coronary artery disease

What is Coronary Artery Disease? Causes, Symptoms and Treatment

Coronary Artery Disease, or CAD, is a condition characterized by poor blood flow in the arteries supplying blood to the heart; it’s also called coronary heart disease. It’s the most common form of heart disease, affecting over 15 million Americans aged 20 and over, and one of the top causes of death in the US. CAD that is untreated and uncontrolled can lead to a heart attack.

Causes

Injury to the inner layer of a coronary artery is the top cause of CAD. This can be caused by:

  • Smoking
  • Chronic high blood pressure
  • Sedentary living
  • Insulin resistance or diabetes
  • High cholesterol

When the inner wall of the artery suffers damage, fatty deposits (plaque) of cholesterol and other cell waste start accumulating in the artery, and causes atherosclerosis.

If any of the arteries on the heart’s surface – coronary arteries on the left or right, left circumflex artery or left anterior descending artery –  get partially or entirely blocked, blood is not able to flow properly.

These arteries are responsible for supplying the heart with blood; the heart is responsible for pumping blood throughout the body. To do this work properly, the heart also needs blood. And if it doesn’t get a steady, sufficient blood supply to perform its function, it can lead to CAD.

Symptoms of CAD

Insufficient blood supply to the heart can manifest in many different ways. The most common is angina, or chest discomfort, which can be felt as pain, burning, tightness or heaviness in the chest. Unfortunately these symptoms are sometimes mistakes for indigestion or heart burn. Other symptoms of CAD can be:

  • Dizziness
  • Sweating
  • Pain in the arms and/or shoulder (especially left)
  • Difficulty breathing

The greater the restriction in blood flow, the more intense the symptoms; if the blood flow is completely cut off by the blockage, the heart muscle starts to die, if not restored quickly. This death of heart muscle is a heart attack. Any of these symptoms lasting 5 minutes or over is potentially dangerous, and must be attended to immediately.

Symptoms of CAD for women

In addition to the symptoms mentioned above, women may also experience:

  • Nausea and vomiting
  • Pain in the back
  • Jaw pain
  • Breathing difficulty not accompanied by chest pain

Men are more prone to heart disease than women, however, have the same risk post menopause, especially after 55.

Chronic decreased blood flow to the heart may weaken the heart, and cause arrhythmia or abnormal heart rate or rhythm, and may also not pump the required amount of blood for the body. Usually, these abnormalities can be detected by the doctor when you’re being examined.

Risk factors for CAD

By understanding the risk factors for CAD you can work out a plan in conjunction with your healthcare practitioner to diminish the possibility of you developing it.

  • Elevated blood pressure
  • Elevated levels of cholesterol
  • Diabetes or insulin resistance
  • Obesity
  • Sedentary lifestyle
  • Smoking tobacco
  • Excessive consumption of alcohol
  • Unhealthy diet
  • Frequent and intense emotional stress
  • Pre-eclampsia in pregnancy
  • Age – 45+ for men, and 55+ for women
  • Genetics – family history of CAD

Diagnosing CAD

CAD is diagnosed through reviewing your medical history, examining you physically, and conducting tests, like:

  • ECG – monitors electrical signals in the heart and indicate if you’ve had an attack
  • Echocardiogram – Ultrasound waves create a picture of the heart; reveals if heart function is ok
  • Stress Test – Measures heart stress during physical activity, and rest.
  • Catheterization – a dye is injected into the coronary arteries through a catheter inserted into an artery in the forearm or groin to render a radiographic image of the arteries and identify blockages
  • CT scan – reveals calcium deposits in arteries if any

Treatment

The first and most important line of treatment is lifestyle changes – switching over to a healthy diet, cutting down on drinks, avoiding smoking, and getting adequate exercise to lose weight; basically, controlling the risk factors. Medical treatment depends on the condition of your health and other risk factors. Treatment options include:

  • Medication to lower cholesterol, high BP or control sugar levels
  • Balloon angioplasty – a surgical procedure to increase the width of blocked arteries and break down plaque deposits, through a stent insertion
  • CABG – coronary artery bypass graft surgery is an open heart surgery performed to restore the heart’s blood flow
  • Enhanced external counter pulsation – a noninvasive procedure to encourage new blood vessels to form so that they can bypass the blocked arteries.
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