What are the coronary arteries?

Coronary arteries supply blood to the heart muscle. Like all other tissues in the body, the heart muscle needs oxygen-rich blood to function, and oxygen-depleted blood must be carried away. 冠状动脉沿着心脏外部延伸，有小分支为心肌供血.

What are the different coronary arteries?

两条主要的冠状动脉是左主干和右主干.

• Left main coronary artery (LMCA). 左冠状动脉主干向心肌的左侧(左心室和左心房)供血。. The left main coronary artery divides into branches:

  • The left anterior descending artery 它是左冠状动脉的分支，为左心脏前部供血.

  • The circumflex artery 左冠状动脉的分支环绕心肌. 这条动脉向心脏的外侧和后部供血.

• Right coronary artery (RCA). 右冠状动脉向右心室供血, the right atrium, and the SA (sinoatrial) and AV (atrioventricular) nodes, which regulate the heart rhythm. The right coronary artery divides into smaller branches, 包括右后降支和急性边缘动脉.

其他较小的冠状动脉分支包括钝缘(OM), septal perforator (SP), and diagonals.

Why are the coronary arteries important?

Since coronary arteries deliver blood to the heart muscle, 任何冠状动脉紊乱或疾病都会减少流向心脏的氧气和营养物质, which may lead to a heart attack and possibly death. Atherosclerosis 炎症和动脉内壁斑块的积聚是否会导致动脉变窄或堵塞. It is the most common cause of heart disease.

What is coronary artery disease?

Coronary heart disease, or coronary artery disease (CAD), 以冠状动脉最内层的炎症和脂肪堆积为特征吗. 脂肪沉积可能在儿童时期形成，并在整个生命周期中继续增厚和扩大. This thickening, called atherosclerosis, 使动脉变窄，减少或阻塞流向心脏的血液.

美国心脏协会估计，超过1600万美国人患有冠状动脉疾病——这是美国男性和女性的头号杀手.S.

What are the risk factors for coronary artery disease?

Risk factors for CAD often include:

• Smoking

• High LDL cholesterol, high triglycerides levels, and low HDL cholesterol

• High blood pressure (hypertension)

• Physical inactivity

• Obesity

• High saturated fat diet

• Diabetes

• Family history

控制危险因素是预防冠心病发病和死亡的关键.

What are the symptoms of coronary artery disease?

冠心病的症状取决于疾病的严重程度. Some people with CAD have no symptoms, some have episodes of mild chest pain or angina, and some have more severe chest pain.

如果到达心脏的含氧血液太少，一个人就会感到胸痛，这就是心绞痛. When the blood supply is completely cut off, the result is a heart attack, and the heart muscle begins to die. 有些人可能心脏病发作了，却从未意识到症状. This is called a "silent" heart attack.

Symptoms of coronary artery disease include:

• 胸痛胸骨后胸部的沉重、紧绷、压迫或疼痛

• Pain spreading to the arms, shoulders, jaw, neck, or back

• Shortness of breath

• Weakness and fatigue

How is coronary artery disease diagnosed?

除了完整的病史和体格检查, 冠状动脉疾病的检查包括:

• Electrocardiogram (ECG or EKG). This test records the electrical activity of the heart, shows abnormal rhythms (arrhythmias), and detects heart muscle damage.

• Stress test (also called treadmill or exercise ECG). 这项测试是当你在跑步机上行走时进行的，以监测运动期间的心脏状况. Breathing and blood pressure rates are also monitored. A stress test may be used to detect coronary artery disease, 或者确定心脏病发作或心脏手术后的安全运动水平. 这也可以在休息时使用特殊的药物来完成，这些药物可以合成地对心脏施加压力.

• Cardiac catheterization. With this procedure, 将一根导线插入心脏的冠状动脉，在将造影剂注入动脉后拍摄x光片. 这样做是为了定位狭窄、堵塞和其他问题.

• Nuclear scanning. 将放射性物质注入静脉，然后用照相机观察它被心肌吸收的过程. This indicates the healthy and damaged areas of the heart.

Treatment for coronary heart disease

Treatment may include:

• Modification of risk factors. Risk factors that you can change include smoking, high cholesterol levels, high blood glucose levels, lack of exercise, poor dietary habits, being overweight, and high blood pressure.

• Medicines. 可用于治疗冠状动脉疾病的药物包括:

  • Antiplatelets. These decrease blood clotting. 阿司匹林、氯吡格雷、噻氯匹定和普拉格雷都是抗血小板药物.

  • Antihyperlipidemics. 这些血液中的低脂(脂肪)，特别是低密度脂(LDL)胆固醇. Statins are a group of cholesterol-lowering medicines, and include simvastatin, atorvastatin, and pravastatin, among others. Bile acid sequestrants--colesevelam, 胆固醇胺、胆甾醇和烟酸是其他用于降低胆固醇水平的药物.

  • Antihypertensives. These lower blood pressure. 几组不同的药物以不同的方式降低血压.

• Coronary angioplasty. With this procedure, 气球被用来在血管中创造一个更大的开口来增加血液流动. 尽管血管成形术是在身体其他部位的血管中进行的, 经皮冠状动脉介入治疗(PCI)是指冠状动脉血管成形术，以允许更多的血液流入心脏. PCI也称为经皮腔内冠状动脉成形术(PTCA). There are several types of PCI procedures, including:

  • Balloon angioplasty. 在阻塞的动脉内充气一个小气球来打开阻塞的区域.

  • Coronary artery stent. 一个微小的网状线圈在阻塞的动脉内扩张以打开阻塞区域，并留在原位以保持动脉畅通.

  • Atherectomy. 动脉内的阻塞区域通过导管末端的微小装置切断.

  • Laser angioplasty. A laser used to "vaporize" the blockage in the artery.

• Coronary artery bypass. 通常简称为“搭桥手术”或CABG(发音为“卷心菜”)。, 这种手术通常用于胸痛(心绞痛)和冠状动脉疾病的患者. During the surgery, 旁路手术是通过在冠状动脉阻塞区域的上方和下方移植一段静脉来实现的, enabling blood to flow around the blockage. Veins are usually taken from the leg, 但是来自胸部或手臂的动脉也可以用来做搭桥手术. 有时，可能需要多次旁路手术来完全恢复心脏所有区域的血液流动.