A typical symptom of CHD is angina pectoris. It can be divided into different stages.

  • Grade 1: Pain and tightness in the chest only occur with heavy physical or mental stress and not in everyday life.
  • Grade 2: Symptoms occur with everyday exertion.
  • Grade 3: Symptoms are already triggered by light physical exertion such as walking
  • Grade 4: Angina pectoris occurs at rest.

Coronary artery disease: examinations & diagnosis

Symptoms of CHD may be typical, but may also be associated with an esophageal reflux disease (heartburn), lung disease, or an inflammation of the heart muscle. The doctor will therefore carry out further examinations after the anamnesis interview and the physical examination with the collection of blood pressure and pulse. The electrocardiogram (EKG) is particularly informative. It is used either in the idle state or with a load on an ergometer. The treating physician gets a precise picture of the heart function with cardiac ultrasound (echocardiography). The next step is the cardiac catheterization. The procedure allows access to the heart through the large blood vessels in the groin. The course of the coronary arteries is depicted very precisely using contrast agents and X-rays. If necessary, the examiner can intervene directly and expand a narrowed vessel.

Coronary artery disease: treatment, therapy & rehab

Acute treatment of CHD in the practice and clinic

Treating a CHD means, on the one hand, relieving symptoms and, on the other hand, preventing consequential damage in good time. The disease is not curable. Basic therapy steps are, for example, a healthy lifestyle with a balanced diet and sufficient exercise and, if necessary, smoking cessation. Treatment with medication is also possible. Anticoagulants such as acetylsalicylic acid (ASA) can prevent thrombosis and a heart attack. Beta blockers can relieve the heart and reduce oxygen requirements. Cholesterol lowering can slow the progress of hardening of the arteries. Nitrates are used to relieve the symptoms of an acute attack of angina pectoris.

Cardiac catheter and bypass surgery

In the event of a heart attack or severe symptoms that cannot be adequately improved with medication, the doctor can mechanically expand the coronary arteries in the cardiac catheter. If this method is unsuccessful, a bypass can be performed in one operation. The surgeon gives the blood a new path and bypasses the constrictions.

Rehabilitation of the KHK in the rehabilitation clinic

If you have been diagnosed with CHD, you have the option of taking special cardiac rehabilitation measures. Various forms of therapy help you to improve your quality of life and your physical resilience as well as to prevent possible secondary diseases. A team of doctors, psychotherapists, physiotherapists, occupational therapists and nutritionists will look after you in the specialized rehabilitation clinic. Your doctor will recommend rehabilitation if you already have a heart failure or a heart attack, or if your symptoms severely restrict you in everyday life. In most cases, the cost of the stay is covered by pension or health insurance.

Movement therapy: strength and muscle building training

In individual training or in groups, the focus of physiotherapy is on initiating and training all physical functions. Each patient is classified according to their personal requirements. The rehabilitation clinic is concerned with increasing your strength and endurance as well as building muscle every day. Your therapists get an exact picture of your professional and private everyday life. Get involved in an active lifestyle that can positively influence your illness.

Occupational therapy: Strengthen professional competence

Specially trained occupational and occupational therapists (occupational therapists) work with you on returning to work and on your everyday skills. In small groups or in one-on-one meetings, you will be gradually introduced to the tasks to be accomplished. Therapy can also include a visit to your workplace. Physical and mental stress are taken into account equally.

Training in CHD and health education

An important aspect of rehab is educating patients about the relationships between their illnesses. Once you understand how CHD occurs, you have the opportunity to actively do something for your own health. You will be practically trained on topics such as healthy eating and smoking cessation. Talks with your relatives are also offered on request. You can significantly reduce unhealthy stress if you take the chance to learn a relaxation technique in rehab. For example, biofeedback, autogenic training, progressive muscle relaxation according to Jacobson or yoga and tai chi are possible.

Back to everyday life with CHD

After a successful cardiological rehab, the sport continues at home. For example, look for a cardio sports group near you. Instructions are given specifically for patients with heart disease and a doctor monitors every training session. In addition, endurance sports are particularly suitable for you, which keep the risk of an overload of the heart muscle low. Try hiking, walking or jogging, cycling or swimming, for example. Choose a constant pace and avoid a final sprint that could overwhelm your heart. Always end your training calmly and with reduced stress.

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