Coronary Artery Disease (heart attack)
Overview
What is Coronary Artery Disease?
Coronary artery disease (CAD) is caused by a build-up of plaque in the walls of the arteries of the heart, causing them to narrow over time. This build-up, called atherosclerosis, can block the flow of blood to the heart muscle, causing a heart attack (myocardial infarction). CAD is the most common type of heart condition in the United States.
Symptoms
Coronary Artery Disease Symptoms
The most common symptoms include chest pain or discomfort but often includes shortness of breath. For many people, however, the first sign of CAD is a heart attack. In addiiton to chest pain, warning signs include:
- Pain or disomfort in the arms or shoulder
- Shortness of breath
- Lightheaedness or nausea
- Weakness and fatigue
- Sweating abnormally
Diagnosis
Coronary Artery Disease Diagnosis
There are several tests used to diagnose CAD. They include:
Non-invasive
This test measures the electrical activity of your heart, including rate and regularity of your heartbeat, and can also tell important information about the condition of the heart muscle.
Ultrasound is used to create a picture of the heart.
Stress test
This test measures your heart parameters while under physical stress (e.g. a treadmill) or chemical stress (e.g. medication to speed up the heart). The efficiency of your heart is tested to determine whether there is a significant degree of CAD.
Uses a CT scan to look for calcium build-up in the coronary arteries.
This test utilizes a CT scan with dye to assess for blockages in the coronary arteries.
Procedural
Cardiac catheterization
During this procedure, your cardiologist obtains hemodynamic information and checks for blockages in the arteries by inserting a thin flexible tube via the groin, neck or arm to reach the heart. X-rays are used and dye is injected through the tube into the arteries of the heart A video monitor allows the cardiologist to see the size and location of any blockages or narrowing in the arteries. Additional tests may be run during the procedure to gain important information about the significance of the blockages that are seen.
Treatments
Coronary Artery Disease Treatments
Your cardiologist may recommend lifestyle changes such as losing weight, stopping smoking, eating more healthfully and beginning an exercise program. Other treatments may also be necessary, such as medications to lower cholesterol or thin the blood to prevent clotting, angioplasty and stent placement.
A variety of drugs may be used to treat CAD. They include:
- Statins help lower high cholesterol.
- Aspirin and other blood thinners help reduce blood clots.
- Beta blockers slow down the heart rate and reduce blood pressure.
- Other medications help control chest pain and prevent the progression of of CAD
Balloon angioplasty may be performed during a cardiac catheterization if the arterial narrowing is extensive. Your cardiologist will use a catheter with a tiny balloon on the tip to open up the artery and restore more normal blood flow.
A small meshlike device called a stent is inserted into an artery to keep it open and improve blood flow. It is often inserted at the same time a baloon angioplasty is performed.
Specialists