INTRODUCTION TO MEDICINE

CARDIOVASCULAR DISEASE IN JAPAN

(Nurul Ainina, 201626099)
Sensei : Professor Aonuma K

Cardiovascular originally comes from two words, "cardiac" and "vessel". Cardiac
means heart, while vessel refers to artery and vena. Hence, cardiovascular defines as the
group of heart and vessel’s disorders in human. It is claimed as the 2 nd rank causing death in
Japan after cancer in, especially in millennial period. Unhealthy lifestyle, less of physical
activity, obesity and improper dietary management recognize as the factors caused this
disease. Beside, cardiovascular also has various types of disorder. Three of them, coronary
artery disease, arrhythmia and heart failure are the most frequent types which attack human b
ody.
Coronary artery disease is the condition which plaque is formed in the wall of
coronary artery. This plaque is composed by fat, cholesterol, calcium, and other substances
found in human body [1]. Basically, plaque reduces the area for blood to flow into the heart
as it blocks some or all part of artery vessel. As the consequence, the supply of blood rich-ox
ygen is interrupted and causing circulatory system disruption. To cure this disease,
Percutaneous Coronary Intervention (PCI), surgery and other medication may be performed.
Before deciding proper treatment, diagnosis should be conducted by the medical staff.
There are several diagnostic tools that can be used, such as electrocardiogram (ECG) for
checking the electrical activity of heartbeat; Stress Radionuclide Perfusion Computed
Tomography (SPECT) and Multi-Detection Computed Tomography (MDCT) for describing
the images of heart and blood circulation process; Angiography; Intra-vascular ultrasound
(IVUS) for assessing plaque characteristics or checking stent development; and Optical
Coherence Tomography (OCT) for visualizing coronary artery in more detail.
In line with the development of diagnostic tools, several advanced treatments also
appear to cure cardiovascular diseases. Percutaneous Coronary Intervention (PCI) is method
that currently are applied for widening the artery's wall. It is usually conducted by inserting
the catheter, balloon and stent into the artery vessel. The balloon and stent are attached to the
catheter. After insertion, the balloon inflates into a certain size and forces the expansion of
narrowing artery by compressing the formation of plaque. Then, the balloon deflates and be
withdrawn from the coronary artery. However, the stent still remains in the artery to hold it
opened. Other treatments that can be applied is Debulking Coronary Atherectomy (DCA),
Rotational Coronary Atherectomy (Rotablator), and Laser Coronary Angioplasty (LCA).
Conceptually, those treatments have similar purpose to destroy the plaque. The difference is
only in the schematic of their work.
Beside coronary artetry disease, arrhythmia is another cardiovascular disorder.
Arrhythmia is medical term for heart problem in which the electrical impulses of heart occur
erratically, sometimes too fast or too slow. Normally, heart beats around 60-80 times per
minute. In case of arrhythmia, it beats irregular. This abnormal condition may lead into the
disruption of blood circulation. The treatment often used for curing this disease is ablation
therapy. In ablation therapy, the tissue causing irregular beats in heart is removed by sending
a certain signal through catheter. The removal of this particular tissue in heart will block the
pathway of abnormal heart beat.

[1]National Insurance Health of United States, 2014