Coronary Artery Disease: Causes, Risk Factors, Symptoms and Treatment

Coronary artery disease is a common heart problem The heart's main blood channels, the coronary arteries, have difficulty supplying the heart muscle with adequate blood, oxygen, and nutrients. Usually, inflammation and plaque formation (a build-up of cholesterol) in the heart arteries cause coronary artery disease.

The symptoms and indicators of coronary artery disease arise when the heart does not get enough oxygen-rich blood. People with coronary artery disease may experience dyspnea and angina (chest pain), which are signs of reduced blood flow to the heart. A complete blockage of the blood flow might cause a heart attack.

The symptoms of coronary artery disease can take years to appear. Likely, symptoms won't become noticeable until a serious blockage or heart attack occurs. By maintaining a heart-healthy lifestyle, coronary artery disease can be prevented. Coronary Heart disease is a term used to refer to Coronary Artery Disease.

Coronary Artery Disease Causes

Coronary artery disease initially manifests as a buildup of lipids, cholesterol, and other substances on the inner walls of the heart arteries. This condition is called atherosclerosis. Plaque is the term for the buildup. Narrowed arteries from plaque buildup can impede blood flow. A blood clot might also result from the plaque rupturing.

The following conditions may damage the coronary arteries in addition to high cholesterol:

• Diabetes or insulin resistance
• Increased blood pressure
• Inadequate physical activity (sedentary lifestyle)
• Tobacco use or smoking

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Coronary Artery Disease Symptoms

Initially, symptoms might not be apparent or they might only become apparent when the heart is beating quickly, such as during exercise. As the coronary arteries narrow, less and less blood reaches the heart, which may cause symptoms to worsen or occur more frequently.

Coronary artery disease signs and indicators might include:

• Angina (pain in the chest). You can feel as though your chest is tightening or straining. Some say they have the impression that someone is standing on top of them. Chest pain often affects the left or center side of the chest. Activity and strong emotions might trigger angina. Minutes after the triggering event generally finishes, the soreness usually goes away. Certain people, especially women, could
• Have transient or intense pain that is felt in the neck, arm or back.
• Dyspnea. It's conceivable that you're experiencing breathing difficulties.
• Tiredness. If the blood flow in your heart is insufficient to meet your body's needs, you may feel unusually tired.
• A heart attack. Fully occluded coronary arteries are the cause of a heart attack. The typical warning signs and symptoms of a heart attack include sweating, shortness of breath, pain in the arms or shoulders, and intense pressure or pain in the chest. Women are less likely to report tiredness, nausea, and soreness in the jaw or neck. There are heart attacks that show no visible signs or symptoms.

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Coronary Artery Disease Risk Factors

A common ailment is heart disease. Age, heredity, other medical conditions, lifestyle choices, and other factors can all affect the condition of the heart arteries. Below are mentioned some of the risk factors associated with coronary artery disease:

• Age. Growing older increases the chance of artery damage and constriction.
• sex. Men are often more prone than women to get coronary artery disease. Women are more vulnerable after menopause, though.
• History within the family. If heart disease runs in your family, you have a higher chance of getting coronary artery disease. This is especially true if you were close to a parent or sibling who had early-onset heart disease. Before the age of 65, your mother or sister has heart disease, or if your father or brother had it before the age of 55, your risk is highest.
• Smoking. If you smoke, give it up. Smoking is harmful to the heart. Smokers have a much-increased risk of heart disease. Inhaling secondhand smoke increases the risk as well.
• Increased BP. Hypertension that is not under control can lead to arterial stiffness, often known as hard and stiff arteries. The coronary arteries may constrict and lower blood flow.
• Increased cholesterol. Bad cholesterol levels in the blood can increase the risk of atherosclerosis. Bad cholesterol is also known as low-density lipoprotein or LDL cholesterol. Low levels of HDL, or high-density lipoprotein, a kind of good cholesterol, can also lead to atherosclerosis.
• Diabetes. The risk of coronary heart disease is increased by diabetes. High blood pressure and obesity are two risk factors that are common to both type 2 diabetes and coronary heart disease.
• Overweight or obese. Being overweight hurts one's overall health. Diabetes type 2 and high blood pressure are associated with obesity.
• Chronic renal sickness. Chronic renal illness patients have an increased risk of developing coronary artery disease.
• Not working out enough. Physical activity is essential for good general health. Coronary artery disease and several of its risk factors are linked to sedentary lifestyles and inactivity.
• Stress. Emotional stress not only exacerbates pre-existing coronary artery disease risk factors, but it also directly damages the arteries.
• Unhealthy consumption of food. Eating meals heavy in trans fats, high in sugar, and high in saturated fats increases the risk of coronary heart disease.
• Consuming alcohol. The cardiac muscle may suffer harm from excessive drinking.  Additionally, it can exacerbate existing coronary artery disease risk factors.
• The quantity of sleep that you receive. Excessive or inadequate sleep has been linked to an increased risk of heart disease.
  • Coexisting risk factors are common. Something risky might trigger another. When certain risk factors are combined, your likelihood of having coronary artery disease increases. For example, metabolic syndrome, a cluster of conditions including elevated blood pressure, elevated blood sugar, extra body fat around the waist, and elevated triglyceride levels increases the risk of coronary artery disease.
  • There are rare instances in which coronary artery disease might develop without any known risk factors. There are more possible risk factors for coronary artery disease:
• During sleep, you breathe in and out (obstructive sleep apnea). This issue will cause your breathing to come and go as you sleep. It might lead to abrupt drops in blood oxygen levels. More blood must be pumped by the heart. There is a rise in blood pressure.
• High-sensitivity CRP (hs-CRP). This protein is found in greater amounts than usual when there is internal inflammation. Elevated hs-CRP levels may raise the risk of heart disease. It is thought that as coronary arteries narrow, the amount of hs-CRP in the blood rises.
• Higher levels of triglycerides. Lipids are blood fats like this one. Increased risk of coronary artery disease may result from elevated levels, especially in females.
• Homocysteine. The amino acid homocysteine is used by the body to make protein and to maintain and repair tissue. However, coronary artery disease may become more prevalent in those with elevated homocysteine levels.
• Pre-eclampsia. Because of this pregnancy issue, urine contains more protein and has higher blood pressure. It could raise the chance of developing heart disease later in life.
• Other pregnancy-related concerns. One of the established risk factors for coronary artery disease is high blood pressure associated with pregnancy or diabetes.
• Certain autoimmune diseases. Atherosclerosis is more common in those with inflammatory conditions such as rheumatoid arthritis and lupus.

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Coronary Artery Disease Diagnosis

To find coronary artery disease (CAD), a medical practitioner will examine you. You're probably going to be asked questions about your medical history and symptoms. Usually, blood tests are done to evaluate your overall health.

Tests for coronary artery disease that are used to track the condition or support the diagnosis include:

• ECG or EKG is another name for a cardiogram. This quick and simple test determines the heart's electrical activity. It might show both slow and fast waves of the heart rate. Based on signal patterns, your healthcare professional can determine if you are having or have had a heart attack.
• Cardiac echography. With the use of sound waves, this test generates pictures of a beating heart. The circulation via the heart and heart valves can be seen on an echocardiography. A heart attack or insufficient oxygen levels might be the cause of weakly beating cardiac sections. 
• Test your level of stress with physical activity. If you notice that your symptoms get worse when you exercise, your doctor could suggest that you ride a stationary bike or walk on a treadmill while having an ECG. If an echocardiography is done while you carry out these exercises, it is referred to as a stress echo. If you are unable to exercise, you can be administered medications that stimulate the heart in a manner comparable to that of exercise.
• Examination of nuclear stress. Similar to a stress test for exercise, this test adds pictures to the ECG recordings. By using a nuclear stress test, one may see how blood flows to the heart muscle under stress and during rest. Radiation tracers are given via IV. The heart arteries are more noticeable in photographs thanks to the tracer.
• Cardiac CT scan. Cardiovascular CT scans can reveal calcium deposits and blockages in the heart arteries. Calcium buildup can cause arteries to narrow.
• Sometimes, this test is conducted with an IV dye. Making detailed pictures of the heart arteries is made easier by the dye. If dye is used, the test is referred to as a CT coronary angiogram.
• Cardiac catheterization and angiography. During a cardiac catheterization procedure, a cardiac physician (cardiologist) carefully inserts a flexible tube (catheter) into a blood vessel, usually in the wrist or groin. The catheter is gradually guided to the heart. It is directed using X-rays. The dye is pumped through the catheter. The dye makes any blockages stand out and makes blood vessels more visible in the images. If you need to treat an arterial blockage, you can blow up a balloon on the catheter tip to open the artery. To keep the artery open, a mesh tube, also known as a stent, is often implanted.

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Coronary Artery Disease Treatment

A balanced diet, increased physical activity, and cessation of smoking are common lifestyle modifications utilized in the treatment of coronary artery disease. Sometimes medicine and treatments are required.

Drugs There are several medications available to treat coronary artery disease, including the following ones:

• Medications that lower cholesterol. The accumulation of plaque in the arteries and poor cholesterol can both be decreased with medication. Among these medications are fibrates, niacin, bile acid sequestrants, and statins.
• Aspirin. Aspirin helps thin blood and prevent clots. The main way to avoid a heart attack or stroke for many people may be to take a daily low-dose aspirin supplement. Frequent usage of aspirin can have major adverse consequences, such as gastrointestinal and stomach bleeding. Be sure to speak with your doctor before beginning a daily aspirin regimen. It might be recommended in addition to or instead of a beta-blocker.
• Beta-blockers. These medications slow the heart rate. They also reduce blood pressure. Beta-blockers may lower your chance of experiencing another heart attack after one.
• Blockers of calcium channels. If you are intolerant to beta-blockers or if they don't work for you, your doctor can suggest one of these medications. Chest discomfort symptoms can be lessened with the use of calcium channel blockers.
• Nitroglycerin. The arteries in the heart enlarge as a result of this medicine. It can aid in managing or reducing chest discomfort. There are three kinds of nitroglycerin available: pill, spray, and patch.
• Ranolazine. People who suffer from angina (chest pain) could feel better with this drug. 

Surgery may be necessary in some situations to clear a blocked artery. Among the options are:

• Stent implantation together with coronary angioplasty. This procedure is meant to clear the coronary arteries of blockage. Another term for it is percutaneous coronary intervention or PCI. A cardiologist, or cardiac expert, guides a tiny, flexible tube known as a catheter to the narrowed section of the heart artery.
  • A small balloon is inflated to help clear the congested artery and improve blood flow. A small wire mesh tube, sometimes known as a stent, may be put into the artery during an angioplasty. The stent keeps the artery's aperture open. It reduces the likelihood of the artery narrowing again. A slow release of medication is used by certain stents to keep the arteries open.
• Coronary artery bypass graft (CABG) procedure. A healthy blood vessel from another part of the body is removed by a surgeon to create a new blood artery in the heart. The blood so avoids the restricted or clogged coronary artery. CABG is the name for an open cardiac surgery. This therapy is usually reserved for patients with several restricted cardiac arteries.

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Coronary Artery Disease Prevention

The same lifestyle decisions that are used to treat coronary artery disease can also be utilized to prevent it. Striving for a healthy lifestyle can help keep your arteries strong and free of plaque. Take the following advice to improve heart health:

• Quit smoking
• Control your blood pressure, cholesterol, and diabetes.
• Exercise regularly
• Maintain a balanced weight
• Eat a diet rich in healthy grains, fruits, and vegetables and low in fat and salt.
• Reduce and manage your stress.

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Coronary Artery Disease Complications

Heart issues may lead to:

• Angina (pain in the chest). If the coronary arteries narrow, the heart may not get enough blood when it's most needed, such as during exercise. This might lead to dyspnea or pain in the chest (angina).
• Cardiac attack. A heart attack might occur if a blood clot develops as a result of a cholesterol plaque cracking open. A clot can prevent bleeding. A lack of blood can cause damage to the heart muscle. The amount of injury you incur will depend on when you obtain therapy.
• Cardiac failure. The heart might get progressively weaker or stiffer due to cardiac artery constriction or high blood pressure, which will make it harder for the organ to pump blood. Heart failure happens when the heart is unable to pump blood as it should.
• Arrhythmias, or irregularities in the heart's beat. Inadequate blood flow can interfere with the heart's normal cardiac impulses, resulting in abnormal heartbeats.

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