Coronary artery disease (CAD) develops when plaque builds up in the coronary arteries, causing them to become narrow or blocked. It can lead to a heart attack, but statins and other treatment options can help.
Coronary artery disease (CAD) interrupts the regular flow of blood to the heart. CAD can cause a heart attack if blood flow to the heart is significantly blocked.
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In this article, we detail the causes, effects, and treatments of CAD. Additionally, we discuss the preventive measures a person can take to reduce their risk of CAD.
CAD tends to develop when cholesterol builds up on the walls of the coronary arteries, creating plaques. This plaque buildup is known as atherosclerosis. Atherosclerosis can happen elsewhere in the body and cause other conditions, including cerebrovascular disease and peripheral artery disease.
These plaques can narrow the arteries, reducing blood flow to the heart, or cause inflammation in and hardening of the blood vessel walls. A clot can sometimes obstruct blood flow, causing serious health problems.
Coronary arteries form the network of blood vessels on the surface of the heart that provide oxygen to it. If these arteries narrow, the heart may not receive enough oxygen-rich blood, especially during physical activity.
High cholesterol, smoking, and other factors increase the risk of developing the condition.
CAD can lead to angina, a type of chest pain that occurs when the heart doesn’t receive enough blood flow.
Angina may cause shortness of breath and the following sensations across the chest:
- squeezing
- pressure
- heaviness
- tightening
- burning
- aching
Angina might also cause the following symptoms:
Complications
A heart attack occurs when the heart muscle does not have enough blood or oxygen, such as when a blood clot develops due to plaque in one of the coronary arteries.
The formation of a blood clot is called coronary thrombosis. If a clot is large enough, it can completely block the blood supply to the heart in that blood vessel.
A heart attack is a medical emergency that can result in death or permanent heart damage. If a person is showing symptoms of a heart attack, it is vital to call emergency services immediately.
CAD
Underlying health conditions, such as high cholesterol and diabetes, and physical damage to arteries, can cause plaque buildup and lead to CAD. The condition has many other risk factors as well.
The plaque deposits consist of cholesterol and other inflammatory products from cells. The buildup of plaque is called atherosclerosis. Plaque deposits can narrow the arteries over time, restricting or stopping blood flow.
If pieces of plaque break off or rupture, platelets cluster in the area, forming a blood clot. Blood clots can block the artery and reduce or block blood flow. This may lead to a heart attack.
The following medical conditions
- high blood pressure (hypertension)
- high levels of low-density lipoprotein (LDL), or “bad,” cholesterol
- low levels of high-density lipoprotein (HDL), or “good,” cholesterol
- diabetes
- chronic kidney disease
Other factors that may increase a person’s risk of CAD include:
- obesity
- smoking
- sedentary lifestyle
- high stress levels
- alcohol misuse
- a low quality diet
- chronic lack of sleep
- family history of CAD
- early menopause
- increasing age
CAD has no cure, but doctors can prescribe medications to prevent the progression of CAD and prevent complications like a heart attack.
Treatment also often involves making lifestyle changes, such as quitting smoking, adopting a healthy diet, and engaging in regular exercise. Doctors may also prescribe medications to prevent the progression of CAD.
However, some people may need to undergo medical procedures.
Medications
Medications that people can take to reduce the risk and manage the symptoms of CAD include:
- Statins: Statins
reduce cardiovascular complications and death in people who have CAD or are at high risk of it. They also reduce the risk of nonfatal vascular events such as heart attacks and strokes. - Beta-blockers: A doctor may prescribe beta-blockers, which reduce heart rate and blood pressure, especially for people who have angina or heart failure
- Nitroglycerin patches, sprays, or tablets: These relax the arteries, reduce the heart’s demand for blood, and soothe chest pain.
- Angiotensin-converting enzyme (ACE) inhibitors: These bring down blood pressure and improve outcomes in many people with CAD.
- Calcium channel blockers: Calcium channel blockers can help dilate blood vessels, slow the heart rate, and lower the blood pressure.
Invasive procedures
Doctors may perform invasive procedures such as coronary bypass surgery to open or reroute blood around blocked arteries. This may be necessary if the arteries have become very narrow or if a person’s symptoms are not responding to medications.
Noninvasive procedures, such as percutaneous coronary intervention (PCI), may be an option in some instances. PCI procedures are a minimally invasive option to widen blood vessels and improve blood flow.
In rare cases, a person may need a heart transplant. However, this is the case only if the heart has severe damage and treatment is not working.
Managing risk factors such as high cholesterol, diabetes, and lifestyle factors can help reduce risk of CAD. People can consider
- being more physically active
- limiting alcohol intake
- avoiding tobacco
- adopting a diet with less sugar, salt, and saturated fat
In addition to making any necessary lifestyle changes, it is crucial that a person continue to take all cholesterol and blood pressure medications that their doctor prescribes.
A doctor can perform a physical examination, take a thorough medical history, and order several tests to diagnose CAD and other types of heart disease. These tests may include:
- Electrocardiogram: This records the electrical activity and rhythm of the heart.
- Echocardiogram: This is an ultrasound scan that monitors the pumping heart. It uses sound waves to provide a video image.
- Stress test: This may involve using a treadmill or medication that stresses the heart to find out how it functions when a person is active. Healthcare professionals can perform these tests using imaging techniques such as echocardiograms and nuclear imaging to assess areas of blockage.
- Coronary catheterization: A specialist will inject dye through a catheter threaded through an artery, often in the leg or arm. The dye shows narrow spots or blockages on an X-ray.
- CT scans: These help a doctor view the arteries, detect calcium within fatty deposits, and identify any heart anomalies.
- Blood tests: Doctors can order these to measure blood cholesterol levels.
CAD occurs when cholesterol deposits develop on the walls of the coronary arteries. The condition causes blockages in the arteries that feed oxygen-rich blood to the heart. The arteries also stiffen, and inflammation increases.
CAD can be difficult to treat and may lead to a heart attack. However, people can help reduce their risk of CAD by getting regular exercise, maintaining a nutritious diet, and avoiding or stopping the use of tobacco products.
People should seek immediate medical attention if they experience chest pain and breathlessness, as these symptoms could indicate a heart attack.