Abstract This paper includes the studies of techniques used to prevent, treat and nutritional or surgical therapies used for Coronary artery disease. This paper also outlines some of the causes and possible threats of having this disease. Coronary artery disease is a big problem, and is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men (Barclay, 2013). Some types of Coronary artery disease are not harmful, but can later develop buildup of plaque in the coronary arteries into possible acute coronary syndrome or ST elevation myocardial infarction. It is important for people to understand the risks of this disease, and people should take proper care of themselves in order to prevent it. This paper also outlines the common techniques for diagnosing coronary artery disease, which include Electrocardiogram (ECG), Echocardiogram, Stress test, Cardiac catheterization or angiogram, or Heart scan (Mayo Clinic staff, 2017).
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'Coronary Artery Disease and Its Symptoms'
The heart is a complex muscle full of ventricles, valves, atriums, and many other parts that all help the body to function correctly. When a person doesn’t treat their body well, the consequences are decreased function or damage to the heart or one if its many parts. Damage to the heart can have long lasting effects, such as narrowing of blood vessels or arteries, and can bring on different forms of heart disease. One of the most common of these diseases is coronary artery disease (CAD). Coronary artery disease has two major causes. The first is genetic influences, and the second is a lack of exercise and a poor diet.
Another cause of coronary artery disease is atherosclerosis, and it develops when a person doesn’t take proper care of their body. Atherosclerosis is a buildup of cholesterol plaque in the walls of arteries causing obstruction of blood flow, which can then cause plaques to rupture, causing acute occlusion of the artery by clot. Plaque is made up of cholesterol, fat and other substances. Atherosclerosis often has no symptoms until a plaque ruptures or the buildup is severe enough to block blood flow. The blood vessels could become inflamed, and the risk of blood clots and heart attacks increase when the build up plaque isn’t taken care of. Sometimes, a narrowed artery may develop new blood vessels to bypass the blockage to get blood to the heart. When exercise or increased stress on the heart occurs, not enough oxygenated blood reaches the heart. When the heart doesn’t get enough oxygenated blood, the artery could become clogged or a heart attack can occur. Some other causes and risk factors for coronary artery disease include age (simply getting older can increase the risk of narrow or damaged arteries), sex, family history, smoking, high blood pressure, high blood cholesterol levels, diabetes, being overweight or obese, physical inactivity or high stress (Mayo Clinic staff, 2017). Sometimes Coronary Artery Disease develops without any classic risk factors. There are many different types of coronary artery disease. Some plaques never obstruct the coronary blood flow and are asymptomatic.
The people that do have symptoms, could have stable, acute coronary syndrome, or ST Elevation Myocardial Infarction. Stable angina is a chest pain or discomfort that most often occurs with activity or emotional stress, and is due to poor blood flow through the blood vessels in the heart. This condition is not a clinical emergency. If a plaque suddenly ruptures, it causes the clotting of the artery, known as coronary thrombosis. Acute coronary syndrome(ACS) is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. ACS causes Non ST-Segment Elevation Myocardial Infarction(NSTEMI) or unstable angina. NSTEMI is a type of heart attack. ST refers to the ST segment, which is part of the ECG (electrocardiogram) heart tracing used to diagnose a heart, and means it is abnormally high above the baseline. Unstable angina means that blockages in the arteries supplying your heart with blood and oxygen have reached a critical level. The affected person has chest pain even at rest. If left untreated, unstable angina can lead to heart attack, heart failure, or arrhythmias (irregular heart rhythms). These can be life-threatening conditions.
In contrast, when the thrombosis completely occludes the vessel, the myocardium, the muscular tissue of the heart, is injured and ST-Elevation Myocardial infarction develops (STEMI). ST-Elevation Myocardial Infarction (STEMI) is a very serious type of heart attack during which one of the heart’s major arteries is blocked. One of the symptoms of coronary artery disease is chest pain, or angina (mentioned earlier). It may feel like pressure or tightness in the chest. Angina usually occurs on the middle or left side of the chest, and can be triggered by emotional or physical stress. When the stress is stopped, usually the pain stops as well. There may also be shortness of breath because the heart can’t pump enough blood to meet the demands of the body. Other symptoms include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. These symptoms can be those of a heart attack, which occurs when an artery is completely blocked. Sometimes though, a heart attack can occur with no signs or symptoms. Also, symptoms can be very different in women then they are in men. Women’s heart attack symptoms can be much more subtle than they are in men. Women’s symptoms can include fatigue and disrupted sleep about a month or two before a heart attack. Women pay feel pressure in the chest but not as sudden as in men.
Other common symptoms for women are shortness of breath, nausea, vomiting and pain spreading throughout the upper body. They both feel chest pain at the beginning and during a heart attack but men have much more abrupt symptoms, such as sudden crushing pain in the chest. For diagnosis, your doctor may suggest a variety of tests such as Electrocardiogram (ECG), Echocardiogram, Stress test, Cardiac catheterization or angiogram, or Heart scan. An electrocardiogram records electrical signals as they travel through the heart and can often reveal evidence of a previous heart attack or one that’s in progress. An Echocardiogram uses sound waves to produce images of the heart.
During an echocardiogram, the doctor can determine whether all parts of the heart wall are contributing normally to the heart’s pumping activity. To perform a stress test the doctor looks for the signs and symptoms occur most often during exercise. This is done by having the patient walk on a treadmill or ride a stationary bike during an ECG. In some cases, medication to stimulate the heart may be used instead of exercise. Cardiac catheterization or angiogram involves a dye being injected into the affected coronary artery or arteries to view the blood flow in the heart. A heart scan or Computerized Tomography (CT) help the doctor see calcium deposits in the arteries. If a substantial amount of calcium is discovered, coronary artery disease is likely. There are many treatments for coronary artery disease. They include lifestyle changes, medication, surgeries, and cardiac rehabilitation.
Cardiac rehabilitation is used to improve the function of the heart. Lifestyle changes include maintaining a healthy diet, healthy weight, good exercise habits, managing stress levels, and not smoking. Patients should eat lots of healthy foods low in fat, such as low-fat dairy products, fruits, legumes, vegetables and whole grains. Patients should avoid sugary foods or drinks, a lot of red meat, and palm or coconut oils. Alcohol consumption should also be kept to a minimum. Exercising at least 2-3 hours per week is also beneficial. The more active the person, the greater the benefit. Medication is required when the lifestyle changes aren’t enough to control blood cholesterol. These medicines decrease blood cholesterol and can even lower the chance of having a stroke or heart attack. There are four common types of medication used in coronary artery disease. 1. The first type is Statin, which helps the liver to produce less of harmful cholesterol. 2. The second type is blood thinners, which help break down blood clots or keep them from forming. 3. Beta blockers are the third type. They decrease blood pressure and slow the heart rate down. 4. The fourth is a calcium channel blocker. Its job is to relax the blood vessels. If medication isn’t sufficient, surgery or other medical procedures may be required.
The most common procedure is called Percutaneous Coronary Intervention. In this procedure, a thin flexible tube usually with a balloon on the end, is inserted into a the blocked coronary artery. Once inside, the balloon is inflated to compress the plaque against the artery wall . During the procedure, a doctor may put a stent, a temporary tubular support, in the artery, which helps prevent blockage. Another treatment is Coronary Artery Bypass Grafting. The other arteries or veins are reconstructed to bypass the blocked artery. Coronary artery disease is the most common type of heart disease, and is the leading cause of death for both men and women in the United States. There are more than 3 million cases in the us per year. Coronary artery disease is also the leading cause of death for most ethnicities.
The risk of coronary artery disease increases in men at 45, and in women at 55. Scientists believe that women are protected from coronary artery disease by female hormones before menopause. But after menopause, the rate of coronary artery disease in women is as high as it is in men. Heart attacks caused by coronary artery disease occur in both men and women, but they are much more common in men. But when women do have a heart attack, they are more likely to die in a year than a male.
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A study conducted by Professor Kristina Sundquist from the Center for Primary Health Care Research in Malmö, Sweden, revealed that genetics played an important role in coronary artery disease (Rattue, 2011). This study showed that individuals with at least one biological parent with Coronary Artery Disease had a 40-60% higher risk of developing the disease than those in the control group. This means that coronary artery disease is more closely associated with genetics than environment. Although, if it isn’t in your family history it doesn’t mean that you cannot get the disease. Overall, it is estimated that coronary artery disease is about 50% genetic and 50% environmental.
Works Cited
- Barclay, L. (2013). Coronary artery disease is leading cause of death for both men and women. The Lancet, 382(9894), 1248.
- Mayo Clinic staff. (2017). Coronary artery disease: Causes. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
- Mayo Clinic staff. (2017). Coronary artery disease: Diagnosis & treatment. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/drc-20350619
- Rattue, G. (2011). Genetic link to coronary artery disease uncovered. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/234249
- Sundquist, K. (2011). Genetics plays an important role in coronary artery disease. ScienceDaily. Retrieved from https://www.sciencedaily.com/releases/2011/11/111117081106.htm
