Cardiovascular disease, a relatively rare event 100 years ago, reached epidemic proportions during the middle of the twentieth century. The term angina pectoris was introduced into the medical literature by william heberden, a british physician, in the latter part of the eighteenth century. He was unable to offer any treatment for this strange malady. It was not until 1910 that recurrent episodes of angina pectoris began to be connected to heart disease by physicians. Chest pain and other manifestations of a heart attack were not identified with obstructions of the coronary arteries until the early 1900s. The first accurate description of the events associated with a heart attack by an american physician occurred in 1912. The illness he described, which afflicted a 55 year old man with no previous evidence of disease, is now a common occurrence in american life. The man died 3 days after the onset of symptoms. A postmortem examination of the heart revealed the formation of a clot that had occluded, or blocked, one of the major coronary arteries. In 1912, this was a medical rarity.Coronary heart disease is responsible for the majority of heart attack deaths, but other forms of heart disease contribute to disability and death. Congenital heart defects exist at birth and affect approximately 32,000 newborns annually. Approximately 5600 of these infants die from their defects. Rheumatic heart disease, caused by a streptococcal infection of the throat or ear, is virtually 100% preventable. Antibiotic treatment during the infection stage will arrest the processes that might lead to rheumatic heart disease. Congestive heart failure occurs when the heart muscle is so damaged that it can no longer contract with sufficient force to pump blood throughout the body. The damage is usually caused by long standing hypertension. Mild to moderate hypertension may be controlled through appropriate lifestyle interventions; severe hypertension requires medication in addition to lifestyle modifications.

Coronary Heart Disease

Coronary heart disease (also known as coronary artery disease) is actually a disease of the arteries that supply the heart with blood and nutrients. A diagnosis of coronary artery disease is made if any artery is 60% occluded. A heart attack, or myocardial infarction (death of heart muscle tissue), occurs when an obstruction or spasm disrupts or terminates blood flow to a portion of the heart muscle. The amount of heart muscle damage is determined by the location of the obstruction or spasm and the speed with which medical intervention is begun. Heart attacks of any magnitude produce irreversible injury and myocardial tissue death. It usually takes 5 to 6 weeks to form a fibrous scar around dead cardiac tissue. This area of dead tissue can no longer contribute to the pumping of blood, resulting in a less efficient heart. Massive heart attacks that cause extensive muscle damage result in death.

Stroke

The majority of strokes (cerebrovascular accidents) follow the same sequence of events that results in coronary heart disease. A stroke is essentially the result of diseased blood vessels that supply the brain. It shares the same risk factors as coronary heart disease, and it takes years to develop.