Coronary artery disease is a common fatal condition. This article includes the symptoms, tests, and treatment of coronary artery disease.
Coronary artery disease is characterized by blockages in the arteries, which supply blood to the heart. This, in turn, will cause nutrition and oxygen deprivation of the heart, which leads to pain and damage to the heart muscle. Heart dysfunction leads to symptoms of a heart attack.
There are two presentations of coronary artery disease. They are stable diseases and heart attacks. In stable diseases, the patients usually complain of chest pain which are retrosternal in origin, and occurs on activities. This kind of pain radiates to the left arm, back and jaw. Many people may also have a heart attack at the first presentation. Heart attack pain may be of similar nature but with severe intensity and is associated with sweating, shortness of breath, syncope, or death. That is why it is so important to know how to spot a heart attack.
A plaque-like substance makes the inner walls of the blood vessels sticky. Inflammatory cells, calcium, and lipoproteins attach to the plaque when they travel through the bloodstream. Also, these materials build along with cholesterol, making the artery walls narrower.
After a narrowed coronary artery is developed, new blood vessels go around the blockage to bring blood to the heart muscle. But when the person feels stressed out, the new arteries may not bring enough oxygen-rich blood to the heart.
The plaque breaks in some cases, and in such cases, a blood clot develops and blocks the supply to the heart muscle. This results in a heart attack. When the blood vessel that carries blood to the brain is blocked, it results in ischemic stroke.
The symptoms of a heart attack include the following:
Pain and pressure or discomfort in the center of the chest, usually on the left side.
Pain, discomfort, or tingling in other parts of the upper body, including the arms, neck, back, jaw, or stomach.
Shortness of breath.
Burping or heartburn, which can be confused with acidity problems.
Sweating or having cold and clammy skin due to low blood pressure.
Abnormal awareness of one's heartbeat.
When the above-mentioned symptoms persist for more than 10 minutes or if they recur, then call for help right away.
There are quite a lot of things that can make one prone to coronary artery disease. Of which, few can be altered while few cannot be. They include the following:
Age, especially older than 65 years.
Gender - Mostly, men are at greater risk of a heart attack when compared with women.
High blood pressure.
Family history of heart disease at a young age.
Being overweight or obese.
Lack of physical activity.
Smoking and even breathing secondhand smoke can increase the risk for heart disease.
Race - Americans and Africans have a higher risk than other races because they have higher blood pressure. Asian and Hispanic people are also at higher risk of heart disease as they have higher rates of obesity and diabetes.
An unhealthy diet with high saturated fat, salt, trans fat, and sugar increases the risk of heart disease.
1) Electrocardiogram (ECG or EKG):
Detects abnormal electrical changes in your heart.
2) Stress Test:
If your resting ECG is normal, then the physician may give a bit of stress to your heart like asking the patient to run or give medicine, which will increase the heartbeat, and under these stressful conditions heart may show abnormal electrical activity and heart disease can be diagnosed.
This test, with the help of sound waves, creates an image of a beating heart and gives information regarding the function of the heart. Functioning of the heart is mentioned in the term called ejection fraction, and the normal value is more than 55%.
4) Cardiac Catheterization or Angiography:
During this test, the doctor inserts a thin pipe into a blood vessel in the leg groin area or the arm near the wrist. This tube is inserted into the heart, and then the medicine called dye is injected, with the help of which heart blood vessels are visualized. The exact site, number, and percentage of blockages can be known from this test. This is the final and the best test for detecting blocks. However, this is expensive and has a risk of bleeding and other complications.
The various options available are lifestyle modifications and medications. If blockages are critical, then the patient may need a procedure to open the blocks, which can either be a stent or bypass surgery.
1) Lifestyle Modifications:
The person should eat plenty of fruits and vegetables and low-fat products. Avoid meat, oily food and quit smoking. Do regular exercise and lose weight if overweight.
Medicines are the most important part of the treatment. This should be consumed as advised and without default. Medicines called statins, which lower cholesterol should be consumed even if cholesterol is normal. Blood pressure-lowering medicines and blood thinners like Aspirin and Clopidogrel are very important. Other medicines like beta-blockers and nitrates help patients with chest pain.
3) Stent Procedure:
A stent procedure is also called angioplasty. The doctor will put a thin pipe in the blocked artery during this procedure and dilate it with a balloon. Also, it keeps the stent in the vessel to hold the artery in the open state. It is very important that patients do not default the medicines after stenting. Otherwise, the risk of stent blockages is very high.
4) Bypass Surgery:
Coronary artery bypass grafting or CABG is the other name of bypass surgery. During bypass surgery, the doctor uses another vessel, which may be from the chest or sometimes legs. Doctors connect this vessel above and below the blockage and bypass the blockage. This vessel is called a graft. Depending upon the number of grafts, the patient is labeled as a double or triple bypass. The bypass surgery is a lengthy and high-risk procedure. It is usually done in individuals having blockages in three or more vessels or blockages in the main artery.
Last reviewed at:
28 Aug 2021 - 4 min read
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