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Coronary Artery Disease - a Common Fatal Heart Problem

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Coronary Artery Disease - a Common Fatal Heart Problem

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Coronary artery disease is a common fatal condition. This article includes the symptoms, tests, and treatment of coronary artery disease.

Medically reviewed by

iCliniq medical review team

Published At January 28, 2017
Reviewed AtDecember 19, 2022

Introduction:

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.

When to Suspect Coronary Artery Disease?

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.

What Are the Causes of Coronary Artery Disease?

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.

What Are the Symptoms of Heart Attack?

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.

  • Vomiting.

  • Nausea.

  • 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.

  • Giddiness.

When the above-mentioned symptoms persist for more than 10 minutes or if they recur, then call for help right away.

What Are the Risk Factors for Coronary Artery Disease?

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.

  • Diabetes.

  • High blood pressure.

  • Family history of heart disease at a young age.

  • Being overweight or obese.

  • High cholesterol.

  • Lack of physical activity.

  • High stress.

  • 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.

What Tests Are Used to Confirm Coronary Artery 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.

3) Echocardiogram:

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.

How to Treat Coronary Heart Disease?

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.

2) Medications:

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.

Frequently Asked Questions

1.

Can Coronary Artery Disease Cause Death?

Coronary artery disease happens when the arteries that supply blood to the heart muscles become hardened and narrowed. Coronary artery disease is a severe condition, but its diagnosis does not always mean death. With early diagnosis and treatment, it can still be managed, and the patient can have a normal life by taking all the necessary precautions.

2.

What Is the Leading Cause of Coronary Artery Disease?

The primary cause of coronary artery disease is plaque build-up in the arteries that supply blood to the heart. Plaque is nothing but cholesterol deposits that accumulate in the arteries and cause the narrowing of the arteries. With more and more plaque deposits, the passage gets partially or entirely blocked.

3.

Can Coronary Artery Disease Be Stopped From Progressing?

A patient can stop the progression of coronary artery disease by changing his diet plan and daily routine. The first step is to make some changes in the diet plan by including more fruits and vegetables and consuming a low-fat diet instead of junk food with high fat and sugar content. In addition to that, regular exercise has to be done to control weight, which will help in more efficient blood circulation. By following these steps along with some medication, the damage caused by the disease can even be reversed.

4.

Does Coronary Artery Disease Have Any Warning Signs?

Coronary heart disease does have some warning signs, which include:
- Chest pain (angina, feeling tightness or pressure in the chest).
- Shortness of breath.
- Fatigue.
- Heart attack.

5.

At What Age Does Plaque Start to Build Up in the Arteries?

The cholesterol or plaque build-up can start early, from adolescence to adulthood. This usually depends upon the diet and physical activity of the person. But during the initial stages, it may not cause any harmful effects however, with growing age, the build-up can be seen in a high amount. As a result, men aged 45 and women after 55 may start showing signs of coronary heart disease.

6.

Does Drinking Lots of Water Affect the Heart?

Drinking enough water and staying hydrated is one of the best methods to support the heart and prevent any long-term heart issues. Drinking enough water daily is as essential as taking low salt intake to avoid heart complications. The recommended amount of fluid by the National Academies of Sciences, Engineering, and Medicine is about 15.5 cups (3.7 liters) for men and 11.5 cups (2.7 liters) for women.

7.

Which Drugs Help in Removing Plaque From Arteries?

Various drugs can be given to prevent plaque accumulation in the arteries, but it usually depends upon the patient's condition. Some of the medications to lower cholesterol levels include statin drugs such as:
  - Atorvastatin (Lipitor).
- Fluvastatin (Lescol XL).
- Lovastatin (Altoprev).
- Pitavastatin (Zypitamag).
- Pravastatin (Pravachol).
- Rosuvastatin (Crestor).
- Simvastatin (Zocor).
If these drugs do not work, other non-statin medications can also be prescribed, such as 
- Ezetimibe (Zetia).
- Evolocumab.
- Bile acid suppressants.
- Omega-3 fatty acids.

8.

Are There Any Surgeries for Treating Coronary Artery Disease?

When the arteries cannot be unblocked using medications, surgeries might be required to clear the arteries, which include:
- Coronary Angioplasty and Stent Placement - In this procedure, a tiny balloon is inflated in the artery to help remove the plaque and improve blood flow. A stent (a small wire mesh tube) is placed in the artery, which helps keep the artery open.
- Coronary Artery Bypass Graft Surgery (CABG) - It is an open-heart surgery performed in patients with narrow arteries.

9.

How Much Time Does Coronary Artery Disease Takes to Develop?

Coronary artery disease is a silent disease that starts developing decades before the first symptom appears. It can be commonly seen at a very young age but does not show any signs or symptoms. It manifests in old age after the 50s and is the primary cause of death in that age group.

10.

What Happens if Coronary Artery Disease Is Not Treated on Time?

Coronary artery disease is a serious condition that can be fatal. In addition, coronary artery disease can lead to other heart conditions, such as irregular heartbeats (arrhythmias) or heart attacks. Proper diagnosis and treatment, and lifestyle changes help manage this condition.

11.

How Serious Is Coronary Artery Disease?

Coronary artery disease is a serious condition as the arteries get narrowed in this disease, which can cause chest pain as the blood supply to the heart muscles and the rest of the body decreases. And without proper treatment, it can weaken the heart muscles. Following that, it can lead to complete heart failure causing death.
Dr. Sagar Ramesh Makode
Dr. Sagar Ramesh Makode

Cardiology

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