Reasons Of Coronary Heart Disease Discussion Paper

Reasons Of Coronary Heart Disease (CHD)

Coronary Heart Disease targets the arteries inhibiting the continual flow of blood carrying different necessary components of survival such as oxygen, vitamins, minerals and others. During this disease, thick build up occurs in the lining of these arteries due to the collection of fat, cholesterol and plaques. This build up thickens the lining making the passage smaller for the flow of bodily fluids. Furthermore, the flow of blood carrying essential components gets pumped against gravity throughout the body with the help of pumping of heart (Mann et al., 2014). Additionally, because of this smaller passage the heart exerts extra pressure for the pumping of the blood along with its components.  This extra pressure leads to imbalance in the optimal functioning of the heart further causing coronary heart disease and ultimate death. To treat the coronary heart diseases, cardiac implantable devices have are used by healthcare professional worldwide for the maintenance of the condition of the heart. There are different types of implantable devices used for the effective remedial treatment (Polyzos, Konstantelias, Falagas, 2015).

Pacemakers are electronic devices that are required to be inserted in the body in order to maintain the equilibrium of slow and irregular rhythm of the heartbeat. This is undertaken by restoring the normal rate of heart ultimately providing adequate circulation of blood. All around the world, most of the most the pacemakers are used in elder people as it provides fast and effective treatment to the elder patients in distress. Some risks are associated with the pacemakers are infection at the site of surgery, disallowed to maintain contact with certain objects such as electromagnetic field and other appliances (Goyal & Rich, 2016).

The implantable cardioverter defibrillators (ICD) are battery powered devices that are surgically placed in the chest or abdomen that monitors the rate of heartbeat and further provides electrical senses for the maintenance of the equilibrium. The pacemakers and implantable cardioverter defibrillators work on the same aim of providing the regular beating of the heart but they differ in the functioning based on the intensity of the electrical impulse send by them. The pacemaker sends low-energy electronic impulses for the restoration of the heartbeat while implantable electronic cardioverter defibrillators first sends low intensity electronic impulses then high intensity electronic impulses for the normal regulation of the beating of the heart (Kramer et al., 2015)Reasons Of Coronary Heart Disease Discussion Paper.

The Cardiac resynchronization device helps in the maintenance of the contraction of ventricles of heart by imparting electrical impulses to the muscles of the heart for the effective functioning of the heart. This device is used in the patients with moderate to severe heart conditions targeting the abnormal beating of the heart. Furthermore, this device plays an essential role in maintaining the condition of heart by increasing the tolerance level, reduction in mortality and remodelling in terms of ventricle size and reduction in the requirement of hospitalization due to irregular beating of the heart (Sardu, Marfella & Santulli, 2014).

Importance Of Implantable Cardioverter Defibrillators (ICD)

Implantable loop recorders are small devices that are implanted into the body in order to regulate the monitoring of the electrical activity and beating of the heart. This device mainly records the information in the continuous manner by freezing the points of irregular results. This is one of the effective diagnostic tools for determining the irregular activities of heart (Raine et al., 2016).

This disease mostly prevails in elderly people above 60 years of age due to advancement in the age. Such growing age leads to weaken body structure, weaken immunity and lower levels of resistance to foreign bodies by the body system. Furthermore, sedentary lifestyle, unhealthy diet, no exercise, increased stressed and tension further contributes to unhealthy life that leads to pathophysiology of coronary heart disease. Increment in the extent of prevalent degrading heart condition finally leads to stroke or ultimate heart failure (Soares et al., 2015). Stroke in elderly people is a sudden effect that targets the brain by breaching the flow of blood carrying essential components. This breach occur when the blood vessels such as arteries and capillaries gets clogged or ruptured and are unable to conduct effective flow even after prolonged and forceful pressure by the heart with the help of continual pumping. Besides this, heart attack is a process that slowly builds up to exert extreme pain in elderly people. This happens when the muscles of heart starts dying due to the lack of presence of oxygenated blood and prevalence of large amount of oxygenated blood. This happens when the flow of blood gets blocked due to formation of certain clot (Piccini et al., 2013)Reasons Of Coronary Heart Disease Discussion Paper.

For the effective formulation, implementation and regulation of cardiac implantable devices in Australia, the Cardiac Society of Australia determines optimal guidelines on the basis of implantation, follow up and selection of the device to be undertaken. Besides this, the Heart Rhythm Society (HRS) further regulates the implementation of these guidelines in various hospitals of Australia. A document has been released by HRS on the effective implementation of cardiac implantable devices and is called as 2017 HRS Expert Consensus on CIED Lead management and Extraction. This statement contains effective information on advisories, lead extraction, data management, patient management, designs and other important factors required for effective usage of these devices (January et al., 2014).

Besides this, the guidelines provided by the Cardiac Society of Australia are based on case history, physical symptoms, radiography such as chest and electrical, indications, data on the three different devices, programming of these devices, information on the nomenclature of pacing nodes, complications, malfunction, diagnosis and non-invasive stimulations. Guidelines on these points help the healthcare professionals in understanding the underlying principles of cardiac implantable devices in terms of their characteristics, procedures, anatomy and physiology of the condition of patient, undertaking of sterile practices for these devices, psychological impact, competent programming, targeting of tachycardia and many others (Jennings, 2016).

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Importance Of Implantable Loop Recorders

A multidisciplinary or multiagency team consist of different healthcare professionals from different background working altogether for the regulation of effective patient-oriented treatment (Bernstein, Manning & Julian, 2016). For the treatment of elderly people suffering from coronary heart disease, different healthcare professionals can be radiologist, cardiologist, cardiovascular surgeon, general physician, nurses, carer, family physician, nephrologists, neurologist, rehabilitation team, nutritionist or dietician, psychiatrist, social worker, psychologist and others. Such healthcare professionals work together in a team to provide pharmacological and non-pharmacological interventions as per the requirement (Bruckel et al., 2014)Reasons Of Coronary Heart Disease Discussion Paper.

References

Bernstein, K. M., Manning, D. A., & Julian, R. M. (2016). Multidisciplinary teams and obesity: role of the modern patient-centered medical home. Primary Care: Clinics in Office Practice, 43(1), 53-59.

Bruckel, J. T., Gurm, H. S., Seth, M., Prager, R. L., Jensen, A., & Nallamothu, B. K. (2014). Use of a heart team in decision-making for patients with complex coronary disease at hospitals in Michigan prior to guideline endorsement. PloS one, 9(11), e113241.

Goyal, P., & Rich, M. W. (2016). Electrophysiology and heart rhythm disorders in older adults. Journal of Geriatric Cardiology: JGC, 13(8), 645.

January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cigarroa, J. E., Cleveland, J. C., … & Murray, K. T. (2014). 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. Circulation, 130(23), e199-e267.

Jennings, G. L. (2016). Reflections on the Heart Foundation of Australia/Cardiac Society of Australia and New Zealand Acute Coronary Syndromes Guideline 2016–A New International Benchmark. Heart, Lung and Circulation, 25(11), 1048-1050.

Kramer, D. B., Matlock, D. D., Buxton, A. E., Goldstein, N. E., Goodwin, C., Green, A. R., … & Reynolds, M. R. (2015). Implantable Cardioverter–Defibrillator Use in Older Adults. Circulation: Cardiovascular Quality and Outcomes, 8(4), 437-446.

Mann, D. L., Zipes, D. P., Libby, P., & Bonow, R. O. (2014). Braunwald’s heart disease: a textbook of cardiovascular medicine. Elsevier Health Sciences.

Piccini, J. P., Hammill, B. G., Sinner, M. F., Hernandez, A. F., Walkey, A. J., Benjamin, E. J., … & Heckbert, S. R. (2013). Clinical course of atrial fibrillation in older adults: the importance of cardiovascular events beyond stroke. European heart journal, eht483.

Raine, D. T., Begg, G. A., Moore, J., Taylor, E. C., Buck, R. T., Honarbakhsh, S., … & Thomas, D. E. (2016). POSTERS (1) 59Multipolar Contact Mapping Guided Ablation of Temporally Stable High Frequency and Complex Fractionated Atrial Electrogram Sites in Patients with Persistent Atrial Fibrillation60intra-cardiac and Peripheral Levels of Biochemical Markers of Fibroses in Patients undergoing Catheter Ablation for Atrial Fibrilation61the don’t wait to anticoagulate project (dwac) by the west of England academic health science network (AHSN) optimises stroke prevention for patients with atrial fibrillation (af …. Europace, 18(suppl 2), ii24-ii35.

Sardu, C., Marfella, R., & Santulli, G. (2014). Impact of diabetes mellitus on the clinical response to cardiac resynchronization therapy in elderly people. Journal of cardiovascular translational research, 7(3), 362-368.

Soares-Miranda, L., Siscovick, D. S., Psaty, B. M., Longstreth, W. T., & Mozaffarian, D. (2015). Physical activity and risk of coronary heart disease and stroke in older adults: the Cardiovascular Health Study. Circulation, CIRCULATIONAHA-115 Reasons Of Coronary Heart Disease Discussion Paper