Coronary Artery Disease (Atherosclerotic Heart Disease): Symptoms, Causes, Diagnosis & Treatment

Coronary artery disease (CAD) is also known as atherosclerotic heart disease and is one of the most common cardiovascular diseases

CAD develops when the blood vessels (coronary arteries) that supply blood, oxygen, and nutrients to the heart become damaged or diseased. Cholesterol-containing deposits (plaque) in arteries and inflammation are usually to blame for coronary artery disease.

The most usual symptom is chest pain or discomfort which may travel to the shoulder, arm, back, neck, or jaw. Occasionally it may feel like a heartburn. Usually, symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. In some cases, shortness of breath may be felt, while in other cases, no symptoms are observed.

In 2015, Atherosclerotic Heart Disease affected 110 million people and resulted in 8.9 million deaths. This makes up 15.6% of all deaths, making it the most common cause of death globally. Rates of CAD are higher among men than women of any given age.

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How Does Coronary Artery Disease Affect Your Body?

In coronary arteries, plaques may narrow the caliber of vessels, leading to decreased oxygen delivery and stable angina. Atherosclerotic plaques also may result in acute coronary syndromes through rupture, secondary thrombus formation, or an acute reduction of blood flow.

What Are The Causes of Coronary Artery Disease?

The most common cause is a vascular injury with cholesterol plaque buildup in the arteries, known as atherosclerosis.

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What Are The Risk Factors of Coronary Artery Disease?

Risk factors for CAD include:

  • Age – Old age increases the risk of damaged and narrowed arteries.
  • Sex – Men are at greater risk of Atherosclerotic Heart Disease. The risk for women increases after menopause.
  • Family history – History of heart disease is associated with a higher risk of CAD, especially if a close relative developed this heart disease at an early age.
  • Smoking – Smoking increases the risk of heart disease.
  • High blood pressure – This can result in hardening and thickening of arteries, thus narrowing the channel through which blood can flow.
  • High blood cholesterol levels – High levels of cholesterol in the blood can increase the risk of formation of plaque and atherosclerosis.
  • Diabetes – Diabetes is associated with an increased risk of Atherosclerotic Heart Disease.
  • Overweight or obesity – Excessive weight worsens other risk factors.
  • Physical inactivity – Lack of exercise is also associated with CAD and some of its risk factors, as well.
  • High stress – Stress may damage arteries as well as worsen other risk factors.
  • Unhealthy diet – Eating saturated and trans fat rich food, salt, and sugar can increase the risk of it.

What Are The Symptoms of Coronary Artery Disease?

As plaque continues to build up in coronary arteries, the signs and symptoms developed, include the following:

  • Chest pain (angina) – Pressure or tightness in the chest, as if someone were standing on it. This pain usually occurs in the middle or left side of the chest and is generally triggered by physical or emotional stress. In some people, especially women, pain may be fleeting or sharp and felt in the neck, arm or back.
  • Shortness of breath – One can experience shortness of breath or extreme fatigue with exertion because of the heart not pumping enough blood to meet the supply or demands of the body.
  • Heart attack – A completely blocked coronary artery causes a heart attack. This is the most common sign and symptom of a heart attack, sometimes accompanied with shortness of breath and sweating.
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How is Coronary Artery Disease Diagnosed?

Apart from asking for medical and family history, the doctor may perform the following tests:

  • Electrocardiogram (ECG) records electrical signals and can often reveal evidence of a previous heart attack or one that’s in progress.
  • In other cases, Holter monitoring may be recommended where a portable monitor is worn for 24 hours as one goes about his normal activities. In the case of abnormalities, blood will inadequately flow to the heart.
  • An Echocardiogram uses sound waves to produce images of the heart and determines whether all parts of the heart wall are contributing normally to the heart’s pumping activity.
  • A Stress test may be conducted if the signs and symptoms occur mostly during exercise. The doctor may ask the patient to walk on a treadmill or ride a stationary bike during an ECG. In some cases, medication is used to stimulate the heart instead of exercise.
  • Another stress test known as a nuclear stress test helps to measure blood flow to the heart muscle at rest and during stress. A tracer is injected into the bloodstream, and special cameras can detect areas in the heart that receive less blood flow.
  • Cardiac catheterization and angiogram is a process that involves the injection of a special dye known as angiogram into the coronary arteries. The dye is injected through a long, thin, catheter that is threaded through an artery, usually in the leg, to the arteries in the heart. This dye outlines narrow spots and blockages on the X-ray images. In the case of a blockage, a balloon can be pushed through the catheter and inflated to improve the blood flow in the coronary arteries. Later, a mesh tube (stent) may then be used to keep the dilated artery open.
  • A CT Scan can help see calcium deposits in the arteries that can narrow the arteries. If a substantial amount of calcium is discovered, the chances of the Atherosclerotic Heart Disease are likely to be high.
  • A CT coronary angiogram, in which a contrast dye is injected intravenously during a CT scan, also generates images of heart arteries.
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How to Prevent And Control Coronary Artery Disease?

  • Quit smoking – Nicotine present in cigarettes constricts blood vessels and forces the heart to work harder. Furthermore, carbon monoxide reduces oxygen in the blood and damages the lining of the blood vessels.
  • Control high blood pressure, high cholesterol and diabetes – Blood pressure and cholesterol in high amount can block the arteries which is why it is advised to control it.
  • Stay physically active – It helps in maintaining a controlled weight and lowering high blood pressure, cholesterol and diabetes.
  • Eat a balanced diet – Eat a low-fat and salt diet, rich in fruits, vegetables, and whole grains.
  • Maintain a healthy weight – Overweight and obesity increase the chance of Atherosclerotic Heart Disease.
  • Reduce and manage stress – Reduce stress and practice healthy techniques for managing stress, such as muscle relaxation and deep breathing.

Treatment of Coronary Artery Disease – Allopathic Treatment

Sometimes aggressive treatments like angioplasty, stent placement and, coronary artery bypass surgery are performed to control to restore and improve blood flow. Medicines used to treat CAD include:

  • Cholesterol-modifying medications
  • Aspirin – This can reduce the tendency of blood to clot, which may help prevent obstruction of coronary arteries.
  • Beta blockers – These drugs slow down the heart rate and decrease blood pressure, which decreases the heart’s demand for oxygen.
  • Calcium channel blockers – These drugs may be used with beta blockers if beta blockers alone aren’t effective and can help improve symptoms of chest pain.
  • Ranolazine – This may help people with chest pain. It may be prescribed with a beta blocker.
  • Nitroglycerin – Nitroglycerin tablets, sprays, and patches can control chest pain by temporarily dilating coronary arteries and reducing the heart’s demand for blood.
  • Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) – These drugs decrease blood pressure and may help prevent the progression of the Atherosclerotic Heart Disease.
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Treatment of Coronary Artery Disease – Homeopathic Treatment

  • Sumbul, Strophanthus, Strontium Carb are effective in lowering the blood cholesterol level.
  • Crataegus oxyacantha, Aurum Metallicum, Baryta Carbonicum, and Calcarea Carbonicum decrease the cholesterol deposit from heart vessels.
  • Aurum metallicum, Belladona, Calcarea carbonica, Glonoine, Lachesis, Natrum muriaticum, Nux vomica, Phosphorus and Plumbum metallicum treat hypertension.

Coronary Artery Disease – Lifestyle Tips

  • Quit smoking
  • Control blood pressure and cholesterol
  • Keep diabetes under control
  • Exercise regularly
  • Participate in cardiac rehabilitation
  • Eat healthy foods
  • Avoid saturated and trans fat, excess salt and excess sugar
  • Avoid or limit the intake of alcohol
  • Maintain a healthy weight
  • Manage stress
  • Dietary sources of omega-3 fatty acids can also be taken

What Are The Recommended Exercises For a Person With Coronary Artery Disease?

  • Walking
  • Swimming
  • Cycling
  • Light jogging

Coronary Artery Disease & Pregnancy- Things to Know

  • Cardiac disease is rare in pregnancy, but it is a leading cause of women dying during that.
  • Pregnant women with pre-existing Atherosclerotic Heart Disease are at an increased risk of adverse events during pregnancy.
  • Although rare, acute coronary syndrome during pregnancy is associated with increased maternal and neonatal mortality and morbidity compared with the non-pregnant situation.
  • It constitutes an important problem because the selection of diagnostic and therapeutic approaches is greatly influenced not only by maternal but also by fetal safety.
  • While pregnant, one should eat a balanced diet, control weight, and also quit smoking.

Common Complications Related to Coronary Artery Disease

  • Chest pain (angina)
  • Heart attack
  • Heart failure
  • Abnormal heart rhythm (arrhythmia)

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