Definition, epidemiology, and prognosis

Abstract

Cardiovascular disease is an all-encompassing term that includes diseases of the heart and coronary arteries, as well as diseases in other vascular beds. It is a major cause of death and disability in the United States, Europe, and worldwide (see Figure 1.1) [1]. Cardiovascular disease that is present in vascular beds outside of the coronary arteries is broadly termed peripheral arterial disease, and patients frequently have disease in such overlapping locations (see Figure 1.2) [2]. Examples include carotid and cerebrovascular disease, which are responsible for stroke and transient ischemic attack. Aortoiliac and femoral artery disease are responsible for limb ischemia and claudication. Cardiovascular disease can also manifest itself in stable or unstable forms. Stable coronary artery disease is characterized by stable angina or silent ischemia detected by stress testing, while unstable coronary artery disease (categorized, more generally, as coronary heart disease) includes myocardial infarction and unstable angina. An increasingly used and preferred term for an unstable event is acute coronary syndrome (ACS). ACS encompasses the spectrum from unstable angina to non-ST-elevation myocardial infarction and, finally, ST-elevation myocardial infarction. This chapter will review the epidemiology and prognosis of cardiovascular disease in general, with a special focus on ACS.