冠狀動脈疾病

冠状动脉堵塞
(重定向自冠心病

冠狀動脈疾病coronary artery disease,CAD)簡稱冠心病,是涉及心臟動脈的斑塊堆積(動脈粥樣硬化)導致流向心肌的血流降低,為最常見的心血管疾病[11]

冠狀動脈疾病
coronary artery disease
同义词Atherosclerotic heart disease,[1]atherosclerotic vascular disease,[2]coronary heart disease[3]
冠狀動脈粥樣(atherosclerosis)硬化示意圖
症状胸痛呼吸困难[4]
併發症心臟衰竭心律不整[5]
类型动脉疾病[*]心血管疾病疾病
病因心臟的動脈英语Coronary arteries 粥樣硬化[6]
风险因素高血壓吸菸糖尿病、缺乏運動、肥胖症高膽固醇血症[6]
診斷方法心电图心脏压力测试英语cardiac stress test, 冠状动脉血管电脑断层扫描英语coronary computed tomographic angiography, 冠狀動脈血管攝影英语Coronary catheterization
預防健康的飲食、規律運動、維持健康的體重、不吸菸[7]
治療经皮冠状动脉介入治疗 (PCI), 冠状动脉旁路移植 (CABG)[8]
藥物阿司匹林, β受体阻滞剂, 硝酸甘油英语医用硝酸甘油[8]
患病率1.1 億 (2015)[9]
死亡數
分类和外部资源
醫學專科心臟病學心脏外科
ICD-9-CM410-414.99、​414.0、​414.9、​414.00
OMIM300464、​607339、​608316、​608318、​608320、​610947、​611139、​612030、​614293
MedlinePlus007115
eMedicine349040
[编辑此条目的维基数据]

冠心病有许多异名近义词,如:冠狀動脈心臟病coronary heart disease,CHD)[12][13]缺血性心臟病ischemic heart disease,IHD)[14]心肌缺血(myocardial ischemia)、冠狀動脈粥樣硬化心臟病coronary atherosclerotic heart disease,CAHD)[15][16]冠狀動脈粥樣硬化心血管疾病[17]

冠心病型態包含穩定型心絞痛非穩定型心絞痛英语Unstable angina心肌梗塞猝死[18]

常見的症狀包括胸痛或不適,有時會轉移到肩膀、手臂、背部、頸部或下顎。有些人可能會有胸口灼熱的感覺。通常症狀在運動或情緒壓力下出現,持續時間不超過數分鐘且休息會緩解。有時會伴隨呼吸困難,有時則是毫無症狀[4]。少數人以心肌梗塞為最初的表現。其他可能的併發症包含心臟衰竭心律不整[5]

危險因子包括:高血壓抽菸糖尿病、缺乏運動、肥胖血液中膽固醇含量過高、營養不良和酗[6][19]。其他的危險因子也包括憂鬱症[20]。潛在的病理機制與冠狀動脈血管粥狀硬化有關[6]心電圖心臟壓力測試冠狀動脈血管攝影英语Coronary catheterization(一種血管攝影)是常見有助於診斷的工具[21]

預防方式包括:健康飲食、規律運動、體重控制以及戒菸[7]。視情況合併使用藥物控制高血糖、高膽固醇或高血壓[7]。只有很有限的證據支持對低風險且沒有症狀的民眾實施篩檢[22]。最初治療和預防措施一樣,包括生活方式調整以及三高(高血糖、高膽固醇或高血壓)的控制[8][23]。進一步的藥物治療包括阿斯匹靈乙型交感神經阻斷劑硝酸甘油的醫療用途[8]。在病況較嚴重的情形下,會考慮進行經皮冠狀動脈介入治療或是冠狀動脈繞道手術[8][24]。對於穩定型心絞痛,經皮冠狀動脈介入治療或是冠狀動脈繞道手術,對於提升存活年限或降低未來心臟病發的效果仍不明確[25]

冠狀動脈疾病在西元2002年是全球第一大死因[26],也是人們住院的主要原因之一[27]。2013年也是全球死因首位,死亡人數自1990年574萬人(12%)攀升至2013年814萬人(16.8%)[11]。而隨著診斷及治療技術進步,經年齡校正後的冠狀動脈疾病死亡率自1980年至2010年則呈現下降趨勢,尤其在已開發國家更為顯著[28]。同時經年齡校正後的冠狀動脈疾病病例數在1990至2010年間亦呈現下降趨勢[29]。根據美國本土於2010年統計,冠狀動脈疾病盛行率於大於65歲族群為20%、45至64歲為7%、18至45歲為1.3%。針對同一年齡層相比,男性的發生率較女性高[30]

治疗

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冠狀動脈是主動脈的分支,負責供應足夠氧和營養素予心肌。冠狀動脈被膽固醇或血凝塊阻塞時,會形成斑塊而引致心臟供血不足,患者需要接受俗稱「通波仔」(粵語打通用的氣球)的血管擴張手術以氣球擴張冠狀動脈,使之暢通。若冠狀動脈血液被嚴重阻塞,可引致很嚴重的後果。血液不能供應到心臟會引致劇烈的心絞痛,然後心臟會衰竭,最嚴重的可導致死亡。當冠心病發作時,須立即口含醫師處方的「脷底丸」(粵語舌下丸之義),其可扩张血管,以增加冠状动脉血流量。冠心病發作可引致嚴重後果,應立即叫救護車求助。

健康的生活方式

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药物治疗

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手術治療

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参考资料

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外部链接

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