Coronary Artery Disease – Causes, Symptoms, Diagnosis and Treatment
Coronary artery disease (CAD), also commonly referred to as coronary heart disease, is a health condition in which plaque affixes itself to the walls of the coronary arteries. Over time, accumulated plaque can create blockages in these blood vessels, preventing the natural flow of oxygen-rich blood to the heart from the lungs.
The plaque that causes coronary artery disease is made up predominantly of lipids, cholesterol and calcium. After adhering to the walls of a blood vessel, this plaque slowly hardens over time, causing a partial blockage of the blood flow through that vein or artery. In extreme cases, the plaque can block as much as 90-100% of the volume of the blood vessel. Another possible scenario includes the rupturing of this hardened plaque, which usually results in a blood clot being formed on the surface of the loosened plaque. If this clot becomes large enough, it can completely block the flow of blood in the artery or travel to the brain and cause a stroke.
Fast Facts about Coronary Artery Disease
- Coronary Artery Disease is a health condition in which plaque builds up on the walls of the coronary arteries impeding proper blood flow.
- Coronary artery disease is the number one cause of death in the United States, claiming over half a million lives annually.
- Although there are a number of scientifically supported causes for coronary artery disease, poor diet (high in fat, sodium and cholesterol) and lack of exercise are typically considered the primary drivers.
- Primary risk factors are: smoking, obesity, diabetes, age and genetic predisposition.
- The two biggest indicators of a potential case of coronary artery disease are angina (chest pain) and shortness of breath.
- Treatment of coronary artery disease typically begins with lifestyle changes. In moderate cases, medications might help treat various causes and symptoms associated with this condition. The most drastic treatments are non-invasive and invasive surgeries.
Common Causes of Coronary Artery Disease
There are only a few scientifically supported causes for coronary artery disease. The most conclusive studies have pointed to a poor diet and exercise routine. Specifically, a diet that is high in fatty foods, sodium or cholesterol can contribute greatly to a person’s predisposition to coronary artery disease. These fats and cholesterols enter the bloodstream and can make up as much as 70% of the substance responsible for creating plaque.
A secondary, though no less important, dietary cause of coronary artery disease is a high level of sodium that often goes hand in hand with a diagnosis of high blood pressure. Prevention and treatment of this condition often begins with administering blood pressure medications and a reduction of sodium in the diet. Furthermore, a specialist may recommend regulating sugar intake, as a high level of blood sugar (characteristic of diabetes) can often contribute to coronary artery disease.
The final major contributing factor to the incidence of coronary artery disease is the habit of smoking. There have been literally hundreds, if not thousands, of studies that indicate even just a handful of cigarettes per day can increase a person’s risk for a litany of health conditions, coronary artery disease being amongst them. Though for many probably the most difficult lifestyle change, it is necessary for the successful treatment and/or prevention of this condition.
Risk Factors for Coronary Artery Disease
Unfortunately for Americans, a large percentage of the population is considered at risk for coronary artery disease in one way or another as this disease is the number one cause of death in the United States.
Although all of us have some inherent risk for coronary artery disease, or similar conditions, as we age, there are still a large number of practices one can adopt to reduce his or her own risk for being diagnosed with coronary artery disease. Most of these practices have been deduced to be effective by analyzing the major risk factors for this condition.
Major Risk Factors
Smoking – Smoking has been shown to raise blood pressure and cholesterol, decrease the level of oxygen in the blood and to constrict blood vessels. All of these effects add up to an increased risk for coronary artery disease.
Diabetes – An increase in the level of sugar in the bloodstream can contribute to the creation of excess plaque and can decrease the efficiency of blood flow throughout the body.
Obesity – Obesity is a contributing factor to a long list of health ailments and coronary artery disease is no exception.
Age – There is no stopping Father Time. Eventually, the risk for each person will increase due to their age and a gradual weakening of the heart muscle.
Family History – This is often the first topic discussed with your doctor during an initial check-up and for good reason. A family history of coronary artery disease has been proven to be a reliable indicator of a person’s likelihood of being affected by the disease.
Symptoms of Coronary Artery Disease
Thankfully, coronary artery disease is not always a phantom condition that springs up overnight. More often than not, patients experience several symptoms for days, weeks or even months before a major coronary event. Unfortunately, many simply attribute these feelings to getting older and overlook the signs being given to them by their body.
The two biggest indicators of a potential case of coronary artery disease are angina and shortness of breath. Shortness of breath is something that occurs naturally during physical exertion. It is common for a person to be short of breath after they exercise or finish a bout of hard labor. However, if you begin to notice yourself being short of breath while doing tasks you used to complete effortlessly, there may be cause for concern. Many heart attack victims mentioned a shortness of breath when cooking dinner or watching TV, tasks that most certainly should not tax the lungs and heart too greatly.
In reference to coronary artery disease, the shortness of breath arises because the plaque build-up limits the amount of oxygen-rich blood going to the heart. If the heart receives less blood, it has lesser ability to pump effectively and deliver blood to other parts of the body. This creates an oxygen deficiency in the body and thus, shortness of breath.
The second major symptom of coronary artery disease is angina, or chest pain. Another result of a lack of oxygen-enriched blood getting to the heart efficiently, angina often manifests itself in the form of a pressure or squeezing sensation in the left center of the chest. Patients have also reported feeling pain in their arms, neck, jaw or back. The defining characteristic of angina is that it gets worse with physical activity or emotional stress and diminishes with rest.
Diagnosing Coronary Artery Disease
There is a large collection of tests and procedures that are at the disposal of doctors for diagnosing coronary artery disease. Some of these are:
The EKG is a painless test that involves placing an assortment of nodes around the chest and abdomen. These nodes collect and record data of the heart’s electrical activity and translate it into a visual. Scientists and researchers have studied the output images of an EKG in great detail. Modern medicine can now use these images to identify a weak heartbeat, an irregular rhythm, an irregular pace or a variety of other conditions.
This procedure involves asking an ambulatory patient to walk on a treadmill, ride a stationary bike or complete some form of exercise with the intent to put stress on the lungs and heart. The clinical staff involved is looking for any signs of pain and discomfort, especially in the chest area. For patients who are not physically capable of vigorous exercise, they receive a chemical injection that will increase their heart rate with no physical effort required.
Even something as simple as studying a sample of the patient’s blood can provide a vast amount of information about the heart’s condition. Laboratory staff can use a blood test to detect high cholesterol, fat, sugar and sodium levels, all of which are indicative of heart conditions like coronary artery disease.
A simple x-ray of the chest cavity can give a physician some insight into the health of the heart and lungs and other organs. Doctors and radiologists will often look for dark spots indicative of calcium build-up or look for scar tissue on the heart.
Treatment Options for Coronary Artery Disease
Among treatment options for coronary artery disease, lifestyle changes are certainly the most reasonable and the most effective option. The generic term – lifestyle changes – is often given to any recommendations made by a physician that serve to change the habits and patterns the patient exhibited that predisposed them to coronary artery disease. These can include the limitation or cessation of smoking and drinking, an improvement in the patient’s diet, an increase in the duration and intensity of exercise and a program to decrease or manage weight at a healthy level.
The second most common remedy for coronary artery disease is the prescription of medicines to treat the various causes and symptoms associated with this disease. These prescriptions can include anticoagulants (blood thinners), calcium channel inhibitors, beta blockers and statins. A combination of these drugs is used to lower blood pressure, prevent blood clots and otherwise alleviate the symptoms of coronary artery disease.
The final and the most drastic course of action for treating coronary artery disease is the use of one or more surgical procedures to restore a proper strength and flow of blood throughout the body.
There are two primary types of surgery for coronary artery disease, non-invasive and invasive. A non-invasive procedure involves threading a thin catheter through a blood vessel in leg and up to the heart, where the surgeon uses imaging technology to guide them to the affected artery. After locating the area of the blockage, they will use a balloon or stent inflated to the proper side to essentially hold the artery open. This is called coronary angioplasty.
An invasive procedure is one such as a graft or a bypass procedure. In these surgeries, the chest cavity is opened and the surgeon will either remove an area of the artery and replace it with another section of tissue or they will graft a portion of a blood vessel into the artery before and after the area of the blockage. This second option works similar to the system of highways that either go through or around a major city, with the city being the area of the blockage and the bypass highways being the new portion of tissue.
It is important to note that surgery is often only used when all other options have been exhausted or if the severity of the blockage is found to be such that it may threaten the patient’s life in the near future.