Coronary artery disease (CAD) is a common heart condition characterised by the narrowing or blockage of the coronary arteries, which supply blood to the heart muscle. This restriction in blood flow can lead to chest pain (angina), shortness of breath, a heart attack, or even death.
The World Health Organization (WHO) identifies cardiovascular diseases as the leading global cause of death. Heart disease refers to various diseases affecting the heart, including coronary artery disease (CAD), also referred to as coronary heart disease. CAD involves the narrowing or blockage of the coronary arteries, which supply blood and oxygen to the heart, due to plaque buildup. Insufficient oxygen-rich blood flow can lead to symptoms like chest pain, breathlessness, and dizziness. You may even experience severe symptoms, such as a heart attack or heart failure, when blood flow is cut off completely or almost completely. Read on to learn all about this disease.
Coronary artery disease (CAD) is primarily caused by atherosclerosis, a condition where plaque builds up inside the coronary arteries, narrowing them and restricting blood flow, oxygen, and nutrients to the heart. This plaque is made up of cholesterol, waste products, calcium, and fibrin (which helps in blood clotting). It causes chest pain and puts you at risk of a heart attack.
Several factors can increase your risk of getting coronary artery disease, including:
Advancing age is a significant risk factor for CAD. The risk increases with age, especially after 45 for men and 55 for women.
Men generally face a higher risk of CAD compared to premenopausal women. However, after menopause, the risk for women catches up and may even surpass that of men.
Individuals with a family history of CAD, are at a higher risk of developing the disease.
Tobacco smoke contains various toxins that damage the blood vessels, leading to atherosclerosis and increasing the risk of CAD.
High blood pressure puts added strain on the heart and blood vessels, accelerating the development of atherosclerosis and increasing the risk of CAD.
Elevated levels of LDL cholesterol (often referred to as “bad” cholesterol) in the blood can enter the coronary arteries, narrowing them and increasing the risk of CAD.
Individuals with diabetes are at a higher risk of CAD due to various factors, including insulin resistance, inflammation, and metabolic abnormalities.
Being overweight or obese, due to a lack of physical activity, contributes to the development of multiple risk factors for CAD, including hypertension, diabetes, and dyslipidemia.
Diets high in saturated fats, trans fats, cholesterol, and refined carbohydrates contribute to the development of atherosclerosis and increase the risk of CAD.
Chronic stress can contribute to CAD in various ways, including increased blood pressure, inflammation, and unhealthy coping behaviours like overeating or smoking.
Lack of vitamin D in your body is linked with an increased risk of heart disease, including high blood pressure, CAD, and heart failure.
Consumption of alcohol and tobacco (even secondhand smoke) significantly elevates the risk of cardiovascular diseases.
Major Symptoms |
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Necessary Health Tests |
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Treatment | Lifestyle changes, such as:
Medications, such as:
Surgery, such as:
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Coronary artery disease (CAD) demonstrates various symptoms, often indicating underlying heart issues. Chest pain, known as angina, is a hallmark symptom, typically felt as pressure, tightness, or squeezing in the chest. This discomfort may radiate to the arms, neck, jaw, or back. Apart from this, one may experience:
In severe cases, a heart attack can occur, which may cause a few symptoms such as intense chest pain, sweating, nausea, and shortness of breath. It is important to note that symptoms can vary widely among individuals, and some might not experience any until a significant event like a heart attack occurs.
The diagnosis of Coronary Artery Disease involves a comprehensive assessment that includes a medical history, a physical examination, and various blood tests. Here’s a detailed breakdown:
The initial step to diagnosing CAD involves gathering information about the patient’s risk factors, such as family history, smoking habits, diet, exercise routine, and any existing medical conditions like hypertension or diabetes.
A thorough physical examination may reveal signs and symptoms such as high blood pressure, abnormal heart sounds, or signs of peripheral vascular disease.
An ECG records the electrical activity of the heart and can reveal abnormalities suggestive of CAD, such as irregular heart rhythms or signs of previous heart attacks.
This non-invasive test uses sound waves to create images of the heart, allowing doctors to assess heart structure and function, including the pumping capacity and any areas of reduced blood flow.
Stress tests evaluate how well the heart functions during physical stress. This can be done through exercise stress tests, where the patient walks on a treadmill while connected to an ECG machine, or pharmacologic stress tests.
Blood tests help assess lipid levels (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), glucose levels (for diabetes screening), and markers of inflammation (such as C-reactive protein) that can indicate an increased risk for CAD.
This test is quite similar to the exercise stress test but adds images to the ECG recordings. It shows how blood moves to the heart muscles at rest and during stress.
A CT scan of the heart is done to see the calcium deposits and blockages in the heart arteries. Calcium deposits can narrow the arteries, increasing the risk of CAD.
This invasive procedure involves injecting contrast dye into the coronary arteries to visualise any blockages or narrowing using X-ray imaging. It provides precise information about the location and severity of CAD.
Treatment for coronary artery disease (CAD) aims to alleviate symptoms, reduce the risk of complications, and improve overall heart health.
Patients are advised to adopt a heart-healthy lifestyle, including a balanced diet low in saturated fats and cholesterol, regular exercise, maintaining a healthy weight, quitting smoking, and managing stress. These lifestyle changes can help prevent the further progression of CAD and reduce the risk of complications.
Various medications are prescribed to manage CAD symptoms and reduce the risk of complications:
In cases where lifestyle changes and medications are not sufficient, surgeries and other procedures may be necessary to restore blood flow to the heart:
Remeber, patients with CAD require regular follow-up appointments with their healthcare providers to monitor their condition!
Coronary artery disease (CAD) affects individuals over the age of 65, but risk factors such as smoking, high blood pressure, high cholesterol, diabetes, obesity, a lack of physical activity, and a family history of CAD can increase the likelihood of developing the condition at a younger age.
Common symptoms of CAD include chest pain or discomfort (angina), shortness of breath, fatigue, weakness, nausea, indigestion, and, in some cases, palpitations or irregular heartbeats. However, it's important to note that some individuals, especially women, may experience atypical symptoms or even be asymptomatic.
Genetic factors can predispose individuals to CAD. A family history of CAD or heart disease, increases the likelihood of developing the condition. However, lifestyle factors such as diet, exercise habits, and smoking also play significant roles in determining an individual's risk.
CAD is a chronic condition that cannot be cured. However, it can be effectively managed through lifestyle modifications, medications, and, in some cases, surgical interventions such as angioplasty or bypass surgery.