What is Coronary Artery Disease?
The coronary arteries are responsible for delivering nutrient- and oxygen-rich blood to the heart. There are two main coronary arteries (right and left), and each branches into smaller arteries responsible for specific sections of the heart. Coronary artery disease occurs when fatty deposits, or plaque, builds up within the inner walls of these arteries, leading to partial or complete blockages. Coronary artery disease progresses slowly and can often go undiagnosed for a long period of time. The consequences can be life-threatening.
What are the Risk Factors Associated with Coronary Artery Disease?
It is estimated that coronary artery disease affects over 16 million Americans, and while the disease does occur across all races and genders, there are some factors which can make certain individuals more susceptible than others. While some of these will be beyond a patient's control, there are several which can be influenced to greatly reduce overall risk. Commonly associated risk factors include:
- Age (over 65)
- Family history of cardiovascular disease
- High cholesterol
- High blood pressure (hypertension)
- Lack of physical fitness
What are the Complications of Coronary Artery Disease?
Blockages of the coronary arteries can lead to serious and even deadly complications. Possible symptoms and medical events resulting from coronary artery disease include:
Heart Attack - A heart attack is damage to the heart muscle sustained when it is deprived of blood and oxygen due to the partial or total block of a coronary artery. Heart attacks range widely in their severity. Some are fatal, whereas others are so small they produce no noticeable symptoms and are only detected through later testing. Prompt medical attention greatly increases the rate of survival and decreases the rate of lasting complications in heart attack sufferers.
Angina - Angina, or chest pain, is a classic symptom of coronary artery disease and can be an early clue to an impending heart attack. Symptoms of angina such as sensations of pressure or squeezing in the chest often occur during times of physical exertion but may present at any time. Any instances of unexplained chest pain should be promptly evaluated by a physician.
Heart Failure - Heart failure occurs when the heart, weakened from an inadequate blood supply, is unable to efficiently pump blood to the rest of the body. The condition may also develop as the result of a heart attack.
Arrhythmia - Like heart failure, arrhythmia, or an irregular heart beat, can develop as the result of a damaged or weakened heart muscle.
How is Coronary Artery Disease Diagnosed?
The first step in reaching a diagnosis of coronary artery disease is an examination by a cardiologist. The physician will assess for risk factors, conduct a physical exam, and order blood tests. Following the exam, additional testing will be needed before a definitive diagnosis can be reached. Common diagnostic tests for coronary artery disease include:
Electrocardiograph Tests - Electrocardiograph tests such as an EKG or stress test record electrical activity in the heart while at rest or during a physical activity like walking on a treadmill. Abnormal results may indicate reduced blood flow or even reveal evidence of a past heart attack.
Echocardiogram - An echocardiogram is a type of ultrasound used to observe the structure of the heart, how it is pumping, and the direction of blood flow. All of these can provide clues regarding the health of coronary arteries and the possibility of restricted circulation.
CT Scan - A computerized tomography (CT) scan takes x-ray images at different angles around the body and then uses a computer to produce more detailed, cross-sectional images. This can help physicians spot problems such as calcium deposits in the arteries.
Cardiac Catheterization and Angiogram - One of the best ways to observe blood flow in the coronary arteries and diagnose blockages is with a cardiac catheterization and angiogram. During the catheterization, a long, thin tube (catheter) is inserted through an artery in the groin, arm or neck and guided to the coronary arteries. Then, the angiogram is performed by injecting a special dye through the catheter and allowing the physician to assess areas of reduced blood flow.
How is Coronary Artery Disease Treated?
Treatment of coronary artery disease will depend on factors such as severity of the condition and overall health of the patient and may include one or more of the following:
Lifestyle Changes - The first step in protecting against coronary artery disease is to implement healthy lifestyle changes that can reduce your risk. Dietary changes can help control high blood pressure, reduce cholesterol, and manage conditions such as diabetes. Regular exercise can help strengthen the cardiovascular system and aid in weight loss, and quitting smoking offers an incredible range of heart health benefits.
Prescription Medications - When lifestyle changes alone aren't enough, prescription medications can help control certain factors that contribute to coronary artery disease, including high blood pressure and cholesterol. Other medications that your physician may recommend can include aspirin, beta blockers or calcium channel blockers.
Angioplasty and Stent Placement - These procedures are minimally invasive and typically performed in a cath lab. They restore proper blood flow by opening the blocked artery. A catheter is used to insert and inflate a small balloon in the affected artery (angioplasty), thereby widening the space. In most cases, this is followed by placement of a mesh stent to help the artery maintain its open position.
Coronary Artery Bypass Surgery - Coronary bypass surgery is a major surgical procedure performed in a hospital setting and under general anesthesia. For this reason, it is reserved for the most severe cases. During the surgery, a blood vessel from another part of the body is used to create a bypass route for blood to flow around the blocked portion of the artery.
CIS physicians are highly-skilled experts in the diagnosis, management, and treatment of coronary artery disease. Our physicians evaluate each patient on a case-by case basis to determine the best course of treatment.