Coronary Artery Disease
Coronary artery disease describes the process of narrowing or blockage of the coronary arteries.
Coronary artery disease describes the process of narrowing or blockage of the coronary arteries. These are the blood vessels which supply the heart muscle with blood and oxygen. The narrowing of the blood vessels is caused by a disease process known as atherosclerosis. Simply explained, it is a build-up of cholesterol and fatty acids (also known as plaque) on the inner lining of the artery wall.
This narrowing of the blood vessel can lead to a shortage of blood and oxygen supply to the heart muscle causing chest pain, also known as angina. When the vessel blocks off completely, the supply of oxygen and blood is cut off causing a heart infarction, better known as heart attack.
Common Symptoms of Coronary Artery Disease
- Chest discomfort or pain (angina)
- Shortness of breath
- Reduced exercise tolerance
- Pain or discomfort to the shoulders or arms with associated numbness or tingling
- Cold sweat
- Pain or discomfort to the epigastric (upper stomach) region
Risk Factors for Coronary Artery Disease
- Physical inactivity
- Overweight/ Obesity
- Hypertension
- Smoking tobacco
- Unhealthy diet or eating patterns
- High cholesterol levels
- Poorly controlled diabetes
- Family history of heart disease, especially if a close relative has a history of a cardiac event at an early age, <65yrs.
Diagnostic tests
If you are experiencing physical symptoms suggestive of coronary artery disease, your specialist will perform a number of tests to assess the likelihood of you having a problem with your coronary arteries. These tests and a description of each is provided in the table below:
| Test | Explanation |
| ECG | Measures the electrical activity, rate and regularity of the heartbeat. |
| Echocardiogram | By means of ultrasound, the compartments and valves of the heart are viewed as an image. |
| Exercise stress test | Measures your hearts activity while you walk on a treadmill. By analyzing the heart function while exercising, we can determine the hearts function when it has to work harder (ie/ pump more blood) |
| Coronary angiogram/ catheterization | By inserting a flexible tube through an artery in your groin or wrist and proceeding it up into the heart whilst injecting dye, the specialist is able to view and determine any changes/ disease to the inner lining of the artery wall. |
| Coronary artery and calcium scan | Computed tomography (CT) scan is used to provide images of any calcium or plaque deposits in the coronary arteries. |
Treatment of Coronary Artery Disease
The chosen treatment is based on the severity of the narrowing of the coronary artery as well as your symptoms.
In most cases where there is evidence of minor to moderate disease, the option is to treat the symptoms and reduce the risk of further narrowing or blockage by means of medication. These medications include blood-thinners such as aspirin, cholesterol lowering agents and a beta blocker to slow down the heart rate and support blood supply to the heart muscle. If there is evidence of high blood pressure, the specialist will include medication to lower this and reduce the effects of wear and tear on the artery.
In the instance of severe blockage to one or more coronary arteries, a procedure known as angioplasty is suggested to open up the blockage by means of a balloon or stent. Where there is evidence of multiple vessel or severe disease, coronary artery bypass surgery is often the treatment of choice. However your specialist will discuss all available treatment options with you in determining the appropriate treatment.
References:
- www.cdc.gov/heartdisease
- www.my.clevelandclinic.org/health
- www.mayoclinic.org/diseases-conditions www.heartfoundation.org.au