Abercrombie France,Theory of etiology and patholog

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Etiology and pathology of coronary heart disease in type theory

Key words: Coronary Heart Disease Pathology
Coronary heart disease
Coronary heart disease, referred to as coronary heart disease or coronary heart disease, sometimes referred to as coronary artery disease, or ischemic heart disease, that due to coronary atherosclerosis leading to myocardial ischemia, lack of oxygen caused by heart disease. Atherosclerosis leading to organ damage in the most common type.
Coronary heart disease or coronary heart disease in this short,[link widoczny dla zalogowanych], at present, although widely used, but it does not express the cause of atherosclerosis,[link widoczny dla zalogowanych], while the broader meaning. Because myocardial ischemia and hypoxia is a result of coronary artery disease, in addition to coronary atherosclerosis, there is inflammation (rheumatic, syphilitic and vascular obliterans, etc.) spasm, embolism, connective tissue disease, trauma and and other congenital malformations, coronary heart disease, including all of these cases the term in fact caused by heart attack. However, the vast majority (95% - 99%) caused by coronary atherosclerosis, hence the term coronary heart disease or coronary heart disease to replace the coronary atherosclerotic heart disease, although not very precise, in the or clinically feasible. As the coronary artery disease or coronary atherosclerosis as coronary heart disease synonymous, in fact, not exactly. Although the sick because of coronary artery, although there was atherosclerosis, but may not cause myocardial ischemia and hypoxia, or clinical coronary artery disease has been demonstrated, but no evidence of myocardial ischemia and hypoxia, only that patients suffering from coronary artery disease or coronary atherosclerosis, but can not be considered having a coronary heart disease. In addition, the term ischemic heart disease, its meaning should be more extensive.
[Etiology and pathogenesis]
The disease is caused by atherosclerosis of coronary atherosclerosis, the most important risk factors are age, male gender, hyperlipidemia, hypertension, smoking and diabetes. The reason why prone to coronary atherosclerosis, may be: ① the arterial intima and part of the luminal membrane of the blood supply directly from the supply of blood through the oxygen and nutrients directly into the intima and media, which is also lipid easy to penetrate. ② the artery and the aorta is almost perpendicular angle, the proximal and the main branches of the proximal impact of blood flow by large and thus vulnerable to injury.
Recent years also found that platelet function and is closely related to the disease. Most platelet function in patients with this disease hyperthyroidism, caused by accumulation of various factors on the sensitivity, the survival time shortened, the circulating blood platelet aggregation rate increased, the occurrence of the release reaction platelet release of β globulin, platelet factor Ⅳ, platelet-derived growth factor, diphosphate adenosine, 5 - serotonin, catecholamine, thromboplastin, histamine,[link widoczny dla zalogowanych], thromboxane A2 and so on. These substances so that more platelet aggregation,[link widoczny dla zalogowanych], thrombosis; increase in coronary permeability; to coronary vasospasm, vascular wall damage; promote vascular smooth muscle cell proliferation leading to coronary atherosclerosis.
[Pathological anatomy and pathophysiology]
About coronary artery, two, opening at the left and right aortic sinus. Left coronary artery with a total length of 1 ~ 3cm dry, and then divided into anterior descending and circumflex artery. Anterior descending artery blood supply to the left ventricular anterior wall in the lower part of the ventricular septum in the first 2 / 3 and the apical flap anterolateral papillary muscle and left atrium; circumflex artery blood supply to the left atrium and left ventricle upper forearm, left ventricular lateral wall and cardiac septal left part or all of the surface and within the papillary muscle after mitral valve. Right coronary artery blood supply to the right ventricle, ventricular septum of the posterior 1 / 3 and cardiac or all of the right diaphragm. All three have many small branches of coronary artery anastomosis with each other, together with the left main coronary artery, four collectively known as the coronary arteries.
Atherosclerosis can affect one in four, two, or three, four coronary arteries can be involved simultaneously. Among the most common involved the left anterior descending artery, the lesions are the most important, followed by the right coronary artery, left circumflex artery and the left main coronary artery. Proximal lesions than distal in the vessel was, the edge of the main branch vessel disease than weight. Plaques are located in branch vessel opening,[link widoczny dla zalogowanych], and often biased towards one side of the blood vessels, crescent, its enough to gradually cause stenosis or occlusion of the disease to understand change is in the .

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