Recognizing the Early Signs of Coronary Heart Disease and How to Treat it Initially ?

Recognizing the Early Signs of Coronary Heart Disease and How to Treat it Initially ?

Cardiovascular disease is the main cause of death in Indonesia, with a mortality rate of 37% in 2013. It is estimated that, until 2030, this disease will remain the main cause of death in the world with an estimated 23.3 million people affected. Countries with low incomes, including Indonesia, have the largest contribution to this mortality rate, which is around 80%. WHO data in 2015 showed that 70% of deaths worldwide were caused by Non-Communicable Diseases, with 45% of them caused by heart and blood vessel disease, or around 17.7 million of 39.5 million deaths. The prevalence of Coronary Heart Disease (CHD) in Indonesia based on the 2013 Riskesdas was 1.5%. BPJS data shows that in 2014, CHD medical expenses reached 4.4 trillion Rupiah, which then increased to 7.4 trillion Rupiah in 2016, an increase of 68.2%. Cardiovascular prevention or prevention aims to reduce the risk of future heart disease by stabilizing, slowing, or even reversing the progression of cardiovascular disease.

Coronary heart disease (CHD) occurs due to a lack of blood supply to the heart muscle due to blockage or narrowing of the coronary arteries caused by damage to the lining of the blood vessels (atherosclerosis). Acute coronary syndrome is a heart attack that occurs due to blockage of the arteries that supply blood to the heart. This is a cardiac emergency condition caused by the death of a portion of the heart muscle. More than 90% of acute coronary syndromes are caused by the rupture of atherosclerotic plaques and the formation of blood clots in the coronary arteries.


Symptoms of Acute Coronary Syndrome include:

1. Pain or discomfort in the chest, usually felt in the substernal area, left chest, or epigastrium, can radiate to the neck, left shoulder, left hand, and back.

2. Sensations such as pressure, squeezing, burning, or pricking.

3. May be accompanied by cold sweat, nausea, vomiting, weakness, dizziness, or even fainting.

4. Symptoms usually appear suddenly and vary in intensity.


Location of chest pain


First Measures in Heart Attack

1. Stopping activities will reduce the heart's workload and can relieve symptoms that appear.

2. If you start to experience symptoms, even if they are mild, call emergency medical services immediately on 119. Do not take your symptoms lightly or try to contain them yourself.

3. It is better to always be ready and call an ambulance when your condition is not too severe than to wait until the condition becomes critical.


Treatment of Acute Coronary Syndrome (Hospital Treatment)

1. Use of pain relievers (eg morphine).

2. Provision of oxygen supplements.

3. Anti-ischemic therapy (eg nitrates, beta blockers, CCB) to reduce the shortage of blood and oxygen supply to the heart.

4. Administration of antiplatelet drugs (such as aspirin, clopidogrel, ticagrelor) and anticoagulants (heparin or low molecular weight heparin) to prevent further blood clots.

5. Fibrinolytic action (for myocardial infarction with ST segment elevation onset less than 12 hours).

6. Percutaneous coronary intervention (PCI) as primary action.


CHD prevention

To prevent coronary heart disease, healthy lifestyle changes are needed with the "CERDIK" principle:

- Routine health checks, including checking blood pressure, cholesterol levels, blood sugar, and measuring weight and height to get a Body Mass Index (BMI) value.

- Avoid exposure to secondhand smoke by quitting smoking and staying away from smoking environments.

- Diligent physical activity at least 30 minutes every day. Start by warming up and stretching before physical activity.

- Implement a healthy and balanced diet in accordance with daily calorie needs. Limit consumption of salt, sugar and fat.

- Make sure you get enough rest by sleeping at least 7 hours every night.

- Manage stress and always think positively in facing daily challenges.


By following the steps above, you can recognize early symptoms of coronary heart disease and take appropriate initial treatment steps. In addition, prevention through healthy lifestyle changes can help reduce the risk of developing coronary heart disease in the future.

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