# The order of the cardiovascular diseases #
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## Hospital-Cardiovascular Diseases ##
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Hospitals in the fight against cardiovascular diseases: challenges and progress
Cardiovascular diseases are the leading causes of death. According to the world health organization (WHO), cases every year, millions of death and Germany is no exception. Hospitals play a Central role in the prevention, diagnosis and treatment of these diseases. But what are the challenges clinicians are facing today, and what advances give hope?
One of the biggest problems is seizures, the high incidence of heart attacks and strokes. In German hospitals every year, hundreds of thousands of patients with such a diagnosis. The emergency departments need to act quickly and efficiently: Every Minute counts when it comes to the care of patients with acute myocardial infarction. Therefore, many hospitals have set up so‑called heart attack networks, ensuring a coordinated supply chain, from first-aid to hospital admission.
The diagnostics has developed in the last few years. Modern methods, such as computed tomography (CT) and magnetic resonance imaging (MRI) allow accurate imaging of the heart and blood vessels. In addition, invasive procedures such as coronary angiography, in the use of a catheter, and contrast, by means of a constriction in the coronary arteries visible. These methods allow Physicians to target and intervene at an early stage.
In the treatment there is significant progress to be made. Percutaneous coronary intervention (PCI), the narrowing of the heart arteries by a balloon catheter, and possibly a Stent to be fixed, has established itself as a standard therapy. Also, the surgical treatment, such as through a Bypass surgery, remains in certain cases, essential. In addition, medications play an important role in the blood pressure-lowering, cholesterol-lowering and Anti-thrombotic agents help to reduce the risk of cardiovascular events in the long term.
However, not only the acute treatment is the focus. Prevention and Rehabilitation are also important. Many hospitals offer a special rehabilitation programs, in which patients are led to a heart attack or surgery to your physical performance approach. To do this, controlled exercise, nutritional counseling and psychosocial support.
Despite all this progress, challenges remain. The demographic change leads to an increase of patients with multiple pre-existing conditions, which complicates the treatment. In addition, the financing of modern treatment methods and devices is a burden for the health system.
In summary: hospitals are Central actors in the fight against cardiovascular diseases. Through the use of innovative diagnostic and treatment procedures, strict quality standards and a holistic approach to Prevention, you can influence the lives of millions of people positively, and the number of preventable deaths and reduce.
Kung nagsimula na ang pag-inom ng gamot para sa mataas na presyon, hindi ibig sabihin na hindi na maaaring gawin ang karagdagang mga hakbang para palakasin ang katawan sa programa ng therapy. Ang benepisyo ng maingat na mga hakbang na pinagkasunduan ng doktor ay nakakatulong para mapigilan ang paglala ng sakit at maiwasang lumipat ito sa mas seryosong yugto.
> Ang pagkontrol sa presyon ay isang napakahalagang gawain, dahil ang pag-inom ng mga tableta na nakakatulong sa pagpapanatili ng normal na mga indikador ay maaaring magbigay ng araw-araw na komportableng buhay, upang maiwasan ang panganib ng hypertensive crisis, atake sa puso, at stroke. Ang mga gamot para sa kontrol ng presyon ay medyo malawakang makukuha sa mga botika, pero tanging ang doktor lang ang makakapili ng tamang gamot na angkop sa therapy. Lahat ng grupo ng gamot para pababain ang presyon ay may iba't ibang mekanismo ng epekto, side effects, at may kaunting posibilidad ng pagkadepende. Ang tamang pagpili ng gamot ay nagbibigay ng mabilis at tuloy-tuloy na resulta, at ang eksperimento sa sarili sa pag-inom ng gamot ay may mataas na posibilidad ng biglaang karamdaman, sakit sa puso at daluyan ng dugo, at sa matinding kaso, maaaring magdulot ng kamatayan.
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The order of the cardiovascular diseases: Pathogenetic cascade and clinical implications
Cardiovascular disease (CVD) is the leading cause of death and include a variety of symptoms, which occur at different levels of the cardiovascular system. An analysis of their typical order allows for a better understanding of the pathogenetic mechanisms and to optimize the prevention and therapy.
1. Predisposing factors and early damage
The development of CVD often begins with predisposing risk factors, including:
Hypertension;
Dyslipidemia;
Diabetes mellitus type 2;
Overweight/Obesity;
Tobacco consumption;
lack of physical activity.
These factors lead to endothelial dysfunction, the first step in the cascade. The endothelium, the inner layer of the blood vessels, it loses its ability to provide adequate vasodilation and shows an increased tendency to Inflammation.
2. Atherosclerosis as a Central process
Then, atherosclerosis develops: lipids (especially LDL cholesterol) deposits in the vascular wall, which triggers a chronic inflammatory response. Macrophages phagocytize the oxidized lipids to form foam cells, which Atheromas develop. These Plaques narrow the vessel lumen and reduce the flow of blood.
3. Clinical manifestations according to the affected vessels
Depending on the localization of atherosclerosis different disease pictures:
Coronary heart disease (CHD): narrowing of the coronary arteries leads to Angina pectoris, acute thrombus formation to myocardial infarction.
Cerebro-vascular disease, atherosclerosis of the cerebral arteries is seizures cause of transient ischemic attacks (TIA) or stroke (apoplekti cher hit).
Peripheral arterial occlusive disease (paod): restriction of the blood flow in the extremities leads to pain when walking (intermittent Klaudikation) and Gewebsschäden in the advanced stage.
4. Heart failure as a result of
Myocardial infarction and chronic conditions (e.g. hypertension) cause damage to the heart muscle. As a result, the heart loses its pumping function, which leads to heart failure. This is manifested by symptoms such as dyspnea, Edema and Fatigabilität.
5. Arrhythmias and other complications
Structural changes of the heart (e.g., scar tissue after infarction) promote electrical dysfunctions. So arrhythmias, including atrial fibrillation is a risk factor for stroke caused.
6. Cycle progression
The sequence is not strictly linear: heart failure can worsen hypertension, arrhythmias increase the thromboembolic risk. These interactions often lead to a self-reinforcing cycle of complications.
Summary
The typical sequence of CVD can be roughly divided as follows:
Risk factors → endoteliale dysfunction → atherosclerosis → regional Ischemia (coronary artery disease, stroke, peripheral arterial disease) → organ damage (heart failure) → secondary complications (arrhythmias, thromboembolism).
Early Intervention in this cascade, for example by lowering the blood pressure, lipid-lowering drugs and lifestyle changes can slow the Progression of cardiovascular diseases significantly and the quality of life and expectation of the patient significantly improve.
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