What Is Coronary Artery Disease?
Cardiovascular disease (CVD) is number one in death rate worldwide. The latest statistics from the Centers for Disease Control (CDC) show over 17 million deaths globally in 2015, which accounts for 31 percent of all deaths attributed to CVD.
Of this number, the most significant percentage, roughly 7.4 million were from coronary artery disease. Coronary artery disease (CAD), sometimes known as coronary heart disease (CHD), is the most common type of CVD and is the top cause of death in both women and men in North America.
CAD is a type of heart disease that causes a buildup of fatty residue, called plaque, in the arteries that supply the blood to the heart. This process called atherosclerosis decreases the area available for blood flow to the arteries that feed oxygen-rich blood to the heart.
If these vessels, called coronary arteries, become too narrowed with plaque, a heart attack or myocardial infarction (MI) can occur.
The MI often happens when a blood clot gets stuck in the constricted artery and causes damage to the heart muscle, which impairs its ability to function correctly.
Over time, the heart can weaken from CAD, and develop congestive heart failure that reduces its pumping capacity. CAD can also lead to arrhythmias that altar hearts normal electrical conduction.
What Causes Coronary Artery Disease?
CAD often occurs due to an injury to the interior lining of the coronary arteries. The damage can happen as early as your childhood years.
Once this damage occurs, fatty substances, called plaques, formed from cholesterol, triglycerides, and other bloodstream waste molecules begin to build up in the wounded section. Atherosclerosis is the term used to describe this process.
The plaque blockage can either partially or wholly obstruct blood flow in the artery. A partial plaque blockage can suddenly rupture, causing platelets to move into the area to mend the vessel.
Risk Factors for Coronary Artery Disease
Risk factors are other health conditions you have or lifestyle habits you engage in that increase the probability of developing CAD.
The known risk factors for coronary artery disease are:
- Advanced age
- Being overweight or obese
- Diabetes
- Familial history of CAD
- High bad (LDL) cholesterol
- Low good (HDL) cholesterol
- High-stress levels
- Hypertension
- Males
- Sedentary lifestyle
- Smoking
Other conditions such as High Sensitivity C-reactive protein, high triglycerides, homocysteine, and sleep apnea can also contribute to the development of CAD.
Symptoms of Coronary Artery Disease
The symptoms of CAD often vary between individuals. Chest pain, known as angina, is a hallmark warning sign that happens because your heart is not receiving enough oxygen-rich blood.
Angina can feel like pressure or tightness in the chest. Angina can also cause pain or discomfort in either shoulder or arm, can move into the neck/jaw or upper back and may occur without any symptoms in the chest.
Some people report that their angina feels like an aching, burning, fullness, heaviness, numbness, or squeezing. In some cases, people have confused angina with heartburn or indigestion.
If angina happens and lasts for longer than five minutes, call 911 as this is often a reliable indicator that the blocked artery needs immediate medical attention to prevent a future MI. If the warning signs last less than five minutes and resolve other own, it’s wise to contact your doctor and schedule an appointment as soon as possible for an evaluation.
Other symptoms of CAD include:
- Dizziness
- Increasing Fatigue
- Fast heartbeat
- Nausea and vomiting
- Not feeling well in general
- Palpitations
- Shortness of breath
- Sleep disturbances
- Sweating more than usual
- Unexplained anxiety
Men and women often experience CAD symptoms differently, with women’s warning signs tending to be more generic, and thus more difficult to diagnose.
Medical Management and Treatment of Coronary Artery Disease
Treatment for CAD focuses on managing controllable risk factors to prevent or further progression of the disease. The medical management plan your physician develops for you will target the following areas:
Lifestyle Modifications
Lifestyle modifications focus on managing and improving these controllable risk factors:
- Diabetes
- High cholesterol
- High-stress levels
- Hypertension
- Overweight or obese
- Sedentary lifestyle
- Smoking
Diet and exercise are two of the primary interventions used to help improve controllable risk factors.
Research has shown that starting and maintaining a low salt; low cholesterol eating plan helps to reduce bad cholesterol, body fat, high blood pressure, and assists with lowering blood sugar levels to the recommended range. Your physician can make an appointment for you to see a registered dietitian who will tailor a plan to meet your unique needs.
Exercise will aid your body to utilize better the food you eat, help you achieve healthy body weight, and regulate blood pressure, cholesterol, and blood sugar levels. A regular exercise plan is also a useful tool for controlling high-stress levels.
Ask your physician to recommend a certified professional trained in exercise prescription for people with CAD. If the hospital in your community has a cardiac rehab program, find out if you qualify, and request that your physician schedule an appointment for you.
If you smoke, quitting will make the single most significant impact on your overall risk of CAD progression because it can cut your risk of a future MI as much as 50 percent. Many communities have smoking cessation programs, so ask your physician about enrollment.
Medications
if exercise and diet are not enough to reduce your controllable risk factors to a manageable level, your doctor will prescribe drugs.
Drugs such as beta blockers, calcium channel blockers, and diuretics will aid with blood pressure control. Statins, fibrates, niacin, and bile acid drugs help to reduce bad cholesterol and elevate your good cholesterol levels.
If you have diabetes, there are different categories of choices, including insulin, that can help you reach blood sugar levels within the recommended guidelines.
If you are having difficulty stopping smoking, medication such as Chantix and Wellbutrin have demonstrated positive results.
Interventional Procedures
If the blockages in your arteries are severe enough, your physician will schedule you for an angioplasty or stent procedure. Angioplasty and stenting will open the blocked artery and allow complete blood flow to return to the obstructed area.
If angioplasty and stenting are not an option, your physician will visit with you about undergoing a Coronary Artery Bypass Graft (CABG).
CAD is the single most prevalent form of disease worldwide. However, it is a treatable condition when it’s detected early enough.
Many people with CAD can have active and healthy lifestyles and live to and beyond their full life expectancy. The key to remember is to seek medical care when you experience warning signs, and work with your physician to manage your condition best.