Coronary Artery Disease

What is coronary artery disease?

Coronary artery disease is a very common type of heart
disease, it is the most common heart disease in the US.
Coronary heart disease can develop because of damaged or
diseased blood vessels that supply the heart with
blood,nutrients and oxygen.
The main causes of CAD is the cholesterol-containing plaques
in the coronary artery and the inflammation. These buildups
can narrow those arteries, decreasing the blood supply to the
heart. This may eventually result in chest discomfort (angina),
shortness of breath, or other signs and symptoms of coronary
artery disease. In case of complete blockage, a heart attack
may develop

Symptoms

Reduced blood flow may not create any symptoms at first. As
plaque builds up in your coronary arteries, the typical symptom
to appear is angina, or chest pain and discomfort.
Some people consider that the first sign that someone has CAD
is having a heart attack. These are the most common
symptoms of the coronary artery disease:
● Angina. A chest tightness or pain occurs on the middle or
left side of the chest. Physical or mental stress can trigger
the anginal, and it lasts for a few minutes and goes away.
The pain may be felt in areas other than the chest; like the
neck, arm, or back.
● Shortness of breath. Because of the lack of blood supply
to the heart, fatigue and shortness of breath will develop.
● Heart attack. As a result of the complete blockage of the
coronary artery; signs of heart attack can develop. Typical
signs and symptoms of heart attack are arm or shoulder
pain, crushing chest pain, shortness of breath and
sweating.
There are some other symptoms that are not typical, but
are common in some patients. These symptoms tend to
happen to women more than men; like jaw and neck pain,
nausea, fatigue, and sometimes shortness of breath.

What causes coronary artery disease?

Coronary artery disease is caused by plaque buildup in the
walls of the coronary arteries. It’s thought that it begins with
damage to the coronary artery’s inner layer, it may be caused
by some factors, including hypertension, smoking,
hypercholesterolemia, diabetes, insulin resistance, and
sedentary lifestyle.
The fatty deposits and cellular wastes begin to collect at the
injury site causing atherosclerosis. After that, the plaque may
rupture and trigger the release of platelets to repair the injury
site. The platelets tend to clump together at the injury site and
can block the artery, causing a heart attack.

Risk factors

Smoking, hypertension, diabetes, hypercholesterolemia,
obesity, physical inactivity, and stress are risk factors of CAD.
Eating unhealthy food that contains large amounts of sugar,
salt, saturated fats, and trans fats worsen the health and can
lead to a lot of heart diseases.
Family history has a significant role in the heart diseases, age,
also, is an important factor, as the risk of narrowing or damage
of the arteries increases when getting older.
It’s important to notice that men at more risk of CAD than
women, but the risk increases in women after menopause.

Complications

CAD can lead to some complications, including:
● Angina, because of the narrowing of the coronary arteries.
Angina may be triggered by physical activity.
● Heart attack, as a result to the heart artery blockage
● Heart failure, when the heart becomes too weak to pump
the blood all over the body. That’s because of the oxygen
and nutrients abbreviation.
● Arrhythmia, when the electrical impulses are interrupted
by the inadequate blood supply.

How is coronary artery disease diagnosed?

After taking the patient’s medical history, the doctor should
perform some diagnostic tests, including ECG,
echocardiogram, exercise stress test, nuclear stress test,
cardiac catheterization and angiogram, and cardiac CT scan

What is cardiac rehabilitation and recovery?

Cardiac rehab is a customised outpatient program of exercise
and patient education to improve the quality of life and protect
patients from any other cardiac event.
It is a program designed for the patient that includes physical
activity, medical and mental counselling, and health education
like following a healthy diet, taking medications on time, and
stopping bad life habits.
A team of specialists supervise the patient closely and monitor
his health and medical habits.

Prevention

Modifying the lifestyle is the key for the prevention of coronary
artery disease. These are some tips to follow to improve the
heart health:
● Smoking cessation
● Eating more healthy food like vegetables, fruits, low-fat,
low-salt food, and whole grains.
● Stopping unhealthy food that contains saturated fats and
much sugars and salts.
● Weight control
● Increasing physical activity
● Controlling cholesterol level, blood glucose and blood
pressure.
● Reducing stress

Treatment

Usually, CAD treatment involves a lot of aspects, including:

Lifestyle

Smoking cessation, improving dietary habits, exercise daily,
weight reduction and stress control promote healthier arteries.

Drugs

To treat CAD, we can use various drugs, like:
1. Cholesterol-modifying medications, as statins, niacin,
fibrates, and bile acid sequestrants reduce the chances of
plaques buildup.
2. Aspirin, to reduce the tendency of blood clotting. It’s
important to consider bleeding or GIT disorders before
prescribing aspirin.
3. Beta blockers, to reduce the heart rate, blood pressure,
and the heart’s oxygen demand.
4. Calcium channel blockers, to improve chest pain and can
be used in combination with beta blockers.
5. Ranolazine, to help improve symptoms of chest pain and
can be used with beta blockers.
6. Nitroglycerin, in different dosage forms like tablets, sprays,
and patches can dilate the coronary arteries, thus
reducing the cardiac demand of blood and the chest pain.
7. ACE inhibitors and ARBs, to decrease blood pressure.

Procedures to restore and improve blood flow

● Some options to restore and improve blood flow are:
● Angioplasty and stent placement – percutaneous
coronary revascularization
● Coronary artery bypass surgery

Lifestyle and home remedies

To prevent any progression of the disease, the patient should
follow some steps. He should quit smoking, check their blood
cholesterol and blood pressure regularly, keep diabetes under
control, exercise more, reduce their weight, manage stress, and
practice cardiac rehabilitation.

Alternative medicine

Some alternative medicines are thought to be a contributing
factor to CAD, including fish and fish oil, flax and flaxseed oil,
and some sources of omega-3 fatty acids.
It’s important for patients to ask their doctor before taking any
medication or alternative medicine to improve their cardiac
health.

Sources

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