Coronary Artery Disease

Heart disease, also known as the “silent killer”, is one of the most common causes of death worldwide, though many people live with this disease for many years without knowing it. Types of heart diseases include coronary artery disease, cardiomyopath, valvular heart disease, pericardial disease, and congenital heart disease. The most common type of heart disease is coronary artery disease.

Coronary artery disease (CAD) is when the arteries that supplies blood for the heart muscle gradually hardens and thickens (artherosclorosis) because of the buildup from salt, fat, cholesterol and other substances (plaque) on their inner walls. This process leaves the heart with a lack of oxygen and blood, forcing it to work harder (high blood pressure/hypertension). As the heart continues to do this, the wall of the arteries weakens and becomes very fragile. At this stage, one of the arteries may rupture and form a blood clot that clogs up in the artery and block the pathways for blood to flow through to the heart muscle, resulting to a heart attack.

Causes of CAD include smoking, stress, obesity, lack of exercise and having an unhealthy diet that involves too much sodium, fat and cholesterol. These are things people can change in their every day life to prevent CAD, or slower the process if it has already started, but having a family history of heart disease is something people cannot change to prevent themselves from the disease.

Symptoms may occur if a person is found to have coronary artery disease, including nausea, shortness of breath, vomiting, heavy sweating or angina, which is a pain usually around the back, chest, arm, or neck. The pain usually lasts from 1-20 minutes and is consistent but not severe.

Using medications such as cholesterol lowering drugs, Aspirin, Beta-blockers, Nitroglycerin, Calcium channel blockers, or Angiotensin may treat CAD symptoms. Although these medications do not stop the narrowing of the arteries, they increase the efficiency of the heart and reduce the symptoms.

People with heart muscle disease, heart failure or any other irreversible heart injuries that cannot be treated with any medications or surgeries may require a heart transplant. The number of transplants performed each year may vary in many different countries. For example, 32 transplants are performed in Australia each year, while there are 283 transplants performed each year in Germany, and only 2 transplants in Singapore.

Australia’s transplant success rates are one of the best in the world. 84% of all heart transplants are successful, with the patient’s survival rate of 90% at one year and 70% at five years.

The benefits of heart transplants is that it gives patients renewed or improved lives and allows them to once again, participate in activities and sports such as walking, running and swimming.

Daniel Winter, aged 23 was a heart transplant patient. He was found to have heart disease and luckily, he received a new heart within only 2~3 months. After the transplant, he returned to his normal lifestyle and precious every day of his life. He interviewed many other children and teenagers who were waiting for a new heart and lifted their spirits more. Daniel knew that he had helped many others by doing this, because when he was interviewed by other people before his transplant, they surely did help him a lot and give him more courage and confidence.

Although most patients return to their normal lifestyle after the transplantation, there are still some drawbacks before and after a heart transplant is done. First of all, in order to receive a new heart, patients have to register on a waiting list. The waiting list for hearts may take up to 1.3 years on average, because out of all the people who die, less than 1% of them are potential donors. In other words, less than 1% of the people who die are brain dead. A person who is brain dead means he/she has an irreversible damage in the brain, causing the brain to lose its functions. There are two definitions of death in Australia. One of them refers to brain death, and the other is defined as, “Irreversible cessation of circulation of the blood (cardiac death-the heart stops forever)”.

Before a heart may be taken from an organ donor, his/her family would have to give consent under very short circumstances. This is a very hard decision for families to make because many people fantasize about brain dead people coming back to life again. Many people have these thoughts, because a person who is brain dead may seem perfectly normal while lying on the hospital bed with normal skin colour and continuous breathing.

If the donor’s family agrees to donate his/her heart, a transplant may be performed