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Coronary Artery Disease

 

What is coronary artery disease?

Coronary artery disease (CAD) is the narrowing or blockage of your coronary arteries. Your coronary arteries are responsible for supplying oxygen-rich blood to your heart. Overtime, plaque buildup in these arteries limits how much blood can reach your heart, causing CAD. 

What causes coronary artery disease? 

CAD begins when fats, cholesterols and other substances collect on the inner walls of the heart arteries, causing the arteries to narrow, blocking blood flow. The plaque can also burst, leading to a blood clot. Besides high cholesterol, damage to the coronary arteries may be caused by:

  • Diabetes or insulin resistance
  • High blood pressure
  • Inactivity
  • Smoking or tobacco use

What are risk factors for developing coronary artery disease?

Coronary artery disease often develops over decades. The most common risk factors for developing CAD can include:

  • Getting older
  • Being male
  • Family history of CAD
  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Obesity
  • Chronic kidney disease
  • Not getting enough exercise
  • Stress
  • Alcohol use

While one of these risk factors can be the cause of CAD, there are often many risk factors at play in the development. Sometimes CAD develops without any classic risk factors. Other possible risk factors can include:

  • Obstructive sleep apnea
  • High triglycerides
  • Preeclampsia
  • Certain autoimmune diseases

What are the symptoms of coronary artery disease?

Symptoms of CAD often go unnoticed until a significant blockage causes problems or a heart attack occurs. When symptoms first start to arise, you may notice your heart beating fast or irregular during normal activities or light exercise. Oter signs and symptoms can include:

  • Chest pain, pressure or tightness in your chest that typically occurs on the middle or left side of the chest. This pain is worse with activity and goes away within minutes of the triggering event ending. In some people, the pain may be brief or sharp and felt in the neck, arm or back.
  • Shortness of breath or the feeling of not being able to catch your breath.
  • Fatigue, especially when doing normal activities.
  • Heart attack, which can be displayed as crushing chest pain or pressure, shoulder or arm pain, shortness of breath and sweating.
  • A heart attack can be potentially life-threatening, so seek medical attention immediately if you suspect you are having a heart attack.

How is coronary artery disease diagnosed?

To diagnose CAD, your provider will review your medical history and perform a physical examination. Be sure to tell your provider about the signs and symptoms you have been experiencing. Additional tests may be needed to help with the diagnosis, including:
Echocardiogram – uses sound waves to create pictures of your beating heart to show how blood is flowing through the heart and heart valves. This can help to determine the severity of the aortic valve disease.

  • Electrocardiogram – records the electrical activity of the heart to determine how fast the heart beats.
  • Chest X-ray – can help to determine if the heart is enlarged through pictures.
  • Cardiac MRI – creates detailed pictures of the heart to determine the severity of aortic valve disease and measure the size of the aorta.
  • CT scan – measures the size of the aorta and looks at the aortic valve more closely. It can also measure the amount of calcium in the aortic valve and determine the severity of aortic valve stenosis.
  • Exercise test – shows how the heart reacts to physical activity and whether you show symptoms during exercise.
  • Coronary Angiogram - can help visualize the blood vessels of the heart (coronary arteries) to identify any blockages or abnormalities in the blood flow to the heart.

What are the treatment options for coronary artery disease?

Treatment for CAD aims to prevent symptoms and most of all, a heart attack. The most common forms of treatment include lifestyle changes, such as quitting smoking, eating healthy and exercising more. In some cases, medication and surgery are needed.

If your provider deems that surgery is needed, they may perform one of these procedures:

  • Coronary angioplasty and stent placement – during this procedure, your provider guides a thin, flexible tube to the narrowed part of the heart artery. A tiny balloon is then inflated to help widen the blocked artery and improve blood flow. A small wire mesh tube may be placed in the artery to help keep the artery open and prevent it from closing again.
  • Coronary artery bypass graft surgery – during this procedure, your provider takes a healthy blood vessel from another part of the body to create a new path for blood in the heart. This allows the blood to go around the blocked or narrowed coronary artery.

Complications of coronary artery disease

If left untreated, CAD can lead to potentially life-threatening complications, including:

  • Chest pain or shortness of breath
  • Heart attack
  • Heart failure
  • Irregular heart rhythms