Atherosclerosis is the fundamental cause of ischaemic heart disease. It involves males about four times more than females. Disorders of lipid metabolism such as diabetes, hypothyroidism and hypercholesterolemia are often associated with coronary atherosclerosis.
There is segmental atherosclerotic plaque often localized within the first 5 cm of the origin of coronary artery form the aorta. A common pattern is occlusion of the proximal anterior descending coronary artery with distal 50% remaining patent. The right coronary artery frequently occluded.
Angina pectoris is the most common manifestation. Patients experience periods of discomfort particularly appearing with exertion. Myocardial infarction is complication of coronary disease. In a small percentage of patients congestive cardiac failure may eventually develop.
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