Health Guide: Coronary Artery Disease
Killing nearly 400,000 people annually, coronary artery disease (CAD) is the most common type of heart disease and is the number 1 killer in the United States. Also called coronary heart disease, or heart disease, CAD is the restriction of blood flow to the heart due to a buildup of plaque in your coronary arteries. This plaque buildup, called atherosclerosis, limits blood flow to the heart muscle and increases the risk of heart attack and stroke.
Causes of Coronary Artery Disease
The disease occurs when a waxy substance, called plaque, deposits on the blood vessel walls. Other substances such as calcium or lipoproteins will also start sticking to the walls of blood vessels. The plaque buildup inflames the blood vessels, causing them to narrow and become rigid. This raises the risk of blood clots and heart attack due to restricted blood flow.
In some cases, a narrowed coronary artery may develop new blood vessels that go around the blockage in an attempt to get blood to the heart. However, during times of stress, the new arteries may not be able to supply the heart with a sufficient amount of oxygen-rich blood.
If a blood clot completely blocks the blood supply to the heart muscle, it will cause a heart attack. If a blood vessel to the brain is blocked, it may result in an ischemic stroke, and if a blood vessel within the brain bursts, a hemorrhagic stroke may result.
Symptoms of Coronary Artery Disease
When your coronary arteries narrow, blood is not able to get to your heart, especially when it’s working hard. The decreased blood flow may not cause symptoms at first, but as the plaque in the coronary arteries continues to build up, the symptoms may develop. Symptoms of CAD may include:
- Shortness of breath
- Palpitations (irregular heart beats, skipped beats)
- A rapid heart beat
- Nausea
- Sweating
- Weakness or dizziness
These symptoms can lead to more serious issues such as angina, or chest pain, heart attack, and heart failure.
Risk factors for Coronary Heart Disease
- Smoking
- High blood pressure
- High cholesterol
- Diabetes or insulin
- Sedentary lifestyle
- Family history
- Overweight or obesity
- High stress
Diagnosing Coronary Artery Disease
If you talk to your healthcare provider about your symptoms and they feel you may have coronary artery disease, they will most likely send you to a heart specialist, or cardiologist. Your doctor will ask questions about medical history, conduct a physical exam and routine blood tests. Some of the tests to confirm coronary artery disease include:
- An electrocardiogram (EKG or ECG) to record heart rhythm
- An echocardiogram, which uses sound waves to record the heart’s structure and motion
- A stress test will show how well your heart performs under various levels of stress
- Cardiac catheterization to show blockages in coronary arteries
- A computerized tomography (CT) scan to help your doctor see calcium deposits in the arteries
Treating Coronary Heart Disease
To treat CAD, there will be a combination of making lifestyle changes, taking medications and possibly undergoing surgical procedures. Lifestyle changes include lowering your risk factors and exercising regularly.
Some of the medications that your doctor may prescribe are as follows:
Cholesterol-modifying medications
These drugs help to reduce cholesterol, the primary material blocking your coronary arteries.
Aspirin - A daily dose of aspirin or other blood thinners may help to reduce the tendency of blood clots.
Beta-blockers -These drugs will help to slow your heart rate and lower blood pressure, which will decrease your heart's demand for oxygen.
Nitroglycerin - Nitroglycerin tablets, sprays, or patches will help to control chest pain by temporarily dilating your coronary arteries.
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) - These drugs are similar and will help to decrease blood pressure, and may help prevent the progression of coronary artery disease.
Procedures to restore and improve blood flow:
Angioplasty and stent placement -The doctor will insert a long, thin tube into the narrowed area of an artery. A wire with a deflated balloon will be inserted and inflated to push the deposits against your artery walls. A stent may be left in the artery to keep it open.
Coronary artery bypass surgery - Using a vessel from another part of your body, a surgeon will create a bypass around blocked coronary arteries to allow blood to around. This is reserved for serious cases of CAD, as it requires open-heart surgery.
