”Your heart is your health,” a slogan put forward by the World Health Organization 20 years ago, reminds people to protect the heart as a vital organ. According to the World Heart Federation, on average, one in three deaths is caused by cardiovascular disease, and the number of deaths from heart disease and stroke worldwide is as high as 17.2 million each year. Coronary heart disease (coronary atherosclerotic heart disease) is currently the most common cause of human death. Although modern medical technology and preventive medicine have dramatically reduced mortality from ischemic heart disease since the mid-1960s, the number of newly diagnosed patients with coronary artery disease is still increasing, even in the next decade. This disease that does not spare humans, like many human causes of death, still persists. In our country, the number of patients with coronary heart disease is also expected to increase due to improved economic conditions, quality of life, changes in the social environment and lack of health education efforts. Before we understand how the heart function is gradually damaged by the disease, it is better to understand how delicate and complex the normal heart is. The normal heart is only about the size of our fist and is usually located in our left side of the chest cavity. It is made up of four chambers, four valves, two large arteries, and two sets of veins. The used dark red venous blood enters the right heart through the upper and lower vena cava, then enters the pulmonary artery and its branches, where it is oxygenated and reoxygenated in the alveoli, and then turns into bright red arterial blood, which enters the left heart from the pulmonary vein and shoots from the left heart to the aorta, where it is transported to all parts of the body, as far as the toes. Each contraction of the heart ejects about 70 ml of blood, so about 750,000 ml of blood can be pumped out under about 100,000 contractions per day. You can imagine how much strength our left ventricle needs for such a long distance and such a large amount, and the completion of this work also requires very complex and precise procedures to coordinate. In addition to the above, the coronary arteries are responsible for providing nutrient blood to the heart muscle, which is busy with large and small circulation, and are specially differentiated by a group of coronary arteries that surround the heart. When healthy, the coronary arteries are the heart’s friends, but in the event of disease, they often betray the heart when it needs oxygen the most. Coronary artery disease occurs most often in men, especially those older than 50, but the course of this hardening of the blood vessels actually begins at a young age. Due to some factors such as dietary habits, smoking, lack of exercise, high blood pressure and genetics, some plaques will gradually form, mostly composed of cells and connective tissue, with some tissue debris and fat in the center. These plaques will be deposited on the wall of the tube, and over time, they will get bigger and bigger and merge with the adjacent plaques, blocking the blood vessels and making them brittle, hard and narrow. A hardened blood vessel is like an old lead pipe with a thick layer of rust and deposits built up on the inner edge. A narrowed blood vessel cannot accommodate a larger amount of blood flow through it, and without enough blood, there is not enough hemoglobin – a protein that carries oxygen – for the heart muscle to get enough oxygen. The body may be able to tolerate blood with little oxygen at rest, but when organ activity increases, oxygen demand rises and so does blood demand. If the arteries are narrowed and cannot expand to increase blood flow to organ tissues, or if for some reason the walls are contracted and blood flow is reduced, so that the oxygen demand of the organs exceeds the amount of oxygen supplied by the blood flow, ischemia results. In pain or anger, the heart warns you with chest tightness and pressure that you must immediately stop activities that increase the load on your heart muscle. This is not an uncommon occurrence and can hide a considerable danger, which we call angina pectoris. Angina usually strikes after walking, climbing, or eating, with a cramping sensation in the chest, similar to a tightening sensation, or pressure, as if an unbearable weight is pressing on the forehead, and the pain extends to the left arm, neck, and jaw. The pain felt by the patient is mostly cold sweat, nausea, vomiting, shortness of breath, and sometimes even the feeling of death. However, these symptoms may be relieved if the patient stops the activity and rests immediately. The symptoms will worsen after a period of time, not only when walking and other exertions occur, but also when swallowing, coughing, relieving stool, talking, and also during sleep, making the patient have to get up. Sudden emotional or exercise stimulation causes the blood vessels to tighten, which may tear the thrombotic plaque in the coronary artery wall. Once this occurs, the torn clot will cause the clot to clump and completely block the blood vessel, worsening the already inadequate blood flow to the heart. If the ischemic situation does not improve within 10 minutes, a myocardial infarction can result. In the event of a myocardial infarction, approximately 20% of patients will die before reaching the emergency room, but the death rate will be reduced by at least half if they reach the hospital in time. Although the blockage of a small branch of the coronary artery does not alert the patient, the damage to the heart muscle is small enough to cause a major problem, and this injured, swollen heart muscle will barely last until it gradually heals and scars. However, this area, which cannot beat as strongly and regularly as other areas, will still impair the contraction power of the ventricles. As the patient recovers from each myocardial infarction, he loses a piece of good heart muscle and adds a piece of crusted tissue, and the strength of the ventricles gradually decreases as a result. Over time, this can become heart failure. If a very large branch is suddenly occluded, it may cause extensive myocardial necrosis, which may lead to sudden cardiac death. In most patients who die, multiple infarctions usually occur and have been treated successfully several times, but there is a progressive loss of heart function that eventually leads to heart failure. The loss of heart function may be due to loss of contractility, or it may be due to arrhythmias caused by necrotic heart muscle that disrupts the consistency of the heart’s contractions. The left ventricle, the heart’s most powerful pump, the powerhouse of nutrients for tissues and organs throughout the body, is damaged in almost every heart attack – with every cigarette, piece of cream, slice of meat and rising blood pressure, the coronary arteries are made harder and harder, offering increasing resistance to blood flow. Nowadays, the age of onset of coronary heart disease has a tendency to become younger and younger. Clinically, we have encountered several patients who have already developed significant narrowing of all three blood vessels before the age of thirty, so we must pay attention to this and not neglect the maintenance of our health because we think we seem to be in pretty good health. For coronary heart disease, two levels of prevention are advocated in China. Primary prevention is prevention for people without coronary heart disease, aiming at delaying and preventing the occurrence and development of coronary atherosclerosis. Obesity, smoking, hypertension, diabetes, hyperlipidemia, and type A personality (aggressive and impatient personality) are all high-risk factors closely related to coronary heart disease. Therefore primary prevention involves maintaining blood pressure, lipids, blood glucose and body weight in a normal range; developing good habits, trying to live a regular life, not smoking or smoking less; doing 30 minutes of moderate intensity exercise at least 4 days a week; diversifying food and adjusting energy intake to encourage consumption of fruits, vegetables, whole grain cereals and breads, fish (especially fish rich in Omega-3 fatty acids) Lean meats, low-fat dairy products; the ability to reduce stress in work life, adjust their emotions, and maintain a good mood. Secondary prevention refers to the treatment of patients who already have coronary heart disease or atherosclerotic lesions to reduce the occurrence of coronary heart disease events and reduce the mortality rate of coronary heart disease. It mainly includes drug therapy, interventional therapy and coronary artery bypass surgery, either alone or in combination, depending on the condition. Cardiac surgery focuses on coronary artery bypass surgery, which involves the creation of one or more bypasses (tubes, usually using internal mammary artery, radial artery, saphenous vein, and other self-vascular material) to allow blood from the aorta to bypass the narrowed and blocked coronary artery to supply blood to the distal apical region of the heart and re-establish blood flow to the myocardium. This method is very effective and has a high rate of long term patency. The superior medical skills of our Professor Wu Qingyu have enabled several patients diagnosed with end-stage coronary artery disease in foreign hospitals who needed heart transplantation to be treated to regain their lives after his coronary artery bypass surgery, saving the patients a lot of burden and significantly improving their quality of life. Today’s rapidly advancing science and technology has led to breakthroughs in the treatment of coronary heart disease (from small lifestyle improvements to heart transplantation). Tests such as ambulatory electrocardiograms, echocardiograms, 64-row CT, and coronary angiograms help to provide a complete picture of the heart and coronary arteries. It is the cardiologist’s job to assess the patient’s condition with the assistance of these tests. The cardiologist needs to assess not only the current condition of the patient’s heart and coronary arteries, but also to note the possibility of rapid deterioration, make a quick judgment and, by all means, counteract this damage. The goal of treatment now is to reduce the likelihood that the heart will be exposed to stress and to maintain the heart’s longevity and resilience. But one should know that all treatments slow down the degree of atherosclerosis and cannot stop it absolutely and completely. More than 2,000 years ago, the Yellow Emperor’s Classic of Internal Medicine mentioned: “The best doctor treats diseases that have not yet occurred”, meaning that the best doctor treats diseases that have not yet occurred. In fact, the best doctor should be yourself rather than a doctor, you should know your own body best and know how to adjust yourself to keep your body in a better condition. So, love yourself, please start from the heart.