Coronary Artery Disease

BY Nicha Visuthranukul, Tawanporn Limitlaohaphan

EDITED BY Pakpol Kunopasvorakul

What is coronary artery disease?

Coronary artery disease(CAD) or ischemic heart disease is a heart disease that is the most prevalent form in the US. Sign of CAD will be notified through health care checkup; however, people do not usually notice until a heart attack.

Causes:

Atherosclerosis is the major cause of coronary artery disease. Atherosclerosis is where your arteries become narrowed and plugged up with a cholesterol called plague, which makes it difficult for blood to flow through them. When plaque builds up in the arteries, it can damage the coronary arteries and limit the blood to a certain part in your body. Heart muscle will not get enough oxygen and nutrients, and it will lead to the condition called myocardial ischemia. It causes chest discomfort and might increase the chance for a heart attack.

Symptoms

There are several symptoms of CAD, and the most common one is angina, which is caused by excessive plaque clotting in arteries. This leads to the blockage of blood flow through all organs. Here are some symptoms:

• Angina or chest pain

• Weakness

• Light-headedness

• Nausea (feeling sick to your stomach)

• Shortness of breath

• Palpitations or irregular heartbeat

• Fatigue

• Pain in chest, abdomen or upper body

• Cold sweat

Coronary artery disease can be considered as the leading cause of death in both men and women. There are many factors that can develop CAD, which are called “risk factors”. It has been classified to modifiable and non-modifiable:

• Non-modifiable:

- Age: The chance of developing CAD will increase after the age of 45 in men, and 55 for women.

- Gender : CAD are at increased risk compared to women.

- Ethnicity: The risk of heart disease is higher for some ethnicities than others.

- Family history : A family history of heart disease also increases your risk for CAD, especially a family history of having heart disease at an early age (50 or younger)

• Modifiable:

- Overweight : Excess weight comes with high cholesterol, which increases blood pressure.

- Obesity : It may result from cholesterol plaque buildup in the arteries of the heart.

- Hypertension : It adds force and pressure in the artery due to the clogged plague.

- Smoking : Cigarette smokers are 2 to 4 times more likely to get heart disease than nonsmokers. It increases the chance of building up plaque in the blood.

- Poor Diet : The diet that is high in cholesterol and trans fat will harden the artery.

Treatment

The treatment of coronary heart disease (CHD) involves various approaches that aim to alleviate symptoms and minimize the likelihood of developing additional complications. It can be effectively treated through a combination of medication, lifestyle, modifications, and surgery. With the appropriate treatment, the symptoms can be reduced and heart health functionality can be enhanced. Additionally, changing other aspects of lifestyle, such as adopting healthier dietary habits, engaging in regular physical activity, and stopping smoking.

There are two major ways to treat the CAD which are medications such as aspirin, blood-thinning medicines, cholesterol drugs(statins), coronary angioplasty, and bypass graft.

• Blood-thinning medicines:

• Aspirin: It prevents blood clots, and the recommendation for the usage of aspirin is to use it in low-dose for primary prevention.

• Clopidogrel: It prevents blood clots. The usual dose for clopidogrel is 75 mg once a day. This medicine may make consumers bleed more easily than usual.

• Rivaroxaban: It is a type of an anticoagulant that should be taken once or twice a day.

• Ticagrelor: It should be taken twice a day and the prescribed dose should be taken with aspirin.

• Cholesterol drugs decrease the amount of bad cholesterol and remove LDL cholesterol, so it reduces the plaque in the arteries.

• A coronary angioplasty or percutaneous coronary intervention is a treatment that widens the narrowed arteries by using a balloon. Commonly, this kind of procedure is used in an emergency case—a heart attack.

• In the bypass graft procedure, a blood vessel is inserted between the aorta and the section of the coronary artery connecting to the blockage area. This inserted blood vessel is called graft.

Reference:

“5 Overlooked Symptoms That May Signal Heart Trouble.” Harvard Health, 6 Apr. 2022, www.health.harvard.edu/heart-health/5-overlooked-symptoms-that-may-signal-heart-trouble.

ASC of The Heart Institute. “Coronary Artery Disease.” ASC of The Heart Institute, ascheart.com/details/service/coronary-artery-disease. Accessed 29 June 2023.

“Atherosclerosis.” NHS Choices, www.nhs.uk/conditions/atherosclerosis/. Accessed 22 June 2023.

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“Coronary Artery Disease.” Centers for Disease Control and Prevention, 19 July 2021, www.cdc.gov/heartdisease/coronary_ad.htm.

“Coronary Artery Disease.” Centers for Disease Control and Prevention, 19 July 2021, www.cdc.gov/heartdisease/coronary_ad.htm.

“Coronary Heart Disease.” NHS Choices, www.nhs.uk/conditions/coronary-heart-disease/symptoms/. Accessed 22 June 2023.

“Coronary Heart Disease.” NHS Choices, www.nhs.uk/conditions/coronary-heart-disease/treatment/. Accessed 22 June 2023.

professional, Cleveland Clinic medical. “Coronary Artery Disease: Symptoms, Causes & Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease#symptoms-and-causes. Accessed 22 June 2023.

Risk Factors for Coronary Artery Disease - Statpearls - NCBI Bookshelf, www.ncbi.nlm.nih.gov/books/NBK554410/. Accessed 22 June 2023.

Risk Factors for Coronary Artery Disease - Statpearls - NCBI Bookshelf, www.ncbi.nlm.nih.gov/books/NBK554410/. Accessed 22 June 2023.

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Team, The Healthline Editorial. “Coronary Artery Disease Risk Factors.” Healthline, 17 Sept. 2018, www.healthline.com/health/coronary-artery-disease/risk-factors#risk-factors.