Heart disease is a leading cause of death among men and women in the most developed countries. Coronary artery disease affects 16.5 million Americans. The American Heart Association (AHA) estimates that someone in the US has a heart attack about every 40 seconds. In addition, for patients with no risk factors for heart disease, the lifetime risk of having cardiovascular disease is 3.6% for men and less than 1% for women. Having 2 or more risk factors increase the lifetime risk of cardiovascular disease to 37.5% for men and 18.3% in women.
What is it?
Coronary artery disease is also known as ischemic heart disease. This is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis (sometimes called “hardening” or “clogging” of the arteries) is the build-up of cholesterol and fatty deposits (called plaques) on the inner walls of the arteries. These plaques can restrict blood flow to the heart muscle by physically clogging the artery or by causing abnormal artery tone and function.
Without an adequate blood supply, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. This can cause chest pain called angina. If the blood supply to a portion of the heart muscle is cut off entirely, or if the energy demands of the heart become greater than its blood supply, a heart attack (injury to the heart muscle) may occur.
There are two types of risk factors that make a person more susceptible to have coronary artery disease.
Nonmodifiable risk factors (those that cannot be changed)
- Male gender
- Advanced age
- Family history of heart disease
Modifiable risk factors (those you can treat or control)
- Cigarette smoking and exposure to tobacco smoke
- High blood cholesterol and high triglycerides
- High blood pressure (140/90 mmHg or higher)
- Uncontrolled diabetes (HbA1c >7.0)
- Physical inactivity
- Being overweight (body mass index [BMI] 25–29 kg/m2) or being obese (BMI higher than 30 kg/m2)
The diagnosis of Coronary heart disease involves the following:
- Electrocardiograph tests, such as an electrocardiogram (ECG or EKG) or exercise stress tests, use the electrocardiogram to evaluate the electrical activity generated by the heart at rest and with activity.
- Laboratory Tests: include a number of blood tests used to diagnose and monitor treatment for heart disease.
- Invasive Testing, such as cardiac catheterization, involves inserting catheters into the blood vessels of the heart in order to get a closer look at the coronary arteries.
- Other diagnostic tests may include: Nuclear Imaging, Radiographic Tests
Treatment for CAD
There are a couple of treatment options for this disease. It ranges from changes in lifestyle to medical and surgical interventions based on the severity of each case.
- Reduce your risk factors i.e. modifiable factors: this involves controlling the cholesterol taken in from your diet, become more physically active, etc
- Common interventional procedures to treat coronary artery disease include balloon angioplasty (PTCA) and stent or drug-eluting stent placement.
- Coronary artery bypass graft (CABG) surgery: One or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart. These grafts usually come from the patient’s own arteries and veins located in the chest, arm or leg. • Enhanced external counter-pulsation (EECP): This may stimulate the opening of smaller blood vessel branches creating a natural bypass around blocked vessels.
Featured image: Daily Express
Dianabasi is a Medical Writer at Medics Abroad and a medical student at Trinity College Dublin. She is passionate about volunteering and activism.