1, concept: coronary atherosclerotic heart disease (coronary atherosclerotic heart disease) is referred to as coronary heart disease, is due to functional or organic lesions of the coronary arteries resulting in myocardial damage caused by the imbalance between coronary blood supply and myocardial demand, coronary heart disease and cerebrovascular disease together is now a common disease in China. Coronary heart disease mostly develops in middle age and above, but the age of onset is gradually getting younger. The morbidity and mortality rate of men is significantly higher than that of women, but the morbidity rate of women after menopause is gradually similar to that of men. 2. Pathology: In normal people, coronary blood flow is 250 ml per minute at rest, accounting for 5% of cardiac blood output. Myocardial oxygen uptake is relatively constant, about 150 ml of oxygen per 1000 ml of coronary blood flow. myocardial cells oxygen partial pressure is the main factor regulating coronary blood flow. When physical activity or emotional excitement, the number of heart beats increases, the contraction force increases, and the tension of the ventricular wall increases, resulting in increased myocardial oxygen demand, the partial pressure of arterial blood oxygen decreases, and the coronary blood flow increases accordingly to meet the myocardial oxygen demand. If the coronary artery lumen is narrowed, the myocardial oxygen demand increases, but the coronary artery blood supply cannot increase accordingly, and the clinical symptoms of myocardial ischemia appear. Prolonged severe myocardial ischemia can lead to myocardial cell necrosis. Generally speaking, if we compare the heart to a machine, coronary artery disease can be interpreted as a series of symptoms caused by a disorder in the oil supply system of the machine, resulting in a decrease in the maximum oil supply of the machine. 3, symptoms: asymptomatic (insidious), symptomatic (angina pectoris, heart attack, heart failure, sudden death), clinically seen mostly refers to symptomatic coronary heart disease. Common manifestations are as follows: (1) angina pectoris: light luminal stenosis may not show symptoms of myocardial ischemia. In severe cases, the coronary blood flow can be reduced to the extent that it can only meet the oxygen demand of the myocardium at rest; however, when physical labor, emotional excitement and other situations, the increase in myocardial oxygen demand can cause or aggravate the insufficient supply of myocardial blood oxygen, resulting in symptoms such as angina. (2) Myocardial infarction coronary artery spasm or acute obstruction for a long time, the formation of thrombus in the lumen of the blood vessel, so that part of the myocardium occurs severe and persistent ischemia, can cause local myocardial necrosis, that is, myocardial infarction. Myocardial infarction most often occurs in the area of the anterior descending branch of the left coronary artery. Acute myocardial infarction can cause severe arrhythmias, cardiogenic shock, heart failure or ventricular wall rupture, and the mortality rate is still high. (3) Heart failure: Patients who have had a myocardial infarction may later form a ventricular wall tumor because the necrotic myocardium is replaced by paralyzed scar tissue and the diseased ventricular wall is weak. The lesion spreads to the papillary muscle, or the key cord is necrotic and breaks, which produces mitral valve closure insufficiency. If the lesion spreads to the ventricular septum, it can be perforated and become a ventricular septal defect. Long-term myocardial ischemia and hypoxia cause extensive myocardial degeneration and fibrosis, resulting in cardiac dilatation. The clinical manifestation is a syndrome dominated by cardiac insufficiency, called ischemic cardiomyopathy, with a poor prognosis. (4) Sudden death: the onset of acute cardiac arrest or malignant arrhythmia, most of the current sudden deaths are of cardiac origin. 4, treatment: At present, the treatment of coronary heart disease can be divided into three categories: medical drug therapy, mediator therapy and surgical treatment. Should be selected according to the specific circumstances of the patient.