Cardiology, Adult Cardiology

Coronary Artery Disease

Introduction to Coronary Artery Disease

Coronary heart disease, also known as coronary artery disease or ischaemic heart disease, is one of the most common health conditions in the world and is the most common cause of death worldwide.

Written by Doctify Team 27/04/2020

What is Coronary Artery Disease?

Coronary heart disease, also known as coronary artery disease and ischaemic heart disease, is one of the most common health conditions in the world and is in fact the most common cause of death worldwide. In the UK alone 2.3 million people have coronary heart disease as diagnosed and likely many more people live with it as of yet undiagnosed. It can lead to a number of other health conditions though there is much you can do to manage it and reduce the probability of it leading to complications.

What causes Coronary Artery Disease?

The cause of coronary heart disease is the progressive build-up of fatty, cholesterol-containing plaques in artery walls called atheromas. This process is known as atherosclerosis (sclerosis is the narrowing of the artery, hence atherosclerosis is a narrowing caused by atheromas) and can precipitate a range of other vascular conditions. These plaques can impede blood flow to the coronary arteries which directly supply the heart muscle with oxygen and nutrients. Heart attacks, or myocardial infarctions, occur when the atheroma progresses to such a degree that the coronary artery in question is completely blocked and the muscle completely starved of oxygen.

There are a number of risk factors that predispose someone to atherosclerosis such as smoking, alcohol, high blood pressure and cholesterol and diabetes. Additionally the probability increases with age and with certain ethnic groups such as in Afro-Caribbean people.

What are the symptoms of Coronary Artery Disease?

The most common symptoms of coronary heart disease are angina (chest pain) which can radiate to your neck, back and along your arm, palpitations where your heartbeat becomes very noticeable and potentially irregular, and breathlessness.

Severe coronary heart disease has a proportional increase in the symptoms you would experience. Angina has a range of forms from stable angina, chest pain only upon exertion, to unstable angina where the chest pain is constant and severe. Many of the symptoms you experience in coronary heart disease are also comparable to heartburn, but it is important to be able to differentiate the two.

Because of how the disease is caused, at its worst coronary heart disease can lead to heart attacks, which come with intense pain, breathlessness and dizziness and nausea.

How is Coronary Artery Disease treated?

Coronary heart disease is as of yet incurable yet there are a number of options regarding its treatment and the progression of symptoms: Initial treatments involve lifestyle changes such as weight loss, dietary advice, exercise and stopping smoking and excessive drinking.

Beyond that many medications are available to reduce some of the risk factors such as statins (reduce cholesterol), antiplatelet drugs (reduce the chances of clots forming), beta blockers, ACE inhibitors, diuretics and a number of other drugs that can improve your outcomes. The number and types of medication will be based upon the severity of your condition.

Severe coronary artery disease can also be surgically treated: Coronary angioplasty involves surgically treating the blood vessel and atheroma, often leaving a stent in the blood vessel, a small scaffolding to keep it open. In more severe cases a coronary artery bypass graft (CABG) or even a heart transplant may be considered should the narrowing cannot be treated with angioplasty, or when heart muscle is no longer functional.

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