Coronary Artery Disease 

What is coronary artery disease?

Coronary artery disease develops because of obstruction in your coronary arteries. This obstruction is caused by the accumulation of fat and called plaque. 

This obstruction affects the normal circulation of blood to your heart. This results in chest pain (angina), breathing trouble.

The formation of plaque occurs over a period of time. It becomes a hindrance when the accumulation of fatty substances blocks a considerable portion of your coronary arteries. 

It is difficult to keep track of the plaque accumulation that develops in your heart. In many cases, coronary artery disease symptoms develop only at later stages. 

What is the coronary artery?

Your heart needs a constant supply of blood that is rich in oxygen to keep pumping. Coronary arteries are the ones that supplies your heart with oxygen-rich blood.

There are four coronary arteries as follows:

• Right coronary artery
• Left coronary artery
• Left anterior descending artery
• Left circumflex artery

What causes coronary artery disease?

Coronary artery disease is caused by the build-up of plaques inside your arteries. This condition is called Atherosclerosis. Plaques are nothing but the pile-up of fat , cholesterol, calcium, waste products and fibrin (clottting factor). 

The build-up of plaque causes your artery walls to shrink or get stiffened. It can even damage your arteries and affect the transport of oxygen-rich blood and nutrients to your heart. 

Your heart needs a consistent flow of blood along with oxygen and nutrients. If this process gets inhibited, that condition is called Ischemia. It makes you prone to heart attacks. 

How does the disease function?

If you wonder what coronary heart disease is, it inhibits the normal functioning of your heart by building up of plaque in the arteries, the rate at which the plaque gets piled up differs from person to person. 

Plaque accumulation happens at any age. As you age, the plaque gets thicker. Your body reacts to it by sending white blood cells to fight the plaque, as a result, it causes inflammation in your arteries.

The calcification of the plaque that happens over a time period slowly causes rise in blood pressure. Also causing shrinkage of artery walls resulting in low blood supply to the heart.

One of the main complication of Atherosclerosis is the formation of an emboli. The calcified plaque can break into pieces and move along the blood vessels and lodge somewhere else causing loss of blood supply to that region.

What are the warning signs of clogged arteries?

Coronary artery disease symptoms may take years to develop. In most cases, only after a heart attack, do you come to know that you have coronary artery disease. But your body may start to show mild symptoms at times. 

It is also a common misconception that, since it is heart disease, its symptoms arise only in and around your heart. However, the actual symptoms tell us otherwise. 

(symptoms are not gender specific)

Patients have the following signs,

1. Chest discomfort that may last to days, misconception of gastritis is prevelant so mostly ignored by patients.
2. Pain radiating to back, left hand, jaw.
3. Nausea, vomitting, dizziness, palpitations, increased sweating and shortness of breath.

Silent MI – Sometimes patients are asymptomatic, either finding about CAD coincidentally through regular check ups or death due to sudden attack. Such occurrences ranges from 22-40% world wide and upto 70% in India alone.

How Coronary artery disease can be diagnosed?

It is only if you have a heart attack, your doctor will prescribe immediate treatment without any diagnosis. In other cases, your doctor will try to get details of your heart condition and the symptoms that you may experience. 

Coronary artery disease diagnosis can be done by conducting some of the following diagnostic practices:

• Electrocardiograph (ECG) – It records your heart’s electrical activity
• Echo-cardiogram – Uses sound waves to analyse your heart’s structure and functionality
• Cardiac catheterisation – by plugging tiny tubes into blood vessels to identify any blockages in the arteries
• Blood tests and CARDIAC MARKERS
• Computer tomography angiogram
• Treadmill Test
• Nuclear imaging – Using radioactive tracer, it picturises your heart to identify the issues.

How is it treated?

After the initial investigations, the diagnosis is made and the severity is graded. The treatment is based on the severity of the problem.

The patients are started on medical treatment according to the symptoms and severity.These medications can help in lowering your blood pressure, cholesterol levels and to prevent angina. 

In some cases, doctors prefer interventional procedures to remove the plaque, namely:

• Balloon angioplasty
• Stenting

In these treatments, either the balloon or stent (a tiny spring-like object) is inserted in the arteries of your wrist or leg and guided all the way to the blocked area in it. 

Once it reaches the targeted spot, the balloon or stent wide opens the artery walls thus removing the blockade. 

In the advanced stages of this disease, doctors perform coronary artery bypass graft surgery (CABG). It is a surgical procedure that is performed to create a new pathway to supply oxygen-rich blood to your heart. 

How to prevent coronary artery disease?

The adverse effects of this heart condition can be minimized and prevented by making some lifestyle changes. It includes:

• Quit smoking
• Limit alcohol consumption
• Eat healthy food
• Avoid foods with trans fats
• Limit fast-food consumption
• Do exercises regularly, especially cardio workouts

To sum up

The new generation pushes people in to fast forward mode resulting in stress and significant change in lifestyle causing increased prevalence of this disease in young adults also.

Hence, this can be prevented by modification of our lifestyle, good eating habits and moderate exercises, all of which can be motivated and monitored by advancing technologies.

Still, make sure to consult a doctor and not neglect any symptoms that might lead to an inadvertent event.