Coronary heart disease

Coronary heart disease: what is it and how can physiotherapy help?

Coronary artery disease (CHD) is a condition in which the blood vessels that supply oxygen to the heart are narrowed or blocked. The cause of this is usually deposits made of cholesterol, calcium, inflammatory cells and connective tissue that form on the vessel walls. These deposits are also called plaques. If the plaques break or rupture, blood clots can form, which further obstructs or stops blood flow. This can lead to a heart attack or sudden cardiac death.

CHD is a very common and serious disease that causes many deaths and disabilities worldwide. In Germany, around 6 million people suffer from CHD, and around 120,000 people die from it every year. CHD is the most common cause of heart failure, in which the heart can no longer pump enough blood to the body.

The symptoms of CHD can vary depending on the severity and the vessels affected. The most typical complaint is angina pectoris, a feeling of tightness or pain in the chest that often radiates to the left arm or neck. Angina pectoris usually occurs during physical or mental stress when the heart needs more oxygen than it gets. But it can also occur at rest. Other symptoms may include shortness of breath, dizziness, nausea, sweating or a racing heart.

How is CHD diagnosed and treated?

The diagnosis of CHD is based on history, physical examination and various tests that check the function and condition of the heart and blood vessels. These include, for example, an ECG, a stress ECG, an echocardiography, a cardiac catheter examination or a computer tomography of the coronary arteries.

Treatment of CHD has several goals: relieve symptoms, slow or stop disease progression, reduce the risk of complications, and improve quality of life. Treatment always includes drug therapy, which can include various active ingredients such as beta blockers, nitrates, calcium channel blockers, ACE inhibitors, statins or blood thinners, depending on individual needs. The drugs are designed to lower blood pressure, improve blood flow, relieve strain on the heart and reduce cholesterol.

In addition to drug therapy, there are also invasive procedures to treat CHD. The narrowed or blocked vessels are either dilated with a balloon catheter (PCI) or bypassed with a bypass (CABG). These procedures can relieve symptoms and prolong survival, but are not suitable for every patient and also have risks and side effects.

What is the role of physiotherapy in CHD?

Physiotherapy is an important part of rehabilitation after a CHD or a heart attack. Physiotherapy has several benefits for heart health:

- It helps the patient maintain or increase their physical performance.

- It trains the patient how to recognize signs of overload and how to deal with fear and stress.

- It prepares the patient for everyday stress and promotes economical movement behavior.

- It relaxes the muscles and tissues of the chest and improves breathing.

- It supports the patient in changing to a healthy lifestyle that reduces the risk of recurrence of the disease.

Die Physiotherapie bei der KHK umfasst verschiedene Maßnahmen, die individuell auf den Patienten abgestimmt werden. Dazu gehören zum Beispiel:

- A physical workout that promotes endurance, strength, coordination and flexibility. The training can be carried out on a stationary bike, a treadmill, a rowing machine or other equipment. The intensity and duration of the training are controlled based on the patient's heart rate, blood pressure and subjective perception of exertion.

- A respiratory therapy that improves lung function, increases oxygen uptake and reduces shortness of breath. Breathing therapy can include breathing exercises, breathing techniques, breathing aids or inhalations.

- A relaxation therapy that teaches the patient to relax physically and mentally. Relaxation therapy may include progressive muscle relaxation, autogenic training, meditation or other methods.

- Advice and instructions that inform the patient about their illness, their medications, their risk factors and their treatment options. The advice and instructions are intended to motivate the patient to change their lifestyle and stick to the therapy.

Physiotherapy for CHD can be carried out on an outpatient or inpatient basis. The duration and frequency of physical therapy depends on the patient's condition and goals. Physiotherapy is usually recommended for at least three months after CHD.

Conclusion

Coronary heart disease is a serious disease that affects the heart and the entire body. Treatment of CHD requires a combination of medications, invasive procedures, and physical therapy. Physiotherapy is an effective method to relieve symptoms, improve performance, reduce the risk of complications and increase quality of life. Physiotherapy should be individually tailored to the patient and include various aspects such as training, breathing, relaxation and advice. Physiotherapy should be started as early as possible after a CHD or heart attack and continued regularly.