Coronary Artery Disease, Symptoms & Causes
Coronary artery disease, also called CAD, is a condition that affects your heart. It is the most common heart disease in the United States. CAD happens when coronary arteries struggle to supply the heart with enough blood, oxygen and nutrients. Cholesterol deposits, or plaques, are almost always to blame. Read the article to know more.
Nivedita Dar28 Nov, 2024
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Coronary Artery Disease: Beat the Silent Killer . Coronary artery disease is a condition characterized by an inadequate supply of blood and oxygen to the myocardium, resulting from the occlusion of the coronary arteries. This leads to a demand-supply mismatch of oxygen. It typically involves the formation of plaques in the lumen of coronary arteries that impede blood flow. A major cause of death worldwide, CAD is a dreadful condition plaguing mankind.
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Etiology of CAD
Being a multifactorial phenomenon, CAD is caused and affected by a variety of factors, some modifiable and some non-modifiable. Modifiable risk factors include smoking, obesity, lipid levels, and psychosocial variables. Non-modifiable factors include gender, age, family history, and genetics. A faster-paced lifestyle has led people to eat more fast foods and unhealthy meals, which has led to an increased prevalence of ischemic heart diseases. Smoking remains the number one cause of cardiovascular diseases. The male gender is more predisposed than the female gender. Hypercholesterolemia remains an important modifiable risk factor for CAD.Pathophysiology of CAD
The hallmark of the mechanism of injury of CAD is the development of atherosclerotic plaque. Plaque is a build-up of fatty material that narrows the vessel lumen and impedes blood flow. The first step in the process is the formation of a “fatty streak.” A fatty streak is formed by subendothelial (endothelium is the innermost lining of blood vessels) deposition of lipid-laden macrophages, also called foam cells. When a vascular insult occurs, the intima layer breaks, and monocytes migrate into the subendothelial space where they become macrophages. These macrophages take up oxidized fat particles, and foam cells are formed. T cells get activated, releasing cytokines that aid in the pathological process. Growth factors released activate smooth muscles, which also take up oxidized fat particles and collagen, depositing them along with activated macrophages and increasing the population of foam cells. This process leads to the formation of subendothelial plaque. Over time, this plaque could grow in size or become stable if no further insult occurs to the endothelium. If it becomes stable, a fibrous cap will form, and the lesion will become calcified over time. As time passes, the lesion can become hemodynamically significant enough that not enough blood would reach the myocardial tissue during increased demands, causing angina symptoms.Read More - Radiodiagnosis
Diagnosis
Tests to help diagnose or confirm coronary artery disease include: 1.Blood Tests: Blood tests can check blood sugar and cholesterol levels. A high-sensitivity C-reactive protein (CRP) test checks for a protein linked to inflammation of the arteries. 2.Electrocardiogram (ECG or EKG): This quick test checks the electrical activity of the heart, showing how the heart is beating. Sticky patches called electrodes attach to the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which prints or displays the test results. The ECG signal patterns can show if you had or are having a heart attack. 3.Echocardiogram: This test uses sound waves to show blood flow through the heart. Parts of the heart that move weakly may be caused by a lack of oxygen or a heart attack. This may be a sign of coronary artery disease or other conditions. 4.Exercise Stress Test: If your symptoms usually occur during exercise, your healthcare professional may recommend this test. You walk on a treadmill or ride a stationary bike while your heart is checked. Because exercise makes the heart pump harder and faster than it does during most daily activities, an exercise stress test can show heart problems that might otherwise be missed. 5.Cardiac Catheterization and Angiogram: This test can see blockages in the heart arteries. A doctor places a long, thin flexible tube called a catheter in a blood vessel, usually in the groin or wrist. It’s guided to the heart. Dye flows through the catheter to arteries in the heart. The dye helps the arteries show up more clearly on X-ray images and video. Heart treatments may be done during this test.Coronary Artery Disease FAQs
What are the complications of CAD?
Complications of CAD can include heart attack, heart failure, arrhythmias, and sudden cardiac arrest.
What is the role of lifestyle in CAD?
Lifestyle plays a significant role in the development and management of CAD. Factors such as diet, physical activity, smoking, and stress levels can all influence the risk and progression of CAD.
What are the possible interventions in CAD?
Interventions for CAD include lifestyle changes, medications (such as statins, beta-blockers, and antiplatelets), and surgical procedures (such as angioplasty and coronary artery bypass grafting).
What is angina pectoris?
Angina pectoris is a symptom of CAD characterized by chest pain or discomfort that occurs when the heart muscle doesn’t get enough oxygen-rich blood. It often occurs during physical activity or stress.
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