Ishemična bolezen srca: Razlika med redakcijama

'''Koronarne bolezni''' ('''CAD'''), znane tudi kot '''ishemične bolezni srca''' ('''IHD'''),<ref>{{Navedi knjigo|last=Bhatia|first=Sujata K.|title=Biomaterials for clinical applications|year=2010|publisher=Springer|location=New York|isbn=9781441969200|page=23|url=https://books.google.com/books?id=bXtaX468LRYC&pg=PA23|edition=Online-Ausg.}}</ref> so skupina bolezni, ki zajemajo: stabilno [[angina pektoris|angino pektoris]], nestabilno angino pektoris, [[miokardni infarkt]], [[Srčni zastoj|nenadno srčno smrt]].<ref name="Wong2014">{{Navedi revijo|last=Wong|first=ND|title=Epidemiological studies of CHD and the evolution of preventive cardiology.|journal=Nature reviews. Cardiology|date=May 2014|volume=11|issue=5|pages=276–89|pmid=24663092|doi=10.1038/nrcardio.2014.26}}</ref> V skupini [[bolezni srca in ožilja]] je to najpogostejše obolenje.<ref name="GDB2013">{{Navedi revijo|last=GBD 2013 Mortality and Causes of Death|first=Collaborators|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=17 December 2014|pmid=25530442|doi=10.1016/S0140-6736(14)61682-2|volume=385|pages=117–171|pmc=4340604}}</ref> Pogost simptom je bolečina v prsih ali nelagodje, ki se lahko seli v rame, roke, hrbet, vrat, ali čeljust.<ref name="HLB2014">{{Navedi splet|title=What Are the Signs and Symptoms of Coronary Heart Disease?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs|website=http://www.nhlbi.nih.gov/|accessdate=23 February 2015|date=29 September 2014}}</ref> Občasno se lahko občuti kot [[zgaga]]. Običajno se simptomi pojavijo zaradi telesne dejavnosti ali čustvenega stresa, trajajo pa manj kot nekaj minut in ponehajo s počitkom.<ref name="HLB2014">{{Navedi splet|title=What Are the Signs and Symptoms of Coronary Heart Disease?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs|website=http://www.nhlbi.nih.gov/|accessdate=23. 2. 2015|date=29. 9. 2014}}</ref> Pride lahko do [[Dispneja|težav z dihanjem]], včasih pa bolnik ne čuti nobenih simptomov.<ref name="HLB2014">{{Navedi splet|title=What Are the Signs and Symptoms of Coronary Heart Disease?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs|website=http://www.nhlbi.nih.gov/|accessdate=23. 2. 2015|date=29. 9. 2014}}</ref> Prvi znak je lahko tudi sam srčni napad.<ref name="CDC2013">{{Navedi splet|title=Coronary Artery Disease (CAD)|url=http://www.cdc.gov/heartdisease/coronary_ad.htm|website=cdc.gov|accessdate=23. 2. 2015|date=12. 3. 2013}}</ref> Drugi zapleti vključujejo [[srčno popuščanje]] ali neredno bitje srca.<ref name="CDC2013">{{Navedi splet|title=Coronary Artery Disease (CAD)|url=http://www.cdc.gov/heartdisease/coronary_ad.htm|website=cdc.gov|accessdate=23. 2. 2015|date=12. 3. 2013}}</ref>

Dejavniki tveganja so med drugim [[visok krvni tlak]], [[Kajenje tobaka|kajenje]], [[sladkorna bolezen]], pomanjkanje gibanja, [[debelost]], visoke ravni [[holesterol]]a v krvi, slaba prehrana in prekomerno uživanje [[Etanol|alkohola]].<ref>{{Navedi revijo|last=Mehta|first=PK|last2=Wei|first2=J|last3=Wenger|first3=NK|title=Ischemic heart disease in women: A focus on risk factors.|journal=Trends in Cardiovascular Medicine|date=16 October 2014|pmid=25453985|doi=10.1016/j.tcm.2014.10.005|volume=25|pages=140–151}}</ref><ref name="WHO2011">{{Navedi knjigo|last=Mendis|first=Shanthi|last2=Puska|first2=Pekka|last3=Norrving|first3=Bo|title=Global atlas on cardiovascular disease prevention and control|date=2011|publisher=World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization|location=Geneva|isbn=9789241564373|pages=3–18|edition=1st|url=http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf?ua=1}}</ref> Med tveganja spada tudi [[Velika depresivna motnja|depresija]].<ref>{{Navedi revijo|last=Charlson|first=FJ|last2=Moran|first2=AE|last3=Freedman|first3=G|last4=Norman|first4=RE|last5=Stapelberg|first5=NJ|last6=Baxter|first6=AJ|last7=Vos|first7=T|last8=Whiteford|first8=HA|title=The contribution of major depression to the global burden of ischemic heart disease: a comparative risk assessment|journal=BMC medicine|date=26 November 2013|volume=11|page=250|pmid=24274053|doi=10.1186/1741-7015-11-250}}</ref> Osnovni mehanizem bolezni je [[ateroskleroza]] arterij, ki prekrvljajo srčno mišico.<ref name="WHO2011">{{Navedi knjigo|last=Mendis|first=Shanthi|last2=Puska|first2=Pekka|last3=Norrving|first3=Bo|title=Global atlas on cardiovascular disease prevention and control|date=2011|publisher=World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization|location=Geneva|isbn=9789241564373|pages=3–18|edition=1st|url=http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf?ua=1}}</ref> Številni testi so na voljo kot diagnostični pripomoček, tako [[Elektrokardiografija|elektrokardiogram]], test z obremenitvijo srca, koronarna tomografska abgiopatija s pomočjo računalnika &nbsp; in koronarni angiogram.<ref>{{Navedi splet|title=How Is Coronary Heart Disease Diagnosed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/diagnosis|website=http://www.nhlbi.nih.gov/|accessdate=25. 2. 2015|date=29. 9. 2014}}</ref>

Preventiva je zdrava prehrana, redna vadba, ohranjevanje zdrave teže in odpoved tobaku.<ref name="HLB2013P">{{Navedi splet|title=How Can Coronary Heart Disease Be Prevented or Delayed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/prevention|website=http://www.nhlbi.nih.gov|accessdate=25 February 2015}}</ref> Včasih se uporabljajo tudi zdravila za sladkorno bolezen, visok holesterol, ali visok krvni tlak.<ref name="HLB2013P">{{Navedi splet|title=How Can Coronary Heart Disease Be Prevented or Delayed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/prevention|website=http://www.nhlbi.nih.gov|accessdate=25 February 2015}}</ref> Obstaja malo dokazov za teste ljudi, ki imajo nizko tveganje in nimajo simptomov<ref>{{Navedi revijo|last=Desai|first=CS|last2=Blumenthal|first2=RS|last3=Greenland|first3=P|title=Screening low-risk individuals for coronary artery disease.|journal=Current atherosclerosis reports|date=April 2014|volume=16|issue=4|page=402|pmid=24522859|doi=10.1007/s11883-014-0402-8}}</ref> Zdravljenje vključuje iste ukrepe kot preventiva.<ref>{{Navedi revijo|last=Boden|first=WE|last2=Franklin|first2=B|last3=Berra|first3=K|last4=Haskell|first4=WL|last5=Calfas|first5=KJ|last6=Zimmerman|first6=FH|last7=Wenger|first7=NK|title=Exercise as a therapeutic intervention in patients with stable ischemic heart disease: an underfilled prescription.|journal=The American Journal of Medicine|date=October 2014|volume=127|issue=10|pages=905–11|pmid=24844736|doi=10.1016/j.amjmed.2014.05.007}}</ref><ref name="HLB2013Tr">{{Navedi splet|title=How Is Coronary Heart Disease Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment|website=http://www.nhlbi.nih.gov/|accessdate=25 February 2015|date=29 September 2014}}</ref> Priporočajo se dodatno zdravila, kot so sredstva proti oblogam v žilah kot je [[Acetilsalicilna kislina|aspirin]], beta blokatorji, ali nitroglicerin.<ref name="HLB2013Tr">{{Navedi splet|title=How Is Coronary Heart Disease Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment|website=http://www.nhlbi.nih.gov/|accessdate=25 February 2015|date=29 September 2014}}</ref> Postopki, npr. perkutana koronarna intervencija (PCI) ali koronarna obvodna operacija (CABG) se lahko uporabijo v resnih primerih bolezni.<ref name="HLB2013Tr">{{Navedi splet|title=How Is Coronary Heart Disease Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment|website=http://www.nhlbi.nih.gov/|accessdate=25 February 2015|date=29 September 2014}}</ref><ref>{{Navedi revijo|last=Deb|first=S|last2=Wijeysundera|first2=HC|last3=Ko|first3=DT|last4=Tsubota|first4=H|last5=Hill|first5=S|last6=Fremes|first6=SE|title=Coronary artery bypass graft surgery vs percutaneous interventions in coronary revascularization: a systematic review.|journal=JAMA|date=20 November 2013|volume=310|issue=19|pages=2086–95|pmid=24240936|doi=10.1001/jama.2013.281718}}</ref> Pri osebah s stabilno CAD ni jasno, ali PCI ali CABG poleg drugih oblik zdravljenja, podaljšata [[Pričakovana življenjska doba|pričakovano življenjsko dobo]] ali zmanjšata tveganje za srčni napad.<ref>{{Navedi revijo|last=Rezende|first=PC|last2=Scudeler|first2=TL|last3=da Costa|first3=LM|last4=Hueb|first4=W|title=Conservative strategy for treatment of stable coronary artery disease|journal=World journal of clinical cases|date=16 February 2015|volume=3|issue=2|pages=163–70|pmid=25685763|doi=10.12998/wjcc.v3.i2.163}}</ref>

V letu 2013 je CAD bil najpogostejši vzrok smrti na svetu; umrlo je 8.14 milijona ljudi (16,8 %), za primerjavo je leta 1990 bolezen bila vzrok za smrt 5.74 milijona ljudi (12 %).<ref name="GDB2013">{{Navedi revijo|last=GBD 2013 Mortality and Causes of Death|first=Collaborators|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=17 December 2014|pmid=25530442|doi=10.1016/S0140-6736(14)61682-2|volume=385|pages=117–171|pmc=4340604}}</ref> Tveganje za smrt zaradi CAD za dano starost je med leti 1980 in 2010 padlo, še posebej v razvitih državah.<ref>{{Navedi revijo|last=Moran|first=AE|last2=Forouzanfar|first2=MH|last3=Roth|first3=GA|last4=Mensah|first4=GA|last5=Ezzati|first5=M|last6=Murray|first6=CJ|last7=Naghavi|first7=M|title=Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study|journal=Circulation|date=8 April 2014|volume=129|issue=14|pages=1483–92|pmid=24573352|doi=10.1161/circulationaha.113.004042}}</ref>Zmanjšalo se je tudi med letoma 1990 in 2010.<ref>{{Navedi revijo|last=Moran|first=AE|last2=Forouzanfar|first2=MH|last3=Roth|first3=GA|last4=Mensah|first4=GA|last5=Ezzati|first5=M|last6=Flaxman|first6=A|last7=Murray|first7=CJ|last8=Naghavi|first8=M|title=The global burden of ischemic heart disease in 1990 and 2010: the Global Burden of Disease 2010 study|journal=Circulation|date=8 April 2014|volume=129|issue=14|pages=1493–501|pmid=24573351|doi=10.1161/circulationaha.113.004046}}</ref> V [[Združene države Amerike|Združenih državah Amerike]] je leta 2010 približno 20 % ljudi nad 65 let imelo CAD, &nbsp; 7 % ljudi. starih 45 do 64 let ter 1,3 % &nbsp; od 18 do 45 let.<ref name="US2011">{{Navedi revijo|last=Centers for Disease Control and Prevention|first=(CDC)|title=Prevalence of coronary heart disease--United States, 2006-2010.|journal=MMWR. Morbidity and mortality weekly report|date=14 October 2011|volume=60|issue=40|pages=1377–81|pmid=21993341}}</ref> Pogostnost je za dano starost pri moških večja kot pri ženskah.<ref name="US2011">{{Navedi revijo|last=Centers for Disease Control and Prevention|first=(CDC)|title=Prevalence of coronary heart disease--United States, 2006-2010.|journal=MMWR. Morbidity and mortality weekly report|date=14 October 2011|volume=60|issue=40|pages=1377–81|pmid=21993341}}</ref>

Za nestabilno angino gre, kadar se njena &nbsp; jakost, značilnost in pogostnost spreminja. Nestabilna angina pektoris je lahko predhodnik [[Miokardni infarkt|miokardnega infarkta]]. Pri 30 % odraslih, ki se z nejasnim vzrokom za bolečine obrnejo na urgentni oddelek, je vzrok za bolečine obolenje koronarnih arterij.<ref>{{Navedi revijo|last=Kontos|first=MC|last2=Diercks|first2=DB|last3=Kirk|first3=JD|title=Emergency department and office-based evaluation of patients with chest pain|journal=Mayo Clinic Proceedings|date=Mar 2010|volume=85|issue=3|pages=284–99|pmid=20194155|doi=10.4065/mcp.2009.0560}}</ref>