Coronary Artery Disease

Coronary artery disease is a buildup of fatty deposits in the coronary arteries, which supply blood to the heart. This buildup of fat, cholesterol and calcium, known collectively as plaque, can cause a hardening and narrowing of the arteries which restricts blood from reaching the heart. Blood clots can also form and completely block the artery. Coronary artery disease develops gradually and can eventually lead to a heart attack or heart failure. Coronary artery disease is the leading cause of death in the United States for both men and women.

Causes of Coronary Artery Disease

During the aging process, the coronary arteries may become clogged with cholesterol, fat, calcium and other substances which gradually build up on their wall as arterial plaque. This is condition is known as atherosclerosis. Certain factors increase the risk of coronary artery disease, including:

  • High LDL, or bad cholesterol
  • Low HDL, or good cholesterol
  • High blood pressure
  • Smoking
  • Family history
  • Diabetes
  • Obesity
  • Physical inactivity
  • High stress level

The risk of damaged and narrowed arteries increases as people get older. In addition, men generally have a greater risk of coronary artery disease, however, the risk for women increases after menopause.

Symptoms of Coronary Artery Disease

Since the build up of plaque is a gradual process, individuals may not experience any symptoms for some time. Once the coronary arteries narrow to a certain degree, the following symptoms may occur:

  • Angina or chest pain
  • Shortness of breath, especially during physical activity
  • Heart attack
  • Heart failure
  • Arrhythmia

Some patients do not know they have coronary artery disease until they have a heart attack.

Diagnosis of Coronary Artery Disease

Coronary artery disease is diagnosed through a physical examination and a review of symptoms. The patient is hooked up to a heart monitor and an electrocardiogram is administered. The following diagnostic test may also be performed:

  • Blood tests
  • Chest X-ray
  • Echocardiogram
  • Coronary catheterization (angiogram)
  • Stress test

CT and MRI scans may also be performed to diagnose any heart problems and the extent of any damage from a heart attack. The doctor may also recommend that the patient wear a holter monitor for a few days to get an accurate reading of the heart's activity. A holter monitor is a small, portable device that continuously records the heart's rhythms and records the electrical activity of the heart.

Treatment of Coronary Artery Disease

Medications such as beta blockers, nitroglycerin and cholesterol-modifying drugs can help treat coronary artery disease. Aspirin may be recommended to prevent blood clots and thrombolytics may be prescribed to break up any existing clots. Surgical procedures such as angioplasty, stent placement and coronary artery bypass surgery may be necessary to treat severe cases of coronary artery disease.

Prevention of Coronary Artery Disease

Coronary artery disease may be prevented through lifestyle changes to reduce risk factors and the clogging of arteries. Recommended lifestyle modifications include:

  • Quitting smoking
  • Eating a healthy diet
  • Exercising regularly
  • Losing weight
  • Reducing stress

Since coronary artery disease greatly increases the risk for heart attack, it is important to seek regular medical attention to manage the condition and prevent serious complications.

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