There are millions of people worldwide who suffer from coronary artery disease (CAD). Plaque, a fatty substance that builds up on the inner walls of the arteries, narrows or blocks blood vessels that supply the heart with oxygen and nutrients, causing it to become narrow or blocked. As a result, chest pain, shortness of breath, fatigue, and even a heart attack can occur.
An important cause of CAD is atherosclerosis, a process where plaque builds up over time in the arteries. Blood clots can form when the plaque hardens and ruptures, blocking blood flow or traveling to other parts of the body. Plaque can also cause inflammation, which damages the artery walls and increases the risk of narrowing and clotting.
Some factors that increase the risk of developing CAD include:
High blood pressure
High cholesterol levels
Smoking
Diabetes
Obesity
Physical inactivity
Unhealthy diet
Family history of heart disease
Age (older than 45 for men and 55 for women)
Gender (men are more likely to develop CAD than women)
Stress
Excessive alcohol consumption
History of preeclampsia during pregnancy (for women)
The symptoms of CAD may vary depending on the severity and location of the blockage. Some people may not have any symptoms until they have a heart attack. Others may experience:
Angina is a chest pain or discomfort that occurs when the heart does not receive enough blood. It can feel like pressure, tightness, squeezing, burning, or heaviness in the chest. It can also radiate to the arms, shoulders, neck, jaw, or back. It usually occurs when one is physically or emotionally stressed and usually goes away with rest or medication.
Shortness of breath, or difficulty breathing, especially when exerting oneself or lying down.
Fatigue, or feeling tired or weak, due to reduced blood flow to the body.
Dizziness, or feeling lightheaded or faint, due to low blood pressure or abnormal heart rhythms.
Nausea, vomiting, sweating, or palpitations, which are less common symptoms that may accompany chest pain or discomfort.
Heart attacks are life-threatening complications of CAD caused when a blood clot completely blocks an artery, cutting off the blood supply to a part of the heart muscle. They may include the following signs and symptoms:
Severe or persistent chest pain or discomfort that does not go away with rest or medication.
Pain or discomfort in other parts of the body, such as the arms, shoulders, neck, jaw, or back.
Shortness of breath, or difficulty breathing, that may occur with or without chest pain.
Cold sweat, or sudden and profuse sweating.
Nausea, vomiting, indigestion, or abdominal pain.
Lightheadedness, dizziness, fainting, or loss of consciousness.
Anxiety, fear, or a sense of impending doom.
A heart attack is a medical emergency that requires immediate treatment. If you or someone you know has any of these symptoms, contact 911 or your local emergency number immediately. Do not drive yourself to the hospital. If you delay treatment, you could suffer permanent damage to your heart muscle or die.
Other possible complications of CAD include:
A condition in which the heart cannot pump enough blood to meet the body's needs. Symptoms include shortness of breath, swelling of the leg and foot, fatigue, and reduced ability to exercise.
Some arrhythmias can be harmless, while others can be dangerous and cause fainting, strokes, or cardiac arrest.
When a blood clot or bleeding vessel interrupts blood flow to a part of the brain, it is called a stroke. In addition to sudden weakness, numbness, or paralysis of the face, arm, or leg, particularly on one side of the body, confusion, difficulty communicating or understanding, sudden vision problems, sudden dizziness, difficulty walking, or severe headaches without any apparent cause, it can cause sudden confusion, difficulty speaking or understanding.
In order to diagnose CAD, your doctor will ask you about your medical history, family history, symptoms, and risk factors. They will also perform a physical examination and listen to your heart and lungs. They may order various tests to check your heart function and blood flow.
Electrocardiogram (ECG or EKG), a test that measures the electrical activity of the heart and can detect signs of a heart attack, arrhythmia, or damage to the heart muscle.
With an echocardiogram, you can see how well your heart chambers and valves are working, as well as how much blood your heart pumps.
This test measures how well the heart responds to stress and if there is a reduction in blood flow to the heart by exercising or taking a medication that makes the heart work harder.
Your echocardiogram shows youam, a test that involves inserting a thin, flexible tube (catheter) into a blood vessel in the groin or arm and advancing it to the heart. A dye is injected through the catheter and X-rays are taken to show the blood flow through the coronary arteries and identify any blockages.
CT scan uses X-rays and a computer to create detailed images of the heart and the coronary arteries. It can measure calcium deposits in the arteries, a sign of plaque buildup.
In magnetic resonance imaging (MRI), a powerful magnet and radio waves are used to produce detailed images of the heart and coronary arteries. These images can provide information about the heart's structure, function, and blood flow.
The treatment of CAD depends on the severity and extent of the disease, the symptoms, and the patient's overall health. In addition to relieving symptoms, improving blood flow, preventing complications, and reducing the risks of future events, treatment options may include:
It is important to make lifestyle changes, such as quitting smoking, eating healthy, exercising regularly, maintaining a healthy weight, managing stress, and limiting alcohol consumption. With these changes, blood pressure, cholesterol, and blood sugar levels can be lowered, and heart and blood vessel health can be improved.
Some of these medications include antiplatelets, anticoagulants, statins, beta blockers, nitrates, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and others. Blood clots can be prevented, cholesterol lowered, blood pressure reduced, heart rate controlled, chest pain relieved, and complications can be prevented or treated with these drugs.
The opening or bypassing of blocked or narrowed arteries can be achieved through procedures such as angioplasty and stent placement, coronary artery bypass grafting (CABG), or other types of surgery.
The best way to prevent CAD is to adopt a heart-healthy lifestyle and avoid or control the risk factors. Some of the preventive measures include:
Do not smoke or use tobacco products. If you do, quit as soon as possible. Smoking damages the blood vessels and increases the risk of atherosclerosis and heart attack.
Eat a balanced diet that is low in saturated fat, trans fat, cholesterol, salt, and added sugar. Include plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats, including those found in fish, nuts, seeds, and oils. Limit your consumption of red meat, processed foods, and sugary drinks. Consult a dietitian or doctor for dietary advice.
Exercise regularly for 150 minutes per week of moderate-intensity aerobic activity, such as brisk walking, cycling, swimming, or dancing. Besides running, jumping rope, or playing sports, you can also perform 75 minutes of vigorous-intensity aerobic activity each week. Make sure you have some strength training exercises at least twice a week to build and maintain muscle mass. If you have CAD or other health conditions, talk to your doctor before starting or changing your exercise routine.
Keeping a healthy weight is important for your height and body type. Overweight or obesity may increase your risk of high blood pressure, high cholesterol, and diabetes. You must burn more calories than you consume in order to lose weight. You can achieve and maintain a healthy weight by combining a healthy diet with regular exercise.
Manage stress in a positive and healthy manner. Stress can raise blood pressure, heart rate, and hormones, which can damage the arteries and increase your risk of heart attack. Avoid negative coping strategies, such as smoking, drinking, overeating, or isolating yourself, and find ways to cope with stress, such as meditation, yoga, breathing exercises, hobbies, music, or talking to someone you trust.
If you drink too much alcohol, you may raise your blood pressure, triglycerides, and calories, and may interfere with some medications. Women should limit their alcohol consumption to one drink per day, and men should limit it to two drinks per day. In alcohol, a drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.
Follow your doctor's advice on how to keep your blood pressure, cholesterol, and blood sugar levels within normal ranges.
