Coronary Artery Disease Treatment in India

Coronary Artery Disease (CAD) is a disease that occurs when the arteries that supply blood to the heart become narrow due to plaque buildup. Plaque is made up of cholesterol and other fatty substances. CAD is not sudden, as the buildup takes years to reach a level that impacts the heart’s working. Another word for CAD is coronary heart disease (ischemic heart disease).

Associated Anatomy of Coronary Artery Disease (CAD)

Coronary Artery disease affects the blood vessels, i.e., arteries that supply oxygen-rich blood to the heart. There are three main arteries:

• Right Coronary artery
• Left Anterior Descending Artery
• Left Circumflex artery

Coronary Artery Disease Causes

Coronary Artery Disease starts when the vessels start getting significantly narrowed due to plaque formation. Injury to the arteries can be caused by:

• High blood pressure
• Smoking
• Prolonged diabetes
• High levels of cholesterol in the blood
• A sedentary lifestyle

Plaques consisting of fatty substances and cholesterol start building up in the place of injury. This plaque is called atherosclerosis. The plaque slowly builds up over a long period and narrows the arteries restricting blood flow to the heart. Clogged arteries significantly reduce the amount of oxygen-rich blood required for the heart to function. Reduced blood supply could lead to chest pain which can further aggravate heart attack and eventually heart failure.

Coronary Artery Disease Symptoms

Since plaque buildup in the arteries happens gradually over the years, Coronary Artery Disease (CAD) is difficult to detect in its early stages. Over the years, the first signs of CAD are shortness of breath or tiredness. The other main signs of Coronary Artery Disease are:

• Chest pain or tightness in the chest (Angina).
• Shortness of breath
• Pain in the shoulder
• Sweating
• Tiredness
• Nausea

Coronary Artery Disease Symptoms in women are usually different. These include:

• Discomfort in the back or neck
• Cold sweats
• Unexplained anxiety

Coronary Artery Disease Diagnosed

If you are seeing mild symptoms of coronary heart disease or you have a family history of coronary heart disease, a doctor might suggest a few tests to identify the problem.

Electrocardiogram (ECG)

The test measures the heart’s electrical activity and the frequency of heartbeats.

X-Rays

Chest X-rays can help doctors get a clear picture of the heart.

Echocardiogram

Using sonic waves in ultrasound to get a clear picture of the heart to look for regional wall motion abnormalities and valvular structure and function which are affected by coronary artery disease.

Stress Test

Measuring heart rate while walking on a treadmill. The test helps to determine how healthy your heart is while under stress.

Coronary Angiogram

In this test, a dye is injected into the arteries. Then, using an x-ray, it is tracked to understand blockages in the arteries.

Calcium Scan of the Arteries

This scan allows doctors to track calcium buildup and plaque in the arteries.

Coronary Artery Disease Treatment

Your doctor would likely diagnose you with coronary artery disease based on your symptoms. Then, depending on your health, medical history, and various other factors, a treatment plan will be mapped by your doctor.

Lifestyle Changes

The first step in treating or reducing the impact of CAD is a change to a healthier lifestyle. These include,

• No smoking
• Eating foods that are low in trans fat, excessive sugar, and salt
• Following an active lifestyle with sufficient workouts
• Managing stress

Medications

Along with lifestyle changes, doctors would prescribe medications to manage the heart condition. Medications would include drugs to reduce cholesterol, blood thinners, beta-blockers, and other drugs to reduce cholesterol and help prevent further deterioration of the arteries.

Angioplasty

Angioplasty refers to the procedure that can help open blocked arteries through peripheral arterial access using wires

• A long, thin, and flexible wire is inserted into the arteries. The wire is equipped with a deflated balloon.
• The balloon is inflated at the blocked artery walls to increase blood flow.
• A stent is a small tube that may also be used to keep the widened artery walls open.
• Coronary Artery Bypass Graft

Bypass surgery involves using healthy blood vessels from other body parts to bypass the diseased arteries of the heart so that perfusion is re-established to the muscle of the heart. In today’s era bypass surgery is a very safe procedure and has superior long term symptom free survival.

Coronary Artery Disease Risk Factor

Coronary Heart Disease is more likely in case of these risk factors.

• Genetics
• Age
• High cholesterol
• Diabetes
• Hypertension
• Smoking
• Drinking too much alcohol
• Unhealthy diet
• Obesity
• No exercise
• Stress

While Coronary Artery Disease would be difficult to control if you are genetically predisposed to it, the other risk factors would be easier to control.

Possible Complications of Coronary Artery Disease

Although preventive measures are taken to reduce the occurrence of Coronary Artery Disease, it could lead to complications like,

• Heart Attack: If a blood clot forms in the arteries, this could result in the complete blocking of blood to the heart. This could trigger a heart attack and damage the heart muscles irreparably.
• Heart Failure: Reduced blood flow to the heart could weaken heart muscles and make them too weak to function optimally.
• Arrhythmia: Insufficient blood supply can cause irregular heartbeats in the heart. Arrhythmia can lead to heart attack or heart failure if not monitored and checked.

Coronary Artery Disease Primary Prevention

Primary Prevention of Coronary Artery Disease

Primary prevention of CAD means minimizing the chances of the disease occurring. While it may be challenging to prevent CAD if you are genetically predisposed to it, you can take specific measures to prolong the disease as much as possible.

• Managing cholesterol is one of the best ways to reduce the risk of coronary artery disease.
• To control cholesterol, a patient needs to be physically active.
• Limiting alcohol and smoking habits could also help towards reducing CAD.
• A healthy diet consisting of less sodium, sugars, and trans or saturated fats can help prevent CAD.

Secondary Prevention of Coronary Artery Disease

Other than the primary prevention factors of following a healthy lifestyle and managing weight, secondary prevention involves surgical coronary bypass surgery and other medical therapies to reduce the occurrence of CAD.

Epidemiology of Coronary Artery Disease

The epidemiology of Coronary Artery Disease is the study of the occurrence of CAD globally depending on various demographics. CAD is one of the diseases that is one of the leading causes of death globally. Approximately 7% of adults in the United States have CAD.

Expected Prognosis of Coronary Artery Disease

CAD can be identified by studying the signs and symptoms in individuals and the risk factors of each individual. While CAD can be treated with preventive measures like lifestyle changes and medications, it cannot be cured completely.

A person who has been diagnosed with CAD will need to use preventive measures and stick to a healthy lifestyle to prevent severe degradation of the heart.

Natural Progression of Coronary Artery Disease

Coronary Artery Disease starts with a buildup of plaque and fatty substances in the arteries supplying blood to the heart. Over the years, the buildup starts restricting blood flow and compromises the functioning of the heart. If the condition is neglected and not prevented in time, CAD could lead to heart failure and death.

Pathophysiology of Coronary Artery Disease

Coronary Artery Disease deals with the functioning of the heart. The arteries become blocked due to fatty buildup, which affects how the heart functions. The heart needs oxygen-rich blood to keep the body healthy.