Editing Cardiology (section)

=== Coronary artery disease ===
{{Main|Coronary artery disease}}

Coronary artery disease, also known as "ischemic heart disease",<ref>{{cite book|last=Bhatia|first=Sujata K.|title=Biomaterials for clinical applications|year=2010|publisher=Springer|location=New York|isbn=9781441969200|page=23|url=https://books.google.com/books?id=bXtaX468LRYC&pg=PA23|edition=Online-Ausg.}}</ref> is a group of diseases that includes: [[stable angina]], [[unstable angina]], myocardial infarction, and is one of the causes of [[sudden cardiac death]].<ref name=Wong2014>{{cite journal|last1=Wong|first1=ND|title=Epidemiological studies of CHD and the evolution of preventive cardiology.|journal=Nature Reviews. Cardiology|date=May 2014|volume=11|issue=5|pages=276–89|pmid=24663092|doi=10.1038/nrcardio.2014.26|s2cid=9327889}}</ref> It is within the group of cardiovascular diseases of which it is the most common type.<ref name="pmid25530442"/> A common symptom is [[chest pain]] or discomfort which may travel into the shoulder, arm, back, neck, or jaw.<ref name=HLB2014/> Occasionally it may feel like [[heartburn]]. Usually symptoms occur with exercise or emotional [[Stress (psychological)|stress]], last less than a few minutes, and get better with rest.<ref name=HLB2014/> [[Shortness of breath]] may also occur and sometimes no symptoms are present.<ref name=HLB2014>{{cite web|title=What Are the Signs and Symptoms of Coronary Heart Disease?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs|access-date=23 February 2015|date=29 September 2014|archive-url=https://web.archive.org/web/20150224034615/http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs|archive-date=24 February 2015|url-status=dead}}</ref> The first sign is occasionally a heart attack.<ref name=CDC2013/> Other complications include [[heart failure]] or an [[Heart arrhythmia|irregular heartbeat]].<ref name=CDC2013>{{cite web|title=Coronary Artery Disease (CAD)|url=https://www.cdc.gov/heartdisease/coronary_ad.htm|access-date=23 February 2015|date=12 March 2013|archive-url=https://web.archive.org/web/20150302152003/http://www.cdc.gov/heartdisease/coronary_ad.htm|archive-date=2 March 2015|url-status=dead}}</ref>

<!--Cause and diagnosis -->
Risk factors include: [[hypertension|high blood pressure]], [[tobacco smoking|smoking]], [[diabetes mellitus|diabetes]], lack of exercise, [[obesity]], [[hypercholesterolaemia|high blood cholesterol]], poor diet, and excessive [[ethanol|alcohol]], among others.<ref>{{cite journal|last1=Mehta|first1=PK|last2=Wei|first2=J|last3=Wenger|first3=NK|title=Ischemic heart disease in women: A focus on risk factors|journal=Trends in Cardiovascular Medicine|date=16 October 2014|pmid=25453985|doi=10.1016/j.tcm.2014.10.005|volume=25|issue=2|pages=140–151|pmc=4336825}}</ref><ref name=WHO2011b>{{cite book|last1=Mendis|first1=Shanthi|last2=Puska|first2=Pekka|last3=Norrving|first3=Bo|title=Global atlas on cardiovascular disease prevention and control|date=2011|publisher=World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization|location=Geneva|isbn=9789241564373|pages=3–18|edition=1st|url=http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf?ua=1}}</ref> Other risks include [[major depressive disorder|depression]].<ref>{{cite journal|last1=Charlson|first1=FJ|last2=Moran|first2=AE|last3=Freedman|first3=G|last4=Norman|first4=RE|last5=Stapelberg|first5=NJ|last6=Baxter|first6=AJ|last7=Vos|first7=T|last8=Whiteford|first8=HA|title=The contribution of major depression to the global burden of ischemic heart disease: a comparative risk assessment|journal=BMC Medicine|date=26 November 2013|volume=11|page=250|pmid=24274053|doi=10.1186/1741-7015-11-250|pmc=4222499 |doi-access=free }}</ref> The underlying mechanism involves [[atherosclerosis]] of the [[Coronary circulation|arteries of the heart]]. A number of tests may help with diagnoses including: electrocardiogram, [[cardiac stress test]]ing, [[coronary computed tomographic angiography]], and [[Coronary catheterization|coronary angiogram]], among others.<ref>{{cite web|title=How Is Coronary Heart Disease Diagnosed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/diagnosis|access-date=25 February 2015|date=29 September 2014}}</ref>

<!-- Prevention and treatment -->
Prevention is by eating a healthy diet, regular exercise, maintaining a healthy weight and not smoking.<ref name=HLB2013P/> Sometimes medication for diabetes, high cholesterol, or high blood pressure are also used.<ref name=HLB2013P>{{cite web|title=How Can Coronary Heart Disease Be Prevented or Delayed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/prevention|access-date=25 February 2015}}</ref> There is limited evidence for screening people who are at low risk and do not have symptoms.<ref>{{cite journal|last1=Desai|first1=CS|last2=Blumenthal|first2=RS|last3=Greenland|first3=P|title=Screening low-risk individuals for coronary artery disease|journal=Current Atherosclerosis Reports|date=April 2014|volume=16|issue=4|page=402|pmid=24522859|doi=10.1007/s11883-014-0402-8|s2cid=39392260}}</ref> Treatment involves the same measures as prevention.<ref>{{cite journal|last1=Boden|first1=WE|last2=Franklin|first2=B|last3=Berra|first3=K|last4=Haskell|first4=WL|last5=Calfas|first5=KJ|last6=Zimmerman|first6=FH|last7=Wenger|first7=NK|title=Exercise as a therapeutic intervention in patients with stable ischemic heart disease: an underfilled prescription.|journal=The American Journal of Medicine|date=October 2014|volume=127|issue=10|pages=905–11|pmid=24844736|doi=10.1016/j.amjmed.2014.05.007}}</ref><ref name=HLB2013Tr/> Additional medications such as [[antiplatelet drug|antiplatelets]] including [[aspirin]], [[beta blocker]]s, or [[Medical use of nitroglycerin|nitroglycerin]] may be recommended.<ref name=HLB2013Tr/> Procedures such as [[percutaneous coronary intervention]] (PCI) or [[coronary artery bypass surgery]] (CABG) may be used in severe disease.<ref name=HLB2013Tr>{{cite web|title=How Is Coronary Heart Disease Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment|access-date=25 February 2015|date=29 September 2014}}</ref><ref>{{cite journal|last1=Deb|first1=S|last2=Wijeysundera|first2=HC|last3=Ko|first3=DT|last4=Tsubota|first4=H|last5=Hill|first5=S|last6=Fremes|first6=SE|title=Coronary artery bypass graft surgery vs percutaneous interventions in coronary revascularization: a systematic review.|journal=JAMA|date=20 November 2013|volume=310|issue=19|pages=2086–95|pmid=24240936|doi=10.1001/jama.2013.281718|doi-access=free}}</ref> In those with stable CAD it is unclear if PCI or CABG in addition to the other treatments improve [[life expectancy]] or decreases heart attack risk.<ref>{{cite journal|last1=Rezende|first1=PC|last2=Scudeler|first2=TL|last3=da Costa|first3=LM|last4=Hueb|first4=W|title=Conservative strategy for treatment of stable coronary artery disease|journal=World Journal of Clinical Cases|date=16 February 2015|volume=3|issue=2|pages=163–70|pmid=25685763|doi=10.12998/wjcc.v3.i2.163|pmc=4317610 |doi-access=free }}</ref>

<!--Epidemiology  -->
In 2013 CAD was the [[most common causes of death|most common cause of death]] globally, resulting in 8.14 million deaths (16.8%) up from 5.74 million deaths (12%) in 1990.<ref name="pmid25530442">{{cite journal | vauthors = ((GBD 2013 Mortality and Causes of Death Collaborators))| title = Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 | journal = Lancet | volume = 385 | issue = 9963 | pages = 117–71 | date = January 2015 | pmid = 25530442 | pmc = 4340604 | doi = 10.1016/S0140-6736(14)61682-2 }}</ref> The risk of death from CAD for a given age has decreased between 1980 and 2010 especially in [[developed country|developed countries]].<ref>{{cite journal|last1=Moran|first1=AE|last2=Forouzanfar|first2=MH|last3=Roth|first3=GA|last4=Mensah|first4=GA|last5=Ezzati|first5=M|last6=Murray|first6=CJ|last7=Naghavi|first7=M|title=Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study|journal=Circulation|date=8 April 2014|volume=129|issue=14|pages=1483–92|pmid=24573352|doi=10.1161/circulationaha.113.004042|pmc=4181359}}</ref> The number of cases of CAD for a given age has also decreased between 1990 and 2010.<ref>{{cite journal|last1=Moran|first1=AE|last2=Forouzanfar|first2=MH|last3=Roth|first3=GA|last4=Mensah|first4=GA|last5=Ezzati|first5=M|last6=Flaxman|first6=A|last7=Murray|first7=CJ|last8=Naghavi|first8=M|title=The global burden of ischemic heart disease in 1990 and 2010: the Global Burden of Disease 2010 study|journal=Circulation|date=8 April 2014|volume=129|issue=14|pages=1493–501|pmid=24573351|doi=10.1161/circulationaha.113.004046|pmc=4181601}}</ref> In the U.S. in 2010 about 20% of those over 65 had CAD, while it was present in 7% of those 45 to 64, and 1.3% of those 18 to 45.<ref name=US2011/> Rates are higher among men than women of a given age.<ref name=US2011>{{cite journal|last1=Centers for Disease Control and Prevention|first1=(CDC)|title=Prevalence of coronary heart disease—United States, 2006–2010.|journal=MMWR. Morbidity and Mortality Weekly Report|date=14 October 2011|volume=60|issue=40|pages=1377–81|pmid=21993341}}</ref>