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Coronary Artery Disease

disease-of-the-coronary-arteryImportant Answers about Coronary Artery Disease

  • Coronary Artery Disease Overview
  • Coronary Artery Disease Symptoms
  • Diagnosing Coronary Artery Disease
  • Coronary Artery Disease Risk Factors
  • Treatment Options

Coronary Artery Disease

Coronary Artery Disease Overview

Coronary Artery Disease (CAD) refers to the buildup of plaque in the arteries of the heart that have the potential of causing a heart attack. Initially, the plaque will grow on the walls of the coronary arteries until the heart is limited in its ability to pump blood due to the narrowing of the artery. Also referred to as coronary heart disease, CAD plays a part in one out of every four deaths in the United States (2008), making it the leading cause of death in both women and men.

The disease is progressive, where the plaque can rupture or harden. During rupturing caused by the buildup of plaque, blood clots can form to completely block or mostly block the flow of blood through the coronary artery. In time, the plaque will harden and cause the artery to become narrow. Hardened plaque can reduce the flow of oxygenated blood necessary for sustaining life. If the heart muscle is deprived of oxygen-rich blood due to a blockage or reduction in flow, a heart attack or angina (chest pain) can occur.

CAD Symptoms

According to the National Heart, Lung and Blood Institute, the most common symptoms and signs involved with coronary artery disease include:

  • Angina – The most common symptom of coronary artery disease is angina, which causes chest discomfort or pain. The symptom occurs because the heart muscle is deprived of oxygen-rich blood. The symptom feels like squeezing or intense pressure on the chest and can also be felt in the arms, shoulders, back, jaw or neck.

Suffers might believe they are experiencing indigestion when they are really having an angina attack. The pain and discomfort tend to become significantly worse during times of activity and can lessen during rest. However, emotional stress is usually a significant trigger of intense pain caused by angina.

  • Heart Attack – If the heart is denied oxygen-rich blood due to the increased development of plaque in the coronary artery a rupture can occur, causing platelets (blood cell fragments) to stick to the injury site by clumping together and forming blood clots. Large clots can completely or mostly block the flow of blood through the artery.

If the blockage is not opened quickly, portions of healthy heart muscle lacking much-needed oxygen can die. When this occurs, normal healthy heart tissue is damaged and becomes scar tissue, causing long-lasting and/or severe problems.

  • Heart Failure – If the heart is deprived of sufficient blood flow to meet the body’s needs, heart failure can cause the heart to stop working. The most common symptoms involving heart failure include troubled breathing, shortness of breath, swelling in the feet, legs, stomach, ankles and veins of the neck.

Typically, the symptoms occur due to the buildup of fluids caused to the failing heart. Any normal physical activity, like climbing stairs, becomes challenging due to a shortness of breath and feeling tired.

  • Arrhythmia – Many cases involving irregular heartbeats by skipping beats or beating too fast is defined as arrhythmia. The condition can cause a fluttering sensation in the chest (palpitation). However, an arrhythmia can cause the heart muscle to stop beating suddenly causing sudden cardiac arrest (SCA) that could be fatal if the patient does not receive treatment within minutes.

Most individuals experiencing angina or a heart attack will feel discomfort or pain in the chest. If the sensation lasts for just a few minutes, it is likely angina. However, if the discomfort or pain in the chest changes from normal patterns or does not go away during rest, it might be a heart attack. Common symptoms of heart attacks involve:

  • Upper body pain or discomfort in the stomach (upper part) jaw, neck, back and one or both arms.
  • Lack of energy, tiredness (fatigue) and sleeping problems.
  • Shortness of breath
  • Nausea, fainting, lightheadedness, vomiting, cold sweats
  • A sense of fullness
  • Numbness
  • Burning
  • Aching
  • Painful feeling

Diagnosing Coronary Artery Disease

To correctly diagnose coronary artery disease, doctors must know the patient’s symptoms, risk factors, and medical history when conducting a comprehensive physical exam. Doctors typically conduct diagnostic tests including an echocardiogram, electrocardiogram (EKG/ECG), ultrafast (electron-beam) CT scan, exercise stress test, cardiac catheterization, or others.

The results of the multiple tests will assist the doctor in understanding the extent of the disease and how it affects the heart muscle. Only then can the doctor recommend one or more treatments to optimize the patient’s health.

Risk Factors

Many of the risk factors involved in coronary artery disease cannot be changed, meaning the patient has little or no control over the disease progressing or advancing. However, there are major risk factors that can be controlled or modified to minimize the damage and reduce symptoms. The major risk factors involved in CAD include:

  • Getting Older – Statistics indicate that individuals 65 and older have a higher risk of dying from coronary heart disease. Additionally, older age women who had a heart attack have a greater potential than men from dying from the disease within a few weeks after the event.
  • Gender – Statistics have revealed that men have a higher potential of suffering a heart attack compared to women and tend to experience the attack at a younger age. Women of postmenopausal age have a lower death rate than men of the same age.
  • Race and Heredity – Studies show that the child of a parent with heart disease has a higher rate of developing the condition themselves. Additionally, African Americans suffering from severe high blood pressure are at greater risk of heart disease than Caucasians. These rates are also higher among those of Asian, Hawaiian, Native Americans, and Mexican descent. If many members of a family suffered from heart disease, the individual will likely have increased risk factors too.
  • High Blood Cholesterol – A high rate of cholesterol, low-density lipoprotein (bad) cholesterol, and triglycerides have a direct correlation with coronary artery disease.
  • High Blood Pressure – The increased level of blood pressure in the arteries tends to increase the workload of the heart, leading to heart attack, stroke, congestive heart failure and kidney failure.
  • Obesity – Excessive body fat, especially at the waistline, increases the potential of coronary artery disease.
  • Diabetes Mellitus – More than two-thirds of individuals 65 years and older suffering from diabetes will die because of some type of heart disease or stroke.

Treatment Options

There are numerous lifestyle changes and medications available to treat coronary artery disease. Doctors recommend that patients who smoke should quit and avoid consuming process foods. Instead, eating a low sugar, low salt, low trans fat diet and keeping blood sugar (glucose) in control can minimize the potential of developing or feeling the symptoms of coronary artery disease.

The doctor may recommend aspirin or a statin to keep the blood thin. Additional treatment options include:

  • Balloon Angioplasty
  • Coronary artery bypass surgery
  • Stent placement

It is crucial to learn to recognize the signs and symptoms of heart disease. Any sense of nausea, fast heartbeat, dizziness, heart palpitations or shortness of breath might be an indicator of a heart attack or heart failure, requiring emergency care immediately.

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