COLUMBIA (WACH) - More than a million Americans have heart attacks a year. The heart muscle needs a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with blood supply. Coronary artery disease causes the arteries to narrow and blood will not flow properly. Fatty matter, proteins, calcium, and inflammatory cells build up within the arteries to form plaques of different sizes.
The plaque deposits are hard on the outside and soft on the inside. When plaque is hard, the outer shell cracks and platelets come to the area, and blood clots form around the plaque. If a blood clot totally blocks the artery, the heart muscle becomes â??starvedâ?? for oxygen. Over time, death of heart muscle cells occurs, causing permanent damage. This is a heart attack.
â??Heart disease is all about fluid. Itâ??s the heart not being able to perform well; itâ??s too weak, so fluid backs up, for example to the lung or to the circulation and then accumulates inside the body. The other variable that is included in this score is whether the patient is on a specific medication. This medication is called an ACE inhibitor or an angiotensin receptor blocker. The fact that the patient is on that medication is good because it is linked to patients doing better over time; the fact that the patient is not on that may be an indicator the patient is worsening or is doing poorly. The third variable is what we call near heart association functional class that basically grades the degree of shortness of breath. Patients with heart failure have shortness of breath which is a manifestation of fluid that backs up to the lungs and the more shortness of breath that you have, the higher that score. The fourth variable is a little bit more complex to explain, but itâ??s basically related to how we perform given exercise. An analogy can be when we get our car to measure the gas every year or every so often to see how the engine is working, so the emissions in the car are way of judging how our car is doing in general. And in the body is about the same. How well our heart is performing we can measure with a mask and the result of that evaluation we can plug it into the score as well. This is called cardiopulmonary exercise test and the result of that test is the fourth variable of this score.â??