Classification of coronary heart disease in clinical stages and according to ICD
Coronary heart disease, also called ischemic heart disease, are diseases of the heart caused by atherosclerosis (atherosclerosis). This causes oxygen deficiency (ischemia) in the heart muscle. Coronary heart disease are divided into acute (heart attack or myocardial infarction) and chronic (angina pectoris) forms.
The ICD has additional categories, mostly asymptomatic diagnoses. The classifications according to the ICD-9 and ICD-10 are quite diverse. Thus, part of the ICD-10 category of “certain current complications following acute myocardial infarction ‘(code I23) in ICD-9 classified under” no well-defined diseases and complications of heart disease “(code 429), and thus not subject to the coronary heart disease.
Heart attack: sudden closure of a total coronary
A heart attack or stroke occurs when a blood clot suddenly quit a coronary artery. By getting close to the corresponding portion of the heart muscle no longer oxygen and dies. The closure of the coronary artery is accompanied by a sudden, severe and prolonged pain in the chest, often radiating (to the neck, arms, jaws or mouth). Nausea and sweating also occur often. These symptoms may also become less pronounced. The pain does not respond sufficiently at rest and medication. The heart develops at the site of an infarct scar tissue that eventually is. That part of the heart muscle is no longer. Following the loss of myocardial infarction occurs in heart muscle. The severity of a heart attack depends on the size of the damage to the heart. For major damage to the heart muscle is insufficient and heart failure occurs (see: What is heart failure?). Also, narrowing of the coronary arteries leading to a lack of oxygen, which angina pectoris may occur. A heart attack is a dangerous condition with severe arrhythmias (and sometimes death) could be compromised.
Angina pectoris: a temporary shortage in blood supply
Angina pectoris, literally, “chest pain” is caused by a temporary deficiency in the blood supply of the heart. This is almost always one (or more) in a narrowing of the coronary arteries, allowing a part of the heart muscle gets enough oxygen. Most likely, this lack of oxygen on exertion, so if the heart must work harder and the heart muscle needs more oxygen than the narrowed blood vessel can rely. Unlike a heart attack the symptoms of angina pectoris shortly after the effort has ended. Angina pectoris gives a typical oppressive, crushing pain behind the breastbone. If angina occurs at rest (not on exertion), then it is called angina pectoris at rest. The distinction between angina pectoris at rest and a heart attack can be difficult.
Angina pectoris can be divided into stable and unstable angina pectoris. Between two types of angina pectoris are differences in the occurrence of complaints in the pathophysiology and probably also in the forecast.
* In stable angina pectoris there is a stable pattern of complaints with little change in the duration and intensity of the symptoms. The symptoms usually occur at times provocative (eg effort, transition between cold and heat). Pathophysiological view, there is a narrowing of atherosclerotic coronary arteries.
* There is as unstable angina pectoris complaints recently arisen in a period of six weeks have increased in duration and / or severity. The pattern of complaints is similar to that of stable angina pectoris but without provocative moments. The complications created by the appearance of a clot in the coronary artery at the site of an atherosclerotic plaque or lesion.
The ECG provides important information about location and severity
The electrocardiogram (ECG) provides important information about the location and severity of the vascular closure in patients with acute myocardial infarction. Patients with acute myocardial infarction on the basis of the ECG into two categories:
* Myocardial infarction with ST-elevation: there is a final clot at the origin of a coronary. These patients are relatively young and the infarction is often their first clinical manifestation of coronary heart disease.
* Myocardial infarction without ST elevation: the vascular closure is not complete or more peripheral than a heart attack with ST-elevation. These patients usually been known that coronary heart disease.
In stable angina pectoris the ECG usually provides limited information. There are only visible abnormalities on the ECG when there are complaints, so when angina occurs. For this reason, find patients with (suspected) angina pectoris study site where the heart is responsible, as in a walking or cycling test. Then one may be found occurring oxygen deficiency.