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Coronary artery disease, also called coronary heart disease (CHD), is a narrowing of the small blood vessels that supply blood and oxygen to the heart.
CHD is the most common type of heart disease and a leading cause of death in the U.S. It can largely be prevented with healthy lifestyle choices.
The coronary arteries supply blood directly to the heart and are a vital element in the function of the heart muscle. As fatty material and plaque build up in the coronary artery, blood flow is slowed or even completely stopped, resulting in chest pain (stable angina), shortness of breath, heart attack or other related symptoms. This can quickly become a life-threatening emergency.
Any type of damage or blockage to a coronary artery directly affects the heart. As plaque builds and narrows the artery's passageway, the danger of a complete blockage greatly increases. A small clot of blood may attempt to pass through the narrow pathway and become lodged, leading to a lack of oxygen to the heart.
Coronary Artery Disease is caused by a condition called atherosclerosis, or the hardening of the arteries due to plaque buildup. Cholesterol in the bloodstream is the main cause of the plaque buildup. Cholesterol enters the bloodstream a couple of ways: through liver production and consumption of meat and dairy products.
As the plaque collects along the artery wall, it begins to narrow and harden the artery passageway. Eventually, blood flow is slowed and cannot properly feed the heart, which reduces the effectiveness of the heart muscle. The heart muscle attempts to compensate for the lack of oxygen-rich blood by increasing outflow until the muscle becomes fatigued and can no longer function properly.
Another risk of atherosclerosis is embolization, the breakaway of a piece of plaque that can travel to a smaller blood vessel and cause a blockage. This is a common cause of heart attack and stroke. If the plaque finds its way to the heart, lungs or brain, it can cause a stroke, heart attack and pulmonary embolism or contribute to the weakening of an artery wall leading to an aneurysm.
Studies are being conducted on patients with high levels of inflammation-related substances including C-reactive protein and fibrinogen. Increased levels of homocysteine have also been linked to heart attack risk.
It is possible to suffer from coronary artery disease and not experience any symptoms. For others, symptoms are obvious with the most common being chest pain and discomfort (angina). The pain is an indication that the heart is not receiving the proper amount of blood or oxygen. It can be particularly noticeable during increased activity.
Patients experience varying levels of discomfort and symptoms including:
Women, the elderly and diabetics are more likely to have fatigue, shortness of breath and weakness as symptoms of coronary artery disease.
If it is suspected that a patient may be suffering from coronary artery disease, a number of physical exams and diagnostic tests can be performed. Lifestyle changes may be recommended to reduce symptoms, prevent further complications and improve heart functioning.
The following are helpful in treating and preventing the effects of coronary artery disease:
Cholesterol and triglyceride levels should be checked regularly to avoid the progression of coronary artery disease. It is recommended that adults keep their LDL "bad" cholesterol levels below 130-160 mg/dL. The balance between "good" and "bad" cholesterol levels is important for overall health.
If treatment is recommended, a cholesterol-lowering drug may be prescribed, however, few medications have been found to clear plaque. Some patients may benefit from aspirin or anti-platelet drugs to prevent blood clots. Hormone replacement therapy is sometimes used for menopausal patients. It is important to consult a physician before beginning any type of treatment regimen whether using over-the-counter or prescription drugs.
If necessary, surgery can be performed to treat the condition. Examples of possible surgical treatments include angioplasty, stent placement, abdominal aortic aneurysm repair, coronary artery bypass surgery, carotid artery surgery and minimally-invasive heart surgery.
Contact your health care provider if you are at risk for atherosclerosis, especially if symptoms are present.
Consult your physician when starting any type of exercise plan. This is particularly important for patients with coronary heart disease or those who have experienced a heart attack.
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