Coronary artery disease/冠狀動脈疾病

{{Infobox disease

| Name           = 冠狀動脈疾病 / Coronary artery disease

| Image          = Blausen 0257 CoronaryArtery Plaque.png

| Caption        = 冠狀動脈粥樣硬化示意圖

| DiseasesDB     =

| ICD10          = {{ICD10|I|20||i|20}}-{{ICD10|I|25||i|20}}

| ICD9           = {{ICD9|410}}-{{ICD9|414}}, {{ICD9|429.2}}

| ICDO           =

| OMIM           =

| MedlinePlus    = 007115

| eMedicineSubj  = radio

| eMedicineTopic = 192

| MeshID         = D003324


Coronary artery disease (CAD), also known as ischemic heart disease (IHD),[1] atherosclerotic heart disease,[2]atherosclerotic cardiovascular disease,[3] and coronary heart disease,[4] is a group of diseases that includes: stable angina,unstable angina, myocardial infarction, and sudden coronary death.[5] It is within the group of cardiovascular diseases of which it is the most common type.[6] A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.[7] Occasionally it may feel like heartburn.[7] Usually symptoms occur with exercise or emotional stress lasts less than a few minutes and get better with rest.[7] Shortness of breath may also occur and sometimes no symptoms are present.[7] The first sign is occasionally a heart attack.[8] Other complications include heart failure or an irregular heartbeat.[8]

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’’’冠狀動脈疾病’’’({{lang-en|Coronary artery disease, CAD}})又稱為’’’缺血性心臟病’’’或簡稱’’’冠心病’’’({{lang-en|ischemic heart disease, IHD}})[1]、’’’冠狀動脈粥狀硬化心臟病’’’[2]、’’’冠狀動脈粥狀硬化心血管疾病’’’({{lang-en|coronary atherosclerotic heart disease, ’’’CAHD’’’}})[3]和’’’冠狀動脈心臟病’’’({{lang-en|coronary heart disease}})[4],是一群包含穩定型[[心絞痛]]、{{Link-en|非穩定型心絞痛|Unstable angina}}、[[心肌梗塞]]和[[猝死]]的疾病[5]。冠狀動脈疾病是最常見的[[心血管疾病|心臟血管疾病]][6]。常見的症狀包括{{link-en|胸痛|chest pain}}或不適,有時會轉移到肩膀、手臂、背部、頸部或下顎[7]。有些人可能會有{{Link-en|胸口灼熱|Heartburn}}的感覺[7]。通常症狀在運動或情緒壓力下出現,持續時間不超過數分鐘且休息會緩解[7]。有時會伴隨[[呼吸困難]],有時則是毫無症狀[7]。少數人以[[心肌梗塞]]為最初的表現[8]。其他可能的併發症包含[[心臟衰竭]]或[[心律不整]][8]。

Risk factors include: high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol, among others.[9][10] Other risks include depression.[11] The underlying mechanism involves atherosclerosis of the arteries of the heart.[10] A number of tests may help with diagnoses including: electrocardiogram, cardiac stress testing, and coronary angiogram among others.[12]

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危險因子包括:[[高血壓]]、[[吸菸|抽菸]]、[[糖尿病]]、缺乏運動、[[肥胖症|肥胖]]、{{Link-en|血液中膽固醇含量過高|Hypercholesterolemia}}、營養不良和酗[[乙醇|酒]]等[9][10]。其他的危險因子也包括[[重性憂鬱障礙|憂鬱症]][11]。潛在的病理機制與[[冠狀血管|冠狀動脈血管]]的[[動脈粥樣硬化|粥狀硬化]]有關[10]。[[心電圖]]、{{Link-en|心臟壓力測試|Cardiac stress test}}與{{Link-en|冠狀動脈血管攝影|Coronary catheterization}}是常見有助於診斷的工具[12]。

Prevention is by eating a healthy diet, regular exercise, maintaining a healthy weight and not smoking.[13] Sometimes medication for diabetes, high cholesterol, or high blood pressure are also used.[13] There is limited evidence for screening people who are at low risk and do not have symptoms.[14] Treatment involves the same measures as prevention.[15][16] Additional medications such as aspirin beta blockers, or nitrogylcerin may be recommended.[16] Procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) may be used in severe disease.[16][17] 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.[18]


預防方式包括:健康飲食、規律運動、體重控制以及戒菸[13]。視情況合併使用藥物控制高血糖、高膽固醇或高血壓[13]。只有很有限的證據支持對低風險且沒有症狀的民眾實施篩檢[14]。最初治療和預防措施一樣,包括生活方式調整以及三高(高血糖、高膽固醇或高血壓)的控制[15][16]。進一步的藥物治療包括[[阿斯匹靈]]、{{link-en|乙型交感神經阻斷劑|Beta_blocker}}或{{link-en|硝酸甘油|Medical_use_of_nitroglycerin|硝酸甘油的醫療用途}}[16]。在病況較嚴重的情形下,會考慮進行[[冠狀動脈再成形術|經皮冠狀動脈介入治療]]({{lang-en|percutaneous coronary intervention, PCI}})或是[[冠狀動脈搭橋手術|冠狀動脈繞道手術]]({{lang-en|coronary artery bypass surgery, CABG}})[16][17]。對於穩定型心絞痛,經皮冠狀動脈介入治療或是冠狀動脈繞道手術,對於提升存活年限或降低未來心臟病發的效果仍不明確[18]。

In 2013 CAD was the most common cause of death globally, resulting in 8.14 million deaths (16.8%) up from 5.74 million deaths (12%) in 1990.[6] The risk of death from CAD for a given age has decreased between 1980 and 2010 especially in the developed world.[19] The number of cases of CAD for a given age has also decreased between 1990 and 2010.[20] In the United States 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.[21] Rates are higher among men than women of a given age.[21]

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2015-03-29 已整合此篇至中文維基百科「冠狀動脈疾病」條目