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Aneurysm: Sometimes Atherosclerosis can cause weakening of the arterial walls and as time goes by, this wall can protrude in the attenuated area.

The protruding area is called aneurysm and it is exposed to more hazards than normal areas: rupture because of wall weakness, exertion of pressure on other vessels due to the unnatural protrusion and creation of blood clots in the aneurysm with the dangerous possibility of embolism (a thrombus thrown from the heart to a distant location, where it can cause damage).

Sometimes surgical intervention may be necessary.
Angina Pectoris: A condition characterized by recurrent episodes of distressing chest pain resulting from ischemia, i.e. discrepancy between oxygen consumption and oxygen supply to the heart at a given moment. The main reason for Angina Pectoris is occlusion of a Coronary artery (artery of the heart) by an Atherosclerotic plaque, but other cases are also possible, where pains are due to a spasm of a Coronary artery caused by contraction of the smooth muscle in its walls.. At early stages of the disease, the pain appears mainly after strain or excitement accompanied by pulse acceleration. In more advanced stages, pains can appear after slight efforts or even at rest.
Arteriosclerosis (calcification of arteries): Sedimentation of calcium into the arterial walls. This process or condition is different from atherosclerosis.
Atheroma: A lipid sediment narrowing the lumen of an artery. It is formed as part of a disease known as Atherosclerosis.
Atherosclerosis: An arterial disease characterized by the development of lipid plaques in the inner lining of the artery. The lipid sediments are accompanied by local inflammatory processes and by accelerated division of muscle and connective tissue cells; the final result is a plaque narrowing the lumen of the arterial vessel and diminishing the amount of blood that can pass through it at any given time. The clinical effects secondary to the existence of such a plaque in an artery can range from total absence of symptoms, through an expected and gradual clinical manifestation (development of Angina Pectoris in stress situations only) and up to a violent and unexpected event of heart attack.
Balloon angioplasty (coronary angioplasty, PTCA): A therapeutic procedure performed during catheterization (Coronary Angiography) aimed at dilating a Coronary artery with stenosis caused by an atherosclerotic process. The dilatation is performed by inflating a balloon and exerting pressure upon the lipid plaque in the arterial wall.

The ballooning procedure can often replace the necessity of performing bypass surgery and an open heart operation may thus be spared from many patients, although not every lipid plaque can be dilated by this method.

One of the undesired adverse events of this procedure is re-occlusion of the dilated artery after a relatively short time. To minimize the chance of re-occlusion, stents are used.
Balloon catheter, balloon-tip catheter: A catheter with a balloon at its tip used for dilating a blood vessel or a narrowed intestine or for draining the content of an organ, such as the urinary bladder.
Collateral circulation: Circulation bypassing the main (occluded) vessels. Such circulation develops when an occlusion of a main vessel exists.

It is part of the correction and compensation mechanism, by which the growth of natural vessels bypassing the occlusion is promoted.

Such natural bypasses are only partially efficient and seldom constitute an adequate solution of a significant atherosclerotic problem.

Regular aerobic sport activity helps in the development of such natural bypasses.
Coronary Heart Disease, Ischemic Heart Disease (IHD ,CHD): A disease characterized by decreased blood flow in the coronary arteries resulting from stenosis.

In most cases, these stenoses (narrowing) is caused by Atherosclerosis, a process in which lipid plaques are formed upon the arterial wall, whereby the lumen is narrowed and less blood can flow in them at any given moment.

If the oxygen requirement at a given time exceeds the possible supply by the stenosed Coronary artery, relative oxygen deficit ensues. This deficit is called Ischemia.

Ischemia can cause biochemical, electrical and temporary functional alterations in the heart and the patient usually experiences distressing pressure pain in the front of the chest, which is known as Angina Pectoris.

The course of Ischemic disease depends on the extent of the lipid plaques, their localization and the processes occurring in them.

If a lipid plaque grows slowly and is stable, gradual appearance of symptoms is the rule, known as stable Angina Pectoris. The characteristic trait of this form of the disease is the appearance of Ischemia when the demand for oxygen exceeds the supply.

Because the highest oxygen requirement occurs during strenuous heart action, physical exercise or mental stress are known triggers for the appearance of ischemic pain.

If processes inside the lipid plaque cause the rupture of its envelope with creation of a blood clot (thrombus) on its surface, the course of ischemic disease can become stormy and result in myocardial infarction, rhythm disturbances and even sudden death.
External cardiac massage: A rescue action, which is part of the resuscitation procedure. The massage is performed by serial exertion of pressure and relaxation on the chest bone, at the rate of about 100 per minute. The massage is kind of external squeezing of the heart causing its voiding and filling to a certain extent and thus preserving cardiac output and blood flow to vital body organs for the duration of the resuscitation.

The quality of cardiac massage and the proficiency of the person performing it are considered as having major importance on the success of the resuscitation procedure.
Heart-lung machine: In most cardiac surgical procedures temporary interruption of the contractile activity of the heart is required in order to enable the surgeon the performance of the desired repair of the existing damage.

In such situations, blood must be stored in an external machine that practically mimics the heart and lung action.

Such machines include a pump and an oxygenation system. Blood is sent to the machine by tubing inserted to the veins draining oxygen-depleted blood into the right heart. After oxygenation, blood is returned under pressure to a great artery.
Herz-Bypass-Operation: Mit einer Bypass-Operation wird für ein verengtes Blutgefäß am Herzen eine Umleitung gelegt (Bypass: engl. für Umleitung). Meistens werden dafür Venen aus den Beinen oder die inneren Brustarterien verwendet. Bei einer Bypassoperation ist der Einsatz einer Herz-Lungen-Maschine meist notwendig. Minimal invasiv werden zunehmend Bypässe am Herzen auch ohne Herz-Lungen-Maschine operiert. Bypässe mit Arterien sind widerstandsfähig und das Risiko für kurzfristig auftretende Re-Stenosen, als neue Verengungen, ist niedriger als bei Bypässen mit Venen.
Myocardial infarction: This process is called in popular language “heart attack”. Myocardial infarction is caused by occlusion of an artery responsible for blood and oxygen supply to a given area of the heart. Such occlusion usually occurs by a joint action of a lipid plaque (atherosclerosis, sclerosis) and an overlying blood clot (thrombus). As a result of such occlusion, the vital oxygen supply is cut-off from this area and the involved cells undergo a process of necrosis, during which a proportion of cells are irreversibly damaged and die.
Myocardial ischemia: Ischemia is a condition, in which there is discrepancy between oxygen requirement at a given time and the amount of oxygen supplied to the heart. Such discrepancy is usually due to a partial narrowing of an artery caused in most cases by the formation of a lipid plaque in the arterial wall. Narrowing of an artery (stenosis) limits the blood amount flowing through it, with reduced amount of oxygen supplied to the area by such a vessel. Because the oxygen requirement of the heart grows with increased body activity, situations that increase the activity of the heart, such as exercise or mental stress may induce this discrepancy between oxygen demand and supply and thus induce ischemia.
Open Heart Surgery: A surgical intervention requiring temporary interruption of the heart action and connecting the patient to a heart-lung machine.
Spasm of a coronary artery, Prinzmetal’s angina: An abnormal contraction of the smooth muscle of a Coronary artery.

Such contraction causes significant narrowing of the vessel and reduced blood flow that can pass through this artery.

The reduction in blood flow and in oxygen supply may induce symptoms of Angina Pectoris and in some instances even cause Myocardial Infarction.

This condition tends to occur rather in young individuals and to appear at rest.

The treatment is usually medical by drugs preventing smooth muscle contraction.
Stenocardia: See entry: Angina pectoris
Stent: A device in the form of a spring for supporting tubular structures.

The common use of stents in cardiology is as a supplement to Angioplasty (ballooning) procedures. One of the principal problems of the ballooning procedure for dilating a Coronary artery was re-stenosis of the dilated segment after a relative short time.

The use of stents substantially reduced the rate of re-stenosis.

Recently, stents that act also by chemical methods by secreting a substance, which is capable of reducing cell replication (drug eluting stents), were developed. This can further reduce the rate of re-stenosis.
Thrombolysis: Lysis means dissolution, liquefaction. Thrombus is a blood clot. Thus, thrombolysis means chemical dissolution of blood clots by drugs.

The best known drugs for this purpose are streptokinase and TPA.

These drugs are given intravenously in certain cases of myocardial infarction (heart attack) to dissolve the blood clot, which together with a lipid plaque in the arterial wall totally occlude it.

One of the undesired inherent side effects of these drugs is that they can cause bleeding. Therefore, there are strict indications for the administration of such drugs.
Thrombus (blood clot, clot): A solid mass formed by blood clotting in a blood vessel or in the heart. Blood clots consist of a mesh of protein called fibrin, in which blood cells are captured.

The main risk of a thrombus is occluding a blood vessel and thereby reducing or interrupting blood flow in this vessel.

The negative influence of a thrombus may be manifested at the site where it was formed or at a remote site, where it arrives as embolus.

An example of a condition, in which thrombus causes local damage is Myocardial Infarction. Most Myocardial Infarctions occur through a mixed mechanism of thrombus occurring upon a lipid plaque (Atherosclerosis) which together can totally occlude an artery and prevent blood and oxygen supply to a part of the heart nourished by this particular artery.

An example of a thrombus that has an impact on a remote site is embolism. This is an event of a thrombus formed in the heart, which is expelled during ventricular systole to the Aorta and from there it reaches with the blood stream a remote organ, such as brain or kidney, where it causes an ischemic damage.

There are special medical conditions with increased tendency to embolism. Such are for instance rhythm disorders called Atrial Fibrillation or state after valve replacement. Blood clots formed in the heart may be sent from there as thromboembolism to different body organs and cause an ischemic damage to these organs.

Therefore, patients suffering from such conditions are often treated with drugs preventing blood coagulation (sometimes called blood thinners).

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