Coronary Heart Disease: A Case Study

Coronary Heart Disease is a cardiovascular disease which is the leading cause of death in high income countries and causes more than 73,000 deaths in the UK each year. Approximately 1 in 10 women and 1 in 6 men die from CHD, although the chances become similar from the age of fifty. (Nhs.uk, 2016)

CHD is caused by a gradual build up of fatty material called Atheroma within the walls of the coronary arteries, which supply the heart with oxygen rich blood. This causes the arteries to become narrow, restricting the flow of blood to the heart; this process is called Atherosclerosis (figure 1). Atheroma is made up of cholesterol and other waste substances. If a piece of this were to break off, it may cause a blood clot or blockage within the coronary
The most common test is an ECG which is a simple, painless test that records the electrical activity and rhythm of the heart. During an acute myocardial infarction, the ECG evolves through three stages: T wave peaking followed by T wave inversion, ST segment elevation and appearance of new Q waves. Any of these changes may be present without any of the others. (Thaler, 2012) An abnormal reading does not always indicate a heart problem; likewise a normal reading does not automatically rule it out. An echocardiogram can identify the structure and pumping function of the heart, the valve movements and the heart muscle thickness, in order to give a detailed picture of the heart. MRI and CT scans show detailed images of the heart. MRI scans use magnetic field and radio waves to produce the images, whereas CT scans use x-rays. (Nhs.uk,
Areas such as clinical information from history and physical examination, functional and imaging studies and biochemical biomarkers need to be integrated into a new taxonomy of Cardiovascular Diseases to allow personalised disease management. Non-invasive tools have been developed to figure out both structure and function of heart and vessels by ultrasound or magnetic resonance imaging. Combining molecular markers with advanced imaging can further clarify taxonomy, with potential for molecular imaging. (Swedberg et al., 2014) The future goal for personalised medicine within CHD is to enable physiologically realistic models of blood flow through the arteries based on a 3D image during patients' visit. The end goal is for patients to predict and assess their own personal health benefits of treatment, diet and exercise on their own device which would monitor their blood pressure and medication levels daily. (Parlab.eecs.berkeley.edu,