Coronary Artery Disease

WHAT IS IT?
Coronary artery disease results when the major blood vessels that supply blood and oxygen to your heart (coronary arteries) become damaged or diseased.
Inflammation and the accumulation of cholesterol-containing deposits (plaques) in the arteries are usually to blame for coronary artery disease.

The condition is thought to begin with damage or injury to the inner layer of a coronary artery, possibly as a result of smoking, high blood pressure, high cholesterol, or diabetes.

Once the inner wall is damaged, plaques may accumulate at the injury site. If the plaques severely reduce the diameter of the artery, you may experience symptoms of angina. If the plaques break off or rupture, blood cells (platelets) will clump at the site to try to repair the artery. The clump can block the artery, causing heart attack symptoms.

SYMPTOM

• Chest pain (angina). You may feel pressure or tightness in your chest as if someone were standing on it. This pain, called angina, is usually triggered by physical or emotional stress and typically goes away once the activity stops. In some people, the pain may be felt in the abdomen, back or arm.
• Shortness of breath. If your heart can’t pump enough blood, you may develop shortness of breath or extreme fatigue with exertion.
• Heart attack. A completely blocked coronary artery may cause a heart attack

WHAT TESTS TO EXPECT

• Electrocardiogram (ECG). It records electrical signals as they travel through your heart. An ECG can often reveal evidence of a previous heart attack or one that’s in progress. Certain abnormalities may indicate inadequate blood flow to the heart.
• Echocardiogram. An echocardiogram can reveal if parts of your heart have been damaged as a result of a heart attack or if they may be receiving too little oxygen.
• Stress test. During this test, you walk on a treadmill or ride a stationary bike while being monitored with an ECG. There are several variations of this test. In some cases, medication to stimulate the heart may be used instead of exercise.
• Heart-imaging tests. During a coronary angiogram, a special dye is injected into your bloodstream. The dye outlines narrowed spots and blockages in the coronary arteries, which can be seen with various X-ray techniques. Computerized tomography (CT) or magnetic resonance imaging (MRI) procedures may be used to check for blockages or narrowed areas.

1. Medications. Cholesterol-modifying medications, aspirin, Beta-blockers, Nitroglycerin, and Angiotensin-converting enzyme (ACE).
   
   
2. Surgical procedures. 

• Angioplasty and stent placement. A long, thin tube (catheter) is inserted into the narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is inflated, compressing the deposits against your artery walls. A tiny device called a stent may be left in the artery to help keep it open. Some stents slowly release medication to help keep the artery open.
• Coronary artery bypass surgery. A surgeon creates a graft to bypass a blocked coronary artery using a vessel from another part of your body. This allows blood to flow around the blockage. Because this requires open-heart surgery, it’s most often reserved for cases of multiple narrowed coronary arteries.

LIFESTYLE

• Stop smoking. Nicotine constricts blood vessels and forces your heart to work harder. If you smoke, quitting is one of the best ways to reduce your risk of a heart attack.
• Exercise. Exercise helps you achieve and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure — all risk factors for coronary artery disease.
• Eat well. A heart-healthy diet that emphasizes plant-based foods, such as fruits, vegetables, whole grains, legumes and nuts — and is low in saturated fat, cholesterol, and sodium — can help you control your weight, blood pressure, and cholesterol.
• Maintain a healthy weight. Being overweight increases your risk of coronary artery disease. Losing even just a few pounds is beneficial.
• Manage stress. Reduce stress as much as possible. Good techniques for managing stress include muscle relaxation, deep breathing and practices such as yoga and tai chi.
• Control medical conditions. If you have a chronic condition such as high blood pressure, high cholesterol or diabetes, keep it under control.
• Know Your Numbers. Keep a check on your cholesterol level and blood sugar