CAD: Coronary Artery Disease

Coronary heart disease, Coronary artery disease (CAD) and Ischemic heart disease (IHD) are synonyms and includes a bunch of disease like stable angina, unstable angina, myocardial infarction and sudden cardiac death.

Coronary heart disease develops when the arteries that supply blood and oxygen to the heart itself gets blocked due to the cholesterol or other substances gets deposited on the inner side of the blood vessels called the plaque, this narrowing of arteries is called atherosclerosis or arteriosclerosis. If it takes place in one of the major heart supplying arteries then it causes heart attack, stroke or peripheral arterial disease (PAD).

It reduces the elasticity of the blood vessels or narrows the inside area restricting the normal flow of the blood. It leads to the deficiency of oxygen in the heart muscles and causes chest pain also called angina.

Angina can be of two types:

Stable angina is the chest pain which occurs regularly with different activities. Unstable angina is when angina changes its intensity, also it can lead to myocardial infarction.

CAD weakens the blood muscles and leads to reduced functioning of heart in pumping the blood into the body, this is called heart failure. This also develops irregular heartbeat or arrhythmia.

Sometimes the plaque ruptures, gets stuck up in the artery somewhere and totally blocks the blood flow leading to oxygen cut off from that particular area causing permanently damaged heart muscle or scarring of them.

Causes: It is caused due to the cholesterol deposition on the inner lining of the blood vessels of the heart muscles.

Symptoms: Initial detection of the disease is done through its symptoms which are:

• shortness of breath (dyspnea)

• chest pain (discomfort in the chest and increasing into travel into the shoulder, arm, back, neck, or jaw)

• sweating

• nausea

• indigestion

• heartburn

• weakness

At risk: People with risk of getting IHD are/with:

• hypertensive

• smokers

• diabetic

• obese

• high blood cholesterol

• High resting heart rate

• Depression and stress

• Kidney disease

• Family history

• lack of exercise

• poor diet

• excessive alcohol intake

• 40 years old men and women are at great risk of developing this disease.

Diagnostic test: There are many test which help in the diagnosis of CAD:

• ECD or EKD: To measure electrical activity, rate and regularity of heartbeat.

• Chest X-ray: Pictures the heart, lungs and other organs of the chest.

• Echocardiogram: Ultrasound waves are used to picture the heart.

• Exercise stress test (EST): While walking on the treadmill, heart rate is measured.

• Cardiac catheterization: Checks the blockage in the heart arteries by inserting a thin, flexible tube through an artery in the groin, arm or neck to reach the heart to collect blood samples and to inject dye.

• Coronary angiogram: Injected dye is detected via X-rays point out the blocked areas in the arteries.

Prevention: To keep the disease at bay people need to control with medication and keep:

• Blood pressure

• Diabetes

• Cholesterol

• Proper diet

• Regular exercise

• Less alcohol intake

Management: Changes in the lifestyle is very helpful in living fit and healthy. Medications which help in managing the disease includes:

• Antiplatelet like aspirin

• Statins

• Beta blockers

• Calcium antagonists

• Angiotensin-converting enzyme (ACE) inhibitors

• Nitroglycerin.

Some procedures are also done to increase the inner width of the arteries like percutaneous coronary intervention (PCI) like coronary stent and angioplasty or coronary artery bypass grafting (CABG).