Coronary disease refers to the failure of coronary circulation

Coronary circulation

Coronary circulation is the circulation of blood in the blood vessels of the heart muscle . The vessels that deliver oxygen-rich blood to the myocardium are known as coronary arteries...

 to supply adequate circulation to cardiac muscle

Cardiac muscle

Cardiac muscle is a type of involuntary striated muscle found in the walls and histologic foundation of the heart, specifically the myocardium. Cardiac muscle is one of three major types of muscle, the others being skeletal and smooth muscle...

 and surrounding tissue

Tissue (biology)

Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

. It is already the most common form of disease affecting the heart and an important cause of premature death in Europe, the Baltic states, Russia, North and South America, Australia and New Zealand. It has been predicted that all regions of the world will be affected by 2020.

It is most commonly equated with atherosclerotic coronary artery disease, but coronary disease can be due to other causes

Causes

Causes, or causality, is the relationship between one event and another. It may also refer to:* Cause , a term used in law* Causes , an online company...

, such as coronary vasospasm

Coronary vasospasm

Coronary vasospasm is a form of vasospasm affecting the coronary circulation.It can cause Prinzmetal's angina.It can occur in multiple vessels.Atropine has been used to treat the condition....

. It is possible for the stenosis

Stenosis

A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure.It is also sometimes called a stricture ....

 to be caused by the spasm.

Causes

Coronary artery disease, the most common type of coronary disease, which has no clear etiology, has many risk factors, including smoking

Smoking

Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them...

, radiotherapy to the chest, hypertension

Hypertension

Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...

, obesity

Obesity

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...

, diabetes, high alcohol consumption, lack of exercise, inability to manage stress and hyperlipidemia

Hyperlipidemia

Hyperlipidemia, hyperlipoproteinemia, or hyperlipidaemia is the condition of abnormally elevated levels of any or all lipids and/or lipoproteins in the blood...

.

Also, having a Type A behavior pattern

Type A personality

Originally published in the 1950s, the Type A and Type B personality theory is a theory which describes two common, contrasting personality types—the high-strung Type A and the easy-going Type B—as patterns of behavior that could either raise or lower, respectively, one's chances of developing...

, a group of personality characteristics including time urgency and competitiveness, is linked to an increased risk of coronary disease.

Lifestyle changes and reversibility

Lifestyle changes have been shown to be effective in reducing, (and in the case of diet, reversing) coronary disease:

• Healthy diet
  Healthy diet
  A healthy diet is one that helps maintain or improve general health. It is important for lowering many chronic health risks, such as obesity, heart disease, diabetes, hypertension and cancer. A healthy diet involves consuming appropriate amounts of all essential nutrients and an adequate amount of...
  
   has been shown by Dr Esselstyn (along with other life-sytle oriented physicians such as Dr McDougall, and Dr Ornish) to be hugely effective as a treatment of coronary disease, and generalized atherosclerosis. However, the idea of what composes a 'healthy diet' is highly controversial. In numerous peer reviewed studies the progression of heart disease has been shown to halt, and in some cases, the disease process may be reversed.Information recommending the reduction of animal based foods and an increase in plant based foods has been established for over 50 years.
• Weight control
• Smoking cessation
  Smoking cessation
  Smoking cessation is the process of discontinuing the practice of inhaling a smoked substance. This article focuses exclusively on cessation of tobacco smoking; however, the methods described may apply to cessation of smoking other substances that can be difficult to stop using due to the...
  
  
• Exercise
• Fish oil
  Fish oil
  Fish oil is oil derived from the tissues of oily fish. Fish oils contain the omega-3 fatty acids eicosapentaenoic acid , and docosahexaenoic acid , precursors of certain eicosanoids that are known to reduce inflammation throughout the body, and are thought to have many health benefits.Fish do not...
  
   consumption to increase omega-3 fatty acid
  Omega-3 fatty acid
  N−3 fatty acids are essential unsaturated fatty acids with a double bond starting after the third carbon atom from the end of the carbon chain....
  
   intake

Medications to treat coronary disease

• Cholesterol
  Cholesterol
  Cholesterol is a complex isoprenoid. Specifically, it is a waxy steroid of fat that is produced in the liver or intestines. It is used to produce hormones and cell membranes and is transported in the blood plasma of all mammals. It is an essential structural component of mammalian cell membranes...
  
   lowering medications, such as statin
  Statin
  Statins are a class of drugs used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. Increased cholesterol levels have been associated with cardiovascular diseases, and statins are therefore used in the...
  
  s, are useful to decrease the amount of "bad" (LDL) cholesterol.
• Nitroglycerin
• ACE
  Angiotensin-converting enzyme
  Angiotensin I-converting enzyme , an exopeptidase, is a circulating enzyme that participates in the body's renin-angiotensin system , which mediates extracellular volume , and arterial vasoconstriction...
  
   inhibitors, which treat hypertension
  Hypertension
  Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
  
   and may lower the risk of recurrent myocardial infarction
  Myocardial infarction
  Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
  
  
• Calcium channel blockers and/or beta-blockers
• Aspirin
  Aspirin
  Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
  
  

Surgical intervention

• Angioplasty
  Angioplasty
  Angioplasty is the technique of mechanically widening a narrowed or obstructed blood vessel, the latter typically being a result of atherosclerosis. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size...
  
  
• Stents (bare-metal or drug-eluting)
• Coronary artery bypass
• Heart Transplant

See also

• Anomalous aortic origin of a coronary artery
  Anomalous aortic origin of a coronary artery
  Anomalous aortic origin of a coronary artery from the inappropriate sinus of Valsalva with an interarterial, intraconal, or intramural course is a rare heart defect associated with an increased risk of sudden death in children.-CHSS AAOCA study:...