Coronary artery disease (CAD) is the leading cause of death for both men and women in the United States each year. This disease occurs when the arteries that supply blood to the heart muscle becomes hardened and narrows.
The coronary arteries harden and narrow due to buildup of fatty material and plaque on the inner walls of the arteries. Eventually, the blood flow to the heart muscle is reduced and the heart muscle is not able to receive the amount of oxygen it needs. Sometimes platelets gather at the narrowing, forming a clot that decreases or prevents blood flow to the region of the heart supplied by the artery.
Decreased blood flow and oxygen supply to the heart muscle may cause chest pain (angina), shortness of breath or other symptoms. A complete blockage can cause a heart attack.
The disease can occur without any noticeable symptoms. However, the most common symptoms include:
- Chest pain - is the most typical symptom. It can be typical - midchest heaviness or a squeezing feeling that occurs with activity or emotion. It is relieved with rest or nitroglycerine. It can also be atypical - located in the chest, jaw, back, arm or abdomen. It is not related to activity and is not relieved with rest or nitroglycerine.
- Shortness of breath - If your heart can’t pump enough blood to meet your body’s needs, you may develop symptoms of heart failure — shortness of breath, extreme fatigue with exertion, and swelling in your feet and ankles.
- Heart attack - If a coronary artery becomes completely blocked, you may have a heart attack. The classic symptoms of a heart attack include crushing pain in your chest, pain in your shoulder or arm, and shortness of breath. Women are somewhat more likely than men to experience other warning signs of a heart attack, including nausea and back or jaw pain.
- High blood pressure
- Family history
- High cholesterol
- High blood sugar / diabetes
- Overweight or obese
- Menopause in women
- Lack of physical activity
How it is Diagnosed:
If you experience one or more symptoms you should consult your physician as soon as possible. The physician will ask questions about your medical history, do a complete physical exam, and order routine blood tests. They may suggest one or more diagnostic tests as well, including:
- Electrocardiogram (EKG) - this test measures the rate and regularity of your heart beat. It records electrical signals as they travel through your heart. An EKG can often reveal evidence of a previous heart attack or one that’s in progress.
- Echocardiogram - this test uses sound waves to create a moving picture of your heart. It provides information about the size and shape of your heart and how well your heart chambers and valves are functioning. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that are not contracting normally, and previous injury to the heart muscle caused by poor blood flow.
- Angiogram - this test is usually performed along with cardiac catherization. A dye that can be seen by x-ray is injected through the catheter into the coronary arteries. The doctor can see the flow of blood through the heart and the location of blockages.
Making certain lifestlye changes can help treat CAD. These include:
- Eating a healthy diet
- Exercising regularly
- Quitting smoking, if you smoke
- Losing weight, if you are overweight or obese
In addition to making lifestyle changes, medicines may be needed to treat CAD. Some medicines decrease the workload on the heart and relieve symptoms of CAD. Others decrease the chance of having a heart attack or dying suddenly and prevent or delay the need for a special procedure (for example, angioplasty or bypass surgery). Some of the medications commonly used to treat CAD include:
- Cholesterol-lowering medicines
- Beta blockers
- Ace inhibitors
- Calcium channel blockers
In some cases, procedures such as angioplasty or bypass surgery may needed to treat CAD.