Mini-invasive treatment and diagnostic of ischemic heart disease

Abstract

Introduction: Heart diseases represent the main causes of the early dead all over the world. The total number of deaths during the year 2008 induced by heart disease where almost 17,3 billions, this number represent 30% from mortality all over the earth. In our country 55% of deaths are provoked by ischemic heart disease. The primary cause is produced by atherosclerotic plaque in the coronary arteries with the main syndromes acute coronary syndromes (ACS), including unstable angina and acute myocardial infarction (AMT), and sudden cardiac death. To show the importance of coronary angiography like a diagnostic method, and to analyze the frequency of coronary main vessels affections, the role of risk factors and methods of treatments. Materials and Methods: In the study where included 60 patients with defined diagnosis of ischemic heart disease, 76,7% men and 23,3% women, median age 59 years old (range 44-77). After coronary angiography we established that the main coronary perfusion was right one 50%. The left main coronary perfusion was on 36.7 % of patients, and intermediate coronary perfusion was on 13.3% cases. We analyzed the patients’ complaints, disease history, and the results of the clinical and laboratory examination, Coronary angiography, electrocardiography (ECG) in the rest, transthoracic echocardiography (Eco CG), Doppler Eco CG. Results: In the study group where prevailed patients with a lot of risk factors, like Hypertension 35 patients (58.3%), dyslipidemia 28 cases (46.6%), smoke 40 (67%), diabetes 21 patients (35%), stabile angina 38 patients (64%) , instable angina 22 patients (36.6%). The most affected coronary was Left Anterior Descending branch (LAD) 24 patients (40.77%).Right coronary artery (RCA) was affected on 18 patients (30.7%), Circumflex coronary artery (CX) 14 patients (24.6%) and the main Left branch (LM) 3 patients (3.85%).Tri-coronary affections 31 patients (53.3%), bi- coronary affections 10 patients (16.7%), and one coronary affection 18 patients (30%).The coronary lesion data in our study showed that the 25% of lumen vessel lesion was the most frequently. The artery lesion between 75 and 99% was also very frequently. The 100% artery lesion was at 7 patients. Like a method of treatment Percutaneous Coronary Angioplasty (PTCA) was elected like a method of treatment for 28 patients (46.7%). Conclusion: Our data showed that coronary angiography was the most informative method of diagnostic. The presence of the risk factors showed a high incidence of the multiple coronary affections. The study has indicated that the coronary vessels with a bigger lumen were more affected.