Coronary Artery Disease
Coronary artery disease (CAD) affects the arteries that supply blood to the heart. It is produced when these arteries begin to narrow due to the build up of plaque caused by cholesterol, fat deposits, calcium or other substances in the blood. This plaque build up can also be produced in the carotids (which supply blood and oxygen to the brain) or in the arteries carrying blood to the legs, arms and pelvis.
How is it produced?
Some factors, such as smoking, cholesterol, high blood pressure or diabetes can damage the walls of the arteries which, in turn, can harden (a disease known as “atherosclerosis”). Because of this damage, the body tries to protect itself, and this provokes a bigger build up of plaque in the damaged arteries. With the passing of time, the plaque reduces the blood flow through the arteries (or even blocks the arteries completely), thus limiting the flow of oxygen-rich blood to the heart muscle. In other cases, the plaque breaks away and causes a blood clot that reduces or blocks the arteries. This can cause chest pain (angina) or even an acute myocardial infarction (MI). Other factors that can cause CAD are menopause, aging or a family history of heart problems.
What are the symptoms of CAD?
Two out of three people who suffer a MI remember having experienced severe pain in the chest, breathing difficulties or fatigue. The most common symptom is pain in the middle of the chest that then spreads to the back, jaw, left arm, and sometimes the right arm too. With less frequency, pain is felt in the abdomen and can be confused with indigestion. In the case that you have any of these symptoms, you should seek medical care as soon as possible.
How is CAD diagnosed?
There are several ways:
- With an electrocardiogram, also known as ECG, which measures electrical activity in the heart and can show if it has been damaged by a MI.
- With a stress test, which measures the electrical activity in the heart while the patient exercises.
- With a coronary angiogram, which can show arteries blockages or narrowing (generally, a contrast dye is injected, which shows the state of the arteries).
What does treatment of CAD involve?
Treatment should depend on how serious the blockage is, but it should always go hand in hand with a change in lifestyle, exercise and diet. There are drugs that can relieve chest pain because of blockages, but do not treat blockages per se. Among the medical procedures, we can pinpoint the following:
- Angioplasty, which is a non-surgical procedure performed in the hospital. The doctor threads a small tube (known as a catheter) through the groin or arm, and then passes through the artery to get to the site of the blockage. At the top of the catheter, there is a small balloon that inflates slowly and breaks up the blockage.
- Many patients that undergo an angioplasty also get a stent, which is a sort of metal mesh that expands the artery back to its normal size. The stent stays in the artery to help keep the blood flowing. With the passing of time, the affected wall surrounding the device heals.
- Finally, the patient can get a coronary bypass, which is a procedure that requires an open heart surgery to rebuild the arteries or veins affected and replace them with healthy ones, taken from other parts of the body. There are associated risks for all of these procedures, and so it’s very important to consult a specialist.
