Coronary artery disease (CAD) occurs when the arteries supplying oxygen-rich blood to the heart become narrowed or blocked due to a buildup of plaque, which includes cholesterol. This buildup restricts blood flow to the heart. Think of it like two lanes of traffic merging into one due to road construction—traffic still moves, but more slowly. In CAD, you might not notice any symptoms until the plaque causes a blood clot, which is like a barrier blocking the road. This blockage stops blood flow to the heart, leading to a heart attack. CAD can be present for many years without any symptoms, which is why it’s often called a “silent killer.” It is also known as coronary heart disease (CHD) or ischemic heart disease, and is what many people refer to when they talk about “heart disease.”
What Causes Coronary Artery Disease?
Several factors contribute to the development of atherosclerosis, including high cholesterol levels, high blood pressure, smoking, diabetes, and a sedentary lifestyle. Genetic factors can also play a role, as individuals with a family history of heart disease are at a higher risk. Moreover, lifestyle choices such as poor diet, lack of exercise, and excessive alcohol consumption can accelerate plaque buildup.
Types of Coronary Artery Disease
There are two main types of coronary artery disease:
- Stable ischemic heart disease: This is the long-term, ongoing type. Over many years, your coronary arteries slowly become narrower, reducing the amount of oxygen-rich blood that reaches your heart.
- Acute coronary syndrome: This is a sudden and serious type that requires immediate medical attention.
Symptoms and Causes
Common symptoms of chronic CAD include stable angina, which is temporary chest pain or discomfort that occurs in a predictable pattern, usually during physical activity or emotional stress, and goes away with rest or medication like nitroglycerin. Some people may also experience shortness of breath during light physical activity. In some cases, a heart attack might be the first noticeable symptom of coronary artery disease.
How CAD Leads to Heart Attacks
Coronary artery disease can lead to heart attacks when the blood flow to a part of the heart muscle is completely blocked. This blockage is typically caused by a rupture of the plaque that has built up in the coronary arteries, leading to the formation of a blood clot. If the blood clot is large enough, it can completely obstruct the flow of oxygen-rich blood to the heart muscle. Without adequate blood supply, the affected part of the heart muscle begins to die, resulting in a heart attack. The severity of a heart attack largely depends on the size and location of the blockage. Immediate medical intervention is crucial in restoring blood flow and minimizing damage to the heart muscle.
Diagnosing Coronary Artery Disease
Diagnosing CAD involves a combination of medical history evaluation, physical examination, and diagnostic tests. Common tests include electrocardiograms (ECG), stress tests, echocardiograms, and coronary angiography. Echocardiograms use ultrasound waves to create images of the heart, showing its structure and function. Coronary angiography, considered the gold standard for diagnosing CAD, involves injecting a special dye into the coronary arteries to visualize blockages on X-ray images.
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Prevention Strategies for Coronary Artery Disease
Preventive measures entail a healthy diet and regular physical activity.
Keeping a strict control on diabetes by regularly checking on your HBA1C, keeping blood pressure under control , avoid missing the medications and keeping weight under control play a major role in preventing CAD
If one is obese is is very essential to lose weight. For those at high risk, medical interventions might be needed alongside lifestyle changes, including medications to lower cholesterol, manage blood pressure, or control diabetes. Regular check-ups and screenings, like blood tests and imaging studies, are important for early detection of CAD, and in some cases, procedures like angioplasty or coronary artery bypass grafting (CABG) may be necessary to restore proper blood flow to the heart.
Metabolic and Bariatric surgery
Keyhole surgery for remission of type2 diabetes can play a significant role in avoiding CAD in high risk patients whose diabetes is not coming under control.
Bariatric surgery has proved in reducing significant weight , hypertension and thus improving cardiac function to a great extent.1
Treatment for Coronary Artery Disease
The treatment for CAD depends on the severity of the disease and may range from lifestyle changes and medications to surgical interventions. Medications commonly prescribed include statins to lower cholesterol, beta-blockers to reduce blood pressure, and antiplatelet agents to prevent blood clots. In more advanced cases, surgical options such as angioplasty with stent placement or coronary artery bypass grafting (CABG) may be necessary. Angioplasty involves using a balloon to widen the blocked artery, followed by placing a stent to keep it open. CABG involves creating a bypass around the blocked artery using a blood vessel from another part of the body, restoring normal blood flow to the heart muscle.
