What is coronary Artery Disease?
It can also be referred to as coronary heart disease or atherosclerotic heart disease. This disease can be defined as the end result of the accumulation of atheromatous (plaque) within the walls of the coronary arteries that supply the myocardium (the muscle of the heart) with oxygen and nutrients. Plaque (atheromatous) may be made up of fat, cholesterol, calcium and other substances found in the blood.
Causes of coronary Artery Disease
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The most common causes are; smoking, high blood pressure, high cholesterol, and diabetes and radiation therapy to the chest, as used for certain types of cancer. The above causes lead to the buildup of the plaque (atheromatous) in the coronary arteries. The process of the buildup is also called atherosclerosis. The buildup narrows arteries, reduces blood flow to the myocardium and may also lead to the formation of blood clots in the arteries which may cause insufficient blood flow to the heart muscle (ischemia). This in turn causes angina (heart attack).
A common symptom of coronary artery disease (CAD) is angina. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or a squeezing pain in your chest.
You also may feel it in your shoulders, arms, neck, jaw, or back. This pain tends to get worse with activity and go away when you rest. Emotional stress also can trigger the pain.
Another common symptom of CAD is shortness of breath. This symptom happens if CAD causes heart failure. When you have heart failure, your heart can't pump enough blood throughout your body. Fluid builds up in your lungs, making it hard to breathe.
Other signs and symptoms include; Coronary angiography demonstrates "normal" coronary arteries, i. e. no blockages or stenoses can be detected in the larger epicardial vessels, no inducible coronary artery spasm present during cardiac catheterization, characteristic ischemic ECG changes during exercise testing, ST segment depression and angina in the presence of left ventricular wall perfusion abnormalities during thallium or other stress perfusion test, consistent response to sublingual nitrates and postmenopausal or menopausal status.
The severity of these symptoms varies. The symptoms may get more severe as the buildup of plaque continues to narrow the coronary arteries
Treatment and Prevention.
Medical treatment involves drugs (cholesterol lowering medications, beta-blockers, nitroglycerin, calcium antagonists and others), coronary interventions as angioplasty and coronary stent-implantation and coronary artery bypass surgery
Coronary artery bypass surgery, also coronary artery bypass graft (CABG) surgery, is when Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowing's and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle).
Prevention centers on the modifiable risk factors, which include decreasing cholesterol levels, addressing obesity and hypertension, avoiding a sedentary lifestyle, making healthy dietary choices, and stopping smoking. There is some evidence that lowering homocysteine levels may contribute to more heart attacks (NORVIT trial). In diabetes mellitus, there is little evidence that very tight blood sugar control actually improves cardiac risk although improved sugar control appears to decrease other undesirable problems like kidney failure and blindness. Some recommend a diet rich in omega-3 fatty acids and vitamin C. The World Health Organization (WHO) recommends "low to moderate alcohol intake" to reduce risk of coronary artery disease although this remains without scientific cause and effect proof (Wikipedia).
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