Coronary Artery Disease (CAD)

Also known as: Atherosclerotic Heart Disease

Definition: Coronary artery disease is a narrowing or blockage of the arteries and vessels that provide oxygen and nutrients to the heart. It is caused by atherosclerosis, an accumulation of fatty materials on the inner linings of arteries. The resulting blockage restricts blood flow to the heart. When the blood flow is completely cut off, the result is a heart attack.

Signs/symptoms:

-Chest pain that occurs regularly with activity, after eating, or at other predictable times is termed stable angina and is associated with narrowing of the arteries of the heart. Angina that changes in intensity, character or frequency is termed unstable. Unstable angina may precede myocardial infarction.

Causes:

-Caused by atherosclerosis. Cholesterol and other fatty substances accumulate on the inner wall of the arteries. They attract fibrous tissue, blood components, and calcium, and harden into artery-clogging plaques. Atherosclerotic plaques often form blood clots that also can block the coronary arteries (coronary thrombosis).

-Congenital defects and muscle spasms can also block blood flow.

-Infection from organisms such as chlamydia bacteria may be responsible for some cases of coronary artery disease.

Risk factors:

-Smoking (associated with about 36% of cases)

-Family history

-Hypertension

-Obesity (associated with about 20% of cases)

-Diabetes

-Lack of exercise (has been linked to 7-12% of cases)

-Stress

-High blood lipids

-Exposure to the herbicide Agent orange may increase risk.

Diagnosis:

-Diagnosis begins with a visit to the physician, who will take a medical history, discuss symptoms, listen to the heart, and perform basic screening tests. These tests will measure weight, blood pressure, blood lipid levels, and fasting blood glucose levels.

-Other diagnostic tests include resting and exercise electrocardiogram, echocardiography, radionuclide scans, and coronary angiography.

-The treadmill exercise (stress) test is an appropriate screening test for those with high risk factors even when they feel well.

Treatment:

- Coronary artery disease can be treated many ways. The choice of treatment depends on the severity of the disease.

- Treatments include lifestyle changes and drug therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass surgery. Coronary artery disease is a chronic disease requiring lifelong care. Angioplasty or bypass surgery is not a cure.

- Various semi-experimental surgical procedures for unblocking coronary arteries are currently being studied. Atherectomy is a procedure in which the surgeon shaves off and removes strips of plaque from the blocked artery. In laser angioplasty, a catheter with a laser tip is inserted into the affected artery to burn or break down the plaque. A metal coil called a stent can be implanted permanently to keep a blocked artery open. Stenting is becoming more common.

Alternative treatment:

- Natural therapies may reduce the risk of certain types of heart disease, but once symptoms appear, conventional medical attention is necessary.
- A healthy diet (including cold-water fish as a source of essential fatty acids) and exercise, important components of conventional prevention and treatment strategies, also are emphasized in alternative approaches to coronary artery disease.
- Herbal medicine offers a variety of remedies that may have a beneficial effect on coronary artery disease.- Yoga and other bodywork, massage, relaxation therapies, and talking therapies also may help prevent coronary artery disease and stop, or even reverse, the progression of atherosclerosis.
- Vitamin and mineral therapy to reduce, reverse, or protect against coronary artery disease.
- Traditional Chinese medicine may recommend herbal remedies, massage, acupuncture, and dietary modification.

References:

http://medical-dictionary.thefreedictionary.com/coronary+artery+disease

https://en.wikipedia.org/wiki/Coronary_artery_disease