Coronary Artery Disease (CAD)/Atherosclerosis
What is coronary artery disease?
Also known as atherosclerosis of the coronary arteries, CAD, or heart disease, is a disease process in which fatty substances (plaque), such as cholesterol, are deposited on the inner lining of blood vessels (coronary arteries). When CAD is present, blood flow through the coronary arteries, which supply the heart with oxygen, can be reduced or blocked. The heart muscle may not receive enough oxygen and you may experience chest pain or angina.
Because the coronary arteries supply oxygen-rich blood to the heart, untreated blockages can be very serious and lead to a heart attack (myocardial infarction) or even death.
Over the course of a lifetime, many influences can cause one or more of your coronary arteries to become narrowed or blocked.
What are the symptoms of CAD?
CAD can progress very slowly, often without symptoms. Most people do not realize they have heart disease. The first sign that something may be wrong may be an episode of chest pain, angina or even heart attack.
Angina is a diagnosis by a physician, once chest pain symptoms have been thoroughly evaluated. Typical angina signs can include dizziness, a feeling of pressure or discomfort in the chest, heartburn and shortness of breath. Angina can occur as a single symptom or a combination of these symptoms.
For more information on chest pain vs. angina, click here.
What are the risk factors for CAD?
While CAD has long been viewed as a “man’s disease,” heart disease kills more women than men each year. In fact, it is the No. 1 killer of women in the U.S. The risk of heart attack for women increases significantly after age 65.
Mercy Women’s Center offers its Heart-to-Heart program [link here] to educate women about this “silent epidemic.” It includes a personalized assessment to determine if you are at risk of heart disease.
The exact cause of CAD is unknown, but common risk factors include:
- High blood pressure
- Having a close relative with heart disease
- High cholesterol and/or triglycerides in your blood
- Diabetes mellitus
- Smoking
- Excessive weight
- Lack of regular exercise
- People with peripheral vascular disease
Stress, secondhand smoke and abuse of alcohol are also risk factors that contribute to heart disease.
How is heart disease diagnosed?
If you have experienced symptoms or have an increased risk of heart disease, your physician may recommend that you have an exercise stress test, an electrocardiogram (ECG or EKG), chest x-ray, and blood tests.
Stress tests measure changes in the electrical activity of your heart as you perform controlled exercise, and may show if your heart muscle is at risk of dying or if there has been damage to your heart. You may need further testing.
Then, your physician may recommend a cardiac catheterization or coronary angiogram. This is one of the most useful methods to diagnose CAD because it allows the physician, under x-ray, to see exactly where the coronary arteries are narrowed or blocked. This is done by inserting a tiny tube, or catheter, into an artery and guided to your heart, where it is threaded through your heart’s blood vessels and a dye is injected to detect blockages.
What treatment is available?
In some cases, lifestyle changes are enough to halt the progression of CAD and manage the disease. Most patients with heart disease receive medication to prevent a heart attack and their physician recommends a low-fat diet and program of regular exercise. If you smoke, you must stop using all types of tobacco. Tobacco use contributes to the amount of build-up or blockage in arteries and decreases the amount of oxygen supplied to your tissues.
Medications may also be prescribed to lower cholesterol levels in your blood. But there are no drugs available to eliminate blockages in the heart’s arteries. There are several treatment options, however.
- Balloon angioplasty – May be done immediately following a cardiac catheterization. A balloon catheter is inserted and then inflated at the blockage site to open the blood vessel, and then removed.
- Coronary artery stent – A small, slotted, metal cylinder, or stent, is inserted into the clogged artery to act like scaffolding and hold it open. The stent may be coated with a special drug to help keep the artery open.
- Bypass surgery – An operation in which a piece of vein or artery is used to bypass a blockage in a coronary artery.
Mercy offers its Heart-to-Heart screening for women to measure heart health. For information or scheduling, call Mercy Women’s Center at 319-398-6821.
For more information on coronary artery disease, click here www.americanheart.org.
