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Coronary Heart Disease (CHD)In the United States
• CHD is the single largest killer of men and women– 13.5 million have history of MI and/or angina
• Each year 1.5 million people have MI– 500,000 die of MI– 250,000 dies within 1 hr
• By age 60, every 5th man and 17th woman develops CHD (1986 Framingham data)
• 1987 estimated direct and indirect costs of heart disease are $90.9 billion• 56 million adults have elevated LDL-C and warrant 1ntervention (1994
NHANES data)– 26 million qualify for drug therapy– 5.3 million actually receive drug therapy AHA 1997 Heart and Stroke Statistical Update; 1996. AHA, Heart and Stroke Facts: 1996 Statistical Supplement (1993 data).
Cardiovascular Risk Factors
Nonmodifiable • Age• Sex• Family History
Modifiable
• Hypertension
• Hyperlipidemia
• Cigarette Smoking
• Glucose intolerance
(Hyperglycemia)
• Obesity
• Sedentary Lifestyle
• Psychological Stress
Presentation of CoronaryArtery Disease
• Asymptomatic• Silent Ischemia• Sudden Death
• Angina Pectoria• Unstable Angina• Acute Myocardial
Infarction
Unstable Angina
• Definition
• Aspirin
• Heparin
• II b III a inhibitors
• Stress test
• Echocardiogram
Indications ForCoronary Angiogram
• Diagnosis
• Refractory Pain
• Probable High Risk
• Acute Myocardial Infarction