health

Coronary Artery Disease: Symptoms, Diagnosis & Treatment

Dr. Nikhil Eric Saldanha

January 31, 2022

Unhealthy dietary habits may cause unhealthy fats to accumulate in your arteries. The fat deposits may also be called plaque. The accumulation may be in the arteries that carry oxygenated blood to your heart. It is pure blood. Plaque may cause narrowing in the artery, leading to coronary artery disease. In addition, it may affect the blood circulation to the heart. It, in turn, results in a heart attack. 

What is Coronary Artery Disease?

Coronary artery disease is the blockage or narrowing of your coronary arteries due to the accumulation of unhealthy fats called plaque. 

Our bodies have four main coronary arteries. The location of these arteries is above your heart muscle. They are the right and left coronary artery, left circumflex artery, left anterior descending artery. Blockage in any of the arteries may lead to coronary artery disease.

Coronary artery disease may also be termed coronary heart disease (CHD) or Ischemic Heart Disease (IHD). 

The Effect of Coronary Artery Disease

We know that plaque deposits cause coronary artery disease. It may contain bad cholesterol (LDL), unhealthy fats, calcium deposits and fibrin. Plaque is a clot-forming substance that may damage your arteries. In addition, the frequent plaque accumulation makes your artery narrow and rigid. It may further interrupt the blood circulation to your heart.

CAD prevents oxygen and essential nutrients supplied to your heart. As a result, it impairs the function of your heart. This condition is termed ischemia. When your heart gets insufficient blood supply, you may feel uneasy. It may lead to breathlessness, discomfort and chest pain. It is called Angina and may further lead to a heart attack.

Symptoms of Coronary Artery Disease

The accumulation of plaque in your arteries may take years. It does not happen overnight. The same is with the signs. As your arteries narrow, you may observe mild symptoms. It alarms you that your heart is struggling hard to supply pure or oxygenated blood across your body. 

The most common symptoms are chest pain and breathlessness. You may feel it after walking upstairs and maybe even at rest. However, a heart attack is a classic symptom of coronary artery disease. Your doctor may diagnose the condition when you get a heart attack. 

Here are the detailed symptoms. It may help you to seek necessary medical care. It may also prevent further complications.

  • Chest discomfort is the heaviness or tightness in the chest. It may also be pressure or pain, and nature may be dull or squeezing. For example, you may feel chest burn, numbness, fullness, squeezing or a dull ache. The pain or discomfort may also radiate or distribute to other parts. For example, it may spread to your left shoulder, arms, jaws, or neck. 
  • Chest burn is another symptom. It may be similar to what you feel during indigestion. However, many mistake it for gastric discomfort and ignore it. Nonetheless, it may be a warning sign.
  • You may also feel tired or lethargic, and anxious. Dizziness, nauseating or vomiting are other few symptoms.

Risk Factors of Coronary Artery Disease

Risk factors are those conditions that may worsen or trigger any disease. Here are a few risk factors for coronary artery disease, which include:

  • Old age may increase your risk of narrowed arteries.
  • Men are at greater risk of coronary artery disease.
  • A family or genetic history of heart disease can cause coronary artery disease, 
  • People who smoke are at a higher risk of developing heart disease. Breathing in passive smoke is equally harmful.
  • Diabetes is a risk factor for coronary artery disease. Type 2 diabetes and coronary artery disease have similar risk factors, including obesity and high blood pressure.
  • Abnormally high blood pressure may lead to hardening and narrowing of your arteries. It obstructs blood circulation.
  • Abnormal blood cholesterol levels may be a risk factor for plaque deposits and atherosclerosis. 
  • Overweight or obesity typically worsens other risk factors
  • A sedentary lifestyle or lack of exercise may initiate coronary artery disease, and some of its risk factors
  • Risk factors mainly occur together. However, it may trigger one another. 
  • Sleep apnoea causes you to stop and start breathing during sleep frequently. Sudden fluctuation in blood oxygen levels happens during sleep. It, in turn, shoots the blood pressure. It may exert stress on your cardiovascular system. High-sensitivity C-reactive High CRP levels are a risk factor for cardiac disease. The higher levels indicate the extent of narrowing of blood vessels.
  • High triglyceride is a type of bad cholesterol in your blood. Elevated levels increase the risk of coronary artery disease.
  • Alcohol may lead to cardiac muscle damage. It also triggers other risk factors of coronary artery disease.
  • Autoimmune diseases like rheumatoid arthritis aggravate the chance of cardiac disorders.

Complications of Coronary Artery Diseases

Coronary artery disease can lead to:

Chest Pain or Angina

During coronary artery disease, your heart does not receive enough oxygenated or pure blood. It may be particularly during exertion or physical activity and cause shortness of breath. In addition, it results in chest pain or Angina.

Heart Attack

A plaque may rupture to form a blood clot. It completely blocks your artery. The deficiency in blood flow to your heart may affect your cardiac muscle. It may trigger a heart attack.

Heart Failure

If some areas of your heart are chronically deprived of oxygen and nutrients because of reduced blood flow, or if a heart attack has damaged your heart, your heart may become too weak to pump enough blood to meet your body’s needs. This condition is known as heart failure.

Abnormal Heart Rhythm (Arrhythmia)

Inadequate blood supply to the heart or damage to heart tissue can interfere with your heart’s electrical impulses, causing abnormal heart rhythms. This is called Arrhythmia.

Coronary Artery Disease: Diagnosis

You may diagnose coronary artery disease during a regular health check-up. For example, it may be during the physical examination and medical test. Your routine blood investigations as a part of a health check may also help. Otherwise, it may be in an emergency when you suffer from a heart attack. 

Diagnostic investigations for coronary artery disease may include:

  • Blood Investigations: Multiple blood tests determine your health status. It may help to find the affecting factors. These tests may consist of cholesterol, triglycerides and lipoprotein tests. They help assess the level of good and bad cholesterol in your blood. 
  • C-reactive protein: Creatine predicts the possibility of cardiac diseases. 
  • Glucose, HbA1c: It measures the glucose level. It is a risk factor for cardiac disease. 
  • Electrocardiograph tests (ECG) may assess the pumping activity of your heart. It may help diagnose a heart attack, ischemia, or other heart disorder.
  • Stress tests are treadmill tests. It may help to identify the extent of your heart function. It assesses when your heart works hard and depends on the exertion that you may feel during the test. Apart from physical activity, you induce drugs to mimic physical activity. It may detect Angina and coronary blockages.
  • A coronary calcium scan checks the amount of calcium in your coronary artery walls. It may indicate atherosclerosis.
  • Echocardiograms help to check the structures and functions of your heart.
  • Cardiac catheterisation involves the insertion of small tubes into your blood vessels. It may help to assess both cardiac function and coronary artery disease.
  • Nuclear imaging provides pictures of your heart inducing a radioactive tracer to your body.
  • Computed tomography angiogram uses contrast dye to observe 3 dimensional images of your heart. It may help to diagnose any blockage in the coronary arteries.

Natural Ways to Prevent Coronary Artery Disease

The initial phase in treating coronary artery disease is to prevent and restrict your risk factors. It involves making healthy changes in your lifestyle.

The lifestyle modifications adopted to help treat coronary artery disease may also prevent it. A healthy lifestyle is a key to your cardiac health. It may strengthen your arteries and prevent plaque formation. 

Quit Smoking

Smoking may increase plaque deposits in your blood vessels. Moreover, chemicals in cigarette smoke thicken the blood. It may lead to clot formation within your veins and arteries. All these causes obstruction to blood circulation.

Control Your Health Issues

Health issues like high cholesterol, blood pressure and diabetes are significant risk factors for cardiac diseases. For example, high blood glucose may damage your blood vessels and the nerves. Therefore, diabetic patients may be prone to heart disease. Elevated blood pressure causes an abnormal force to your arteries. It may damage artery walls.

Healthy Diet

Eat a well-balanced and nutritious, healthy diet. It strengthens your overall immunity. Avoid junk foods. It may load your arteries with unhealthy fats. In addition, it may trigger plaque formation in your arteries.

Limit Alcohol

Alcohol damages your heart tissues. It also increases the risk of cardiac disease, blood pressure etc. Therefore, try to avoid or limit your alcohol consumption.

Exercise

Regular workouts may help you lose weight and improve your physical and mental health. In addition, it may limit the risk of heart attack with a simple activity, including just half an hour of brisk walking. 

Coronary Artery Disease: Treatment

Treatment may depend on your health condition and the investigation reports. Your doctor may guide you with the treatment plan that suits you the best. However, it is necessary to follow your treatment plan rigorously. It may prevent the escalation of your disorder. Moreover, it limits the risk that may result from coronary artery diseases.

Medications

Your doctor may prescribe medications to manage your heart disorder. However, it may depend on your medical reports and physical health. 

Types of medicines for cardiac disease includes the following drugs.

  • Statins fibrates to lower your cholesterol levels. 
  • Beta-blockers, calcium channel blockers, angiotensin-converting enzymes, or ACE inhibitors lower blood pressure.
  • Nitrates/nitro-glycerine to control Angina 
  • Anticoagulants, aspirin and antiplatelets may prevent blood clots  
  • Medications to control your blood glucose level If you are diabetic 

Surgical and Non-surgical Procedures

You may initiate non-surgical procedures to eliminate plaques in arteries. It may include balloon angioplasty and stenting. 

Balloon Angioplasty

In this procedure, a small incision is made on your wrist or leg. Then there is the insertion of a catheter or a long thin tube into an artery. It carries to the blocked or narrowed site of the artery. The balloon widens the artery. It, in turn, restores blood flow to the heart. 

Coronary Artery Bypass Graft (CABG) Surgery 

It involves creating an alternate path for blood flow from the blocked artery. For example, a blood vessel from your arm or leg becomes the new pathway.

Enhanced External Counterpulsation (EECP)  

The implementation of the EECP is when the usual procedures may not help. In this procedure, Inflatable cuffs squeeze the blood vessels in your lower body to enhance blood circulation to the heart. In addition, it imparts a natural bypass around the affected coronary arteries.

Bottom Line

Coronary artery disease develops when coronary arteries build cholesterol deposits in the arterial walls. It obstructs the arteries. It also thickens them and adds to the obstruction. The coronary artery supplies pure or oxygen-rich blood to the heart. Damage to this artery impacts all the metabolic activities of your body largely.

CAD may be challenging to treat if not diagnosed initially. It may result in a heart attack or stroke. However, you may prevent this disorder. You may take precautions to reduce their risk. Lifestyle modification is the best remedy to safeguard you from this condition. The measures involve regular workouts, adopting a well-balanced diet. In addition, you may avoid smoking and alcohol.

About the Author

Dr. Nikhil did Medicine (MBBS) at St. John’s Medical College and then decided to step away to do a Master’s in Health Psychology at the University of Stirling. On the way to that, he has worked with an NGO, Enfold, on teaching sexual health education in schools and colleges to create a healthy foundation for better sexual health in the nation. He has also worked as a medical content editor with Vinformax. He has now been working with HealthifyMe to bring in a renewed user-centric perspective concerning the users' medical conditions and to support the company with more effective digital tools and devices. He hopes to help improve the healthcare scenario in India.


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