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Coronary artery disease (CAD), the most common type of heart disease, refers to the narrowing of arteries that supply blood to the heart due to a build-up of a sticky substance called plaque. The heart muscle does not get enough oxygen when heart arteries are narrowed. If the heart is starved of oxygen, chest pain (Angina) occurs. A piece of the plaque may break off and cause the body to form a clot on the damaged artery, cutting off oxygen to the heart and leading to a Heart Attack. A heart attack is medically referred to as a myocardial infarction (MI) and is one of the leading killer of both men and women.
Many of these deaths can be prevented because some risk factors for CAD are controllable. These controllable risk factors include high blood pressure, high blood cholesterol, and Diabetes. There are other controllable risk factors related to lifestyle, such as not smoking, maintaining a healthy weight, eating a healthy diet, reducing alcohol consumption, and being physically active.
Although medical treatments for heart disease have come a long way, controlling risk factors remains the key to preventing illness and death from CAD.
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A low supply of oxygen in the heart is most often caused by atherosclerosis, also called "hardening of the arteries." In this condition, fatty deposits called plaques form in the linings of the blood vessels. The plaques make the arteries narrower as they build up, and less blood is able to get through to the heart, depriving it of oxygen.
Atherosclerosis is often the result of too much "bad" cholesterol (low density lipoprotein, or LDL) and triglycerides circulating in the bloodstream.
You are at risk for developing atherosclerosis and CAD if you:
Occasionally, a genetic condition can cause atherosclerosis, leading to heart disease.
Men run a higher risk of developing the disease than premenopausal women. After Menopause, the risk of CAD in women increases, and can be equal to men.
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Some people with CAD might have no symptoms until the disease is severe enough to cause chest pains, or angina pectoris (angina comes from the Greek word for "strangling").
Stable angina is often the first sign that a person has CAD. Chest pain or discomfort occurs with activity and is relieved by rest. With unstable angina, symptoms become less predictable and can occur when you are at rest. This indicates rapid progression of CAD and higher risk of a heart attack and requires that you see a doctor immediately.
Some symptoms of angina include:
If a plaque lining a blood vessel ruptures, it may completely block an area of the heart from receiving the oxygen-rich blood supply it needs. The starved cells in that area will then die, resulting in a heart attack.
The symptoms of a heart attack are similar to those of angina, but much stronger.
Men will often feel:
In women, the main symptoms can be similar to men but may also include:
It's very important to get medical help as quickly as possible if you feel you have the symptoms of a heart attack.
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An electrocardiogram (ECG) detects abnormal electrical cardiac charges. In someone who has had heart damage, the electrical signals that keep the heart beating change as they pass through damaged tissue. This can be detected and measured on an ECG.
An exercise electrocardiogram (or stress test) checks your heart for changes during periods of activity, and it can also show if the coronary arteries are too narrow. An exercise stress test is performed on a treadmill or a stationary bicycle while hooked up to an ECG. A thallium scan allows imaging of blood flow in the heart during exercise. This involves injecting a very small dose of radioactive substance into the bloodstream, which is followed through the heart by a special camera.
With angina, abnormalities in the ECG may only occur while the person is having an angina attack. Some people have "silent angina," where even an attack brings no symptoms. To detect this, you may be asked to wear a monitor for 24 hours. The ECG tape is analysed for irregularities, and then compared with a detailed diary, in which you record your daily activities and any unusual symptoms.
Coronary angiography (or arteriography) is a test used to explore the coronary arteries. A fine tube (catheter) is put into an artery of an arm or leg and passed through the tube into the arteries of the heart. The heart and blood vessels are injected with contrast dye, which is then filmed with an X-ray while the heart pumps. The picture that is seen, called an angiogram or arteriogram, will show problems such as a narrowing or blockage caused by atherosclerosis.
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Your doctor may prescribe any of these medication treatments:
When aggressive treatment is required, your doctor may recommend a procedure to help improve blood flow. Some options include:
Getting medication treatment isn't the only way to combat coronary artery disease. Here are a few heart-healthy tips to help prevent CAD:
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., Acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
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