What Is Coronary Artery Disease?
Your heart is a muscle – a very important muscle that your entire body depends on. As with all muscles, the heart is dependent on blood supply to provide necessary nutrients, fuel and oxygen.
The heart gets its blood supply from the coronary arteries. When the coronary arteries become blocked, narrowed or completely obstructed, the heart cannot get the nutrients, fuel and oxygen it needs. This causes the heart to become weak, develop a heart attack or stop altogether. The blockage, narrowing or obstruction is known as coronary artery disease (CAD).
Signs and Symptoms
Coronary artery disease is the number one killer in the United States. For persons aged 40 years, the lifetime risk of developing CAD is 49 percent in men and 32 percent in women. For those reaching age 70 years, the lifetime risk is 35 percent in men and 24 percent in women. The incidence of CAD rises steeply with age with women lagging behind men by 10 years.
A variety of other factors can increase risk of coronary artery disease, including:
Symptoms
Coronary artery disease makes it more difficult for oxygen-rich blood to move through arteries. Common symptoms of CAD include:
- Angina: Upper body pain or pressure. It's usually felt in the chest, but can also be experienced in the back, belly, and even the jaw
- Shortness of breath: Difficulty taking in air (dyspnea) with exertion, or chest tightness, squeezing or burning.
Sometimes coronary artery disease has no symptoms, called silent CAD. It can go undiagnosed up until someone has a heart attack, irregular heartbeat or other heart conditions.
Diagnosis
Your doctor will take into account several factors in diagnosing coronary artery disease such as family history, symptoms and risk factors. In addition, there are several diagnostic tests that are helpful when used together to diagnose the condition.
Imaging Tests
Coronary CT
During a coronary computerized tomography (CT), angiogram pictures are taken of cross sections or slices of the heart. A coronary artery calcium scoring CT can detect and measure the extent of the calcium deposits in the coronary arteries.
Echocardiography
An echocardiogram uses sound waves to produce an image of the heart, showing how well it is working. It can help determine which areas of the heart are having problems and help identify any damage to the heart.
Diagnostic Procedures
Cardiac Catheterization
This is a minimally invasive test which not only allows visualization of your coronary arteries, but also will allow for possible opening of blockages using a piece of metal scaffolding called a stent.
Stress Test
In a stress test, you perform a physical activity such as jogging on a treadmill to increase the speed of your heartbeat. This helps determine how well your heart performs. Usually, the stress test is accompanied by either nuclear or echocardiographic imaging.
Treatment
Medications
Medicines can be important to:
- Relieve the stress on your heart and lessen coronary artery disease symptoms
- Decrease the risk of heart attack
- Lower cholesterol levels and decrease blood pressure
- Prevent harmful blood clots
Common medications used to treat coronary artery disease include:
- Anticoagulants: Anticoagulants prevent blood clots from forming. They also prevent existing clots from getting larger, which can reduce the risk of heart attack.
- ACE inhibitors: ACE inhibitors help to lower your blood pressure, which lessens the amount of work the heart has to do to supply blood to your body.
- Aspirin: Aspirin helps prevent the platelets in your blood from sticking together and forming clots that can increase your risk of heart attack.
- Beta-blockers: Beta-blockers reduce your myocardial oxygen demand, which can help decrease the strain on your heart
- Calcium channel blockers: Calcium channel blockers help to increase blood flow to the heart and reduce its overall workload.
- Fish oil and other supplements high in omega-3 fatty acids: Foods and supplements with omega-3 fatty acids help to slow plaque buildup in your arteries and lower blood pressure.
- Glycoprotein IIb-IIIa inhibitors: Glycoprotein IIb-IIa inhibitors help to prevent platelets from binding together and forming clots, which reduces your risk of heart attack. Nitroglycerin: Nitroglycerin helps to reduce the myocardial oxygen demand so that your heart doesn’t have as high of a workload.
- Statins: Statins help prevent inflammation, which can help stabilize plaque formation in your arteries.
Procedures
Severe cases of coronary artery disease may warrant medical procedures such as:
- Angioplasty: This procedure opens blocked or narrowed coronary arteries. A thin tube with a balloon or other device is threaded through a blood vessel until it reaches the blocked artery. The balloon is then inflated, pushing the plaque against the artery wall, which widens the artery. The procedure helps to restore blood flow to the heart, alleviate chest pain and decrease the chance of a heart attack.
- CABG (coronary artery bypass graft): This procedure creates new routes for arteries and veins so they can bypass the clogged coronary arteries and reach the heart.
Rehabilitation
Cardiac rehabilitation is another treatment option, usually combined with medicine and surgical methods. Cardiac rehab usually consists of:
- Education, counseling and training. Patient education seeks to inform you of anything you may want to know about your condition, helping you make the best decisions possible to maintain good health. Counseling is available to help you cope with the stress of the condition and managing lifestyle changes.
- Exercise training. Learning how to exercise safely, building muscle strength, and improving stamina can be very important in strengthening your heart and making it healthier.
Lifestyle Management
The key to treating coronary artery disease is to prevent it, or at least reduce the risk of serious cardiac events (such as heart attacks). This is usually done through the following:
- Healthy diet: Greasy, high-fat foods can lead to plaque buildup in your arteries. Instead, begin integrating more fruits and vegetables into your diet, along with lean, non-fried meat. Learn more about how a plant-based diet can benefit your health.
- Quitting smoking: Smoking damages the arteries and can also lead to plaque buildup. Learn how your health improves just weeks after you stop smoking.
- Staying active: Regular exercise strengthens your heart muscle and improves blood flow, which can reduce risk factors for CAD such as high blood pressure and high cholesterol.
Programs and Services
Clinical Trials