Coronary Artery Disease

What Is It?

Coronary artery disease (CAD) is the narrowing of coronary arteries. These are the blood vessels that supply blood and oxygen to the heart. The condition is also called coronary heart disease (CHD).

CAD is usually caused by atherosclerosis. Atherosclerosis is the buildup of plaque inside the coronary arteries. These plaques are made up of fatty deposits and fibrous tissue.

Atherosclerosis can significantly narrow the coronary arteries. This decreases the blood supply to the heart muscle. It triggers a type of chest pain called angina.

Atherosclerosis also can cause a blood clot to form inside a narrowed coronary artery. This causes a heart attack. A heart attack can significantly damage the heart muscle.

Atherosclerosis

The risk factors for atherosclerosis and CAD are basically the same. These risk factors include: 

• High blood cholesterol level 
• High level of LDL (bad) cholesterol 
• Low level of HDL (good) cholesterol 
• High blood pressure (hypertension) 
• Diabetes 
• Family history of CAD at a younger age 
• Cigarette smoking 
• Obesity 
• Physical inactivity 

CAD is the most common chronic, life-threatening illness in most of the world's developed nations.

Symptoms

In most people, the most common symptom of CAD is angina. Angina, also called angina pectoris, is a type of chest pain.

Angina usually is described as a squeezing, pressing or burning chest pain. It tends to be felt mainly in the center of the chest or just below the center of the rib cage. It also can spread to the arms (especially the left arm), abdomen, neck, lower jaw or neck.

Blood Pressure runs high

Other symptoms can include: 

• Sweating 
• Nausea 
• Dizziness or lightheadedness 
• Breathlessness 
• Palpitations 

A patient may mistake heart symptoms, such as burning chest pain and nausea, for indigestion.

There are two types of chest pain related to CAD. They are stable angina and acute coronary syndrome.

Stable angina.
In stable angina, chest pain follows a predictable pattern. It usually occurs after: 

• Extreme emotion 
• Overexertion 
• A large meal 
• Cigarette smoking 
• Exposure to extreme hot or cold temperatures 

Symptoms usually last one to five minutes. They disappear after a few minutes of rest. Stable angina is caused by a smooth plaque. This plaque partially obstructs blood flow in one or more coronary arteries.

Blood clot

Acute coronary syndrome (ACS). 
ACS is much more dangerous. In most cases of ACS, fatty plaque inside an artery has developed a tear or break. The uneven surface can cause blood to clot on top of the disrupted plaque. This sudden blockage of blood flow results in unstable angina or a heart attack.

In unstable angina, chest pain symptoms are more severe and less predictable than in stable angina. Chest pains occur more frequently, even at rest. They last several minutes to hours. People with unstable angina often sweat profusely. They develop aches in the jaw, shoulders and arms.

Many people with CAD, especially women, do not have any symptoms. Or, they have unusual symptoms. In these people, the only sign of CAD may be a change in the pattern of an electrocardiogram (ECG). An ECG is a test that records the heart's electrical activity.

An ECG can be done to  records the heart's electrical activity.

An ECG can be done at rest or during exercise (exercise stress test). Exercise increases the heart muscle's demand for blood. The body can't meet this demand when the coronary arteries are significantly narrowed. When the heart muscle is starved for blood and oxygen, its electrical activity changes. This altered electrical activity affects the patient's ECG results.

In many people, the first symptom of coronary artery narrowing is a heart attack.

Prevention

• You can help to prevent CAD by controlling your risk factors for atherosclerosis. To do this: 
• Quit smoking. 
• Eat a healthy diet. 
• Reduce your LDL (bad) cholesterol. 
• Reduce high blood pressure. 
• Lose weight. 
• Exercise. 

CAD is a long-term condition. People can have different patterns of symptoms.

Plaque in coronary arteries never will disappear completely. However, with diet, exercise and medication, the heart muscle adapts to decreased blood flow.

New, small blood channels can develop to increase the blood flow to the heart muscle.

Heart attack

Lifestyle changes

Lifestyle changes include: 

• Weight loss in obese patients 
• Quitting smoking 
• Diet and medications to lower high cholesterol and high blood pressure 
• Regular exercise 
• Stress reduction techniques, such as meditation and biofeedback

Do your yearly check up and remember to inform them about any abnormal symptoms

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