What is coronary artery disease?
The heart is a muscle that pumps blood. Like all muscles, the heart needs a steady supply of blood to work. Blood that pumps through the heart doesn't feed the heart muscle. Instead the heart muscle is fed by its own arteries. These arteries are called coronary arteries.
Coronary artery disease (heart disease) happens when blood flow through the coronary arteries is partially or totally blocked.
Coronary artery disease is the main cause of angina Angina Angina is pain, discomfort, or pressure in your chest that happens when your heart isn't getting enough oxygen. The lack of oxygen is caused by a narrow or blocked artery to your heart ( coronary... read more , unstable angina Unstable Angina Angina is pain, discomfort, or pressure in your chest that happens when your heart isn't getting enough oxygen. The lack of oxygen is caused by a narrow or blocked artery to your heart ( coronary... read more , and heart attack Heart Attack A heart attack is when blood flow to part of your heart is suddenly blocked and some of your heart muscle dies. Go to an emergency department and chew on an aspirin tablet if you think you're... read more
You're more likely to have coronary artery disease if you're older, male, or have a parent or grandparent who had coronary artery disease before they were 50
Unstable angina and heart attack can cause an abnormal heart rhythm or cause your heart to stop. You can die if you aren't treated quickly. Also, a heart attack causes permanent heart damage.
Supplying the Heart With Blood
Like any other tissue in the body, the muscle of the heart must receive oxygen-rich blood and have waste products removed by the blood. The right coronary artery and the left coronary artery, which branch off the aorta just after it leaves the heart, deliver oxygen-rich blood to the heart muscle. The right coronary artery branches into the marginal artery and the posterior interventricular artery, located on the back surface of the heart. The left coronary artery (typically called the left main coronary artery) branches into the circumflex and the left anterior descending artery. The cardiac veins collect blood containing waste products from the heart muscle and empty it into a large vein on the back surface of the heart called the coronary sinus, which returns the blood to the right atrium.
What causes coronary artery disease?
The most common cause of coronary artery disease is atherosclerosis Atherosclerosis In people with atherosclerosis, patchy deposits of fatty material (atheromas or atherosclerotic plaques) develop in the walls of medium-sized and large arteries, leading to reduced or blocked... read more , commonly known as hardening of the arteries. In atherosclerosis, cholesterol and other fatty material slowly build up in your arteries. This build-up is called an atheroma or plaque. The plaque may:
Narrow the artery, partly blocking blood flow to your heart
Rupture suddenly, causing a blood clot that blocks the artery and causes a heart attack Heart Attack A heart attack is when blood flow to part of your heart is suddenly blocked and some of your heart muscle dies. Go to an emergency department and chew on an aspirin tablet if you think you're... read more
Less common causes include a sudden spasm of a coronary artery, usually from using illicit drugs such as cocaine. During a spasm, the artery suddenly squeezes shut. If it stays shut long enough, you can have a heart attack. Usually the spasm stops and the artery opens up again.
What are the risk factors for coronary artery disease?
Risk factors that you can control or avoid:
Not exercising regularly
Eating too much saturated fat, such as butter, and not enough fruits and vegetables
Risk factors that are important but can't be controlled:
Having people in your family who had coronary artery disease before age 55
Being a man
How can doctors tell if I have coronary artery disease?
Your doctor will ask you questions about your symptoms and do a physical exam and blood tests.
If you have symptoms of a blocked artery, your doctor may do tests:
Stress test Stress Testing A stress test lets doctors see how your heart works when it’s under stress, such as when you exercise. Many heart problems are easier for your doctor to find when your heart is working hard... read more —a test to see whether your heart is getting enough blood when it works hard (is under stress), such as when you exercise
ECG/EKG (electrocardiography) Electrocardiography Electrocardiography is a test that measures your heart’s electrical activity. It's quick, painless, and harmless. The results of that test are shown in an electrocardiogram. It looks like a... read more —a test that measures your heart’s electrical activity, which can be abnormal in coronary artery disease
Cardiac catheterization Cardiac Catheterization Cardiac catheterization (also called cardiac cath) is a heart procedure done in a hospital. The doctor puts a thin plastic tube (catheter) through an artery and into your heart. Doctors get... read more —a test that allows doctors to see if and where your coronary arteries are blocked by putting a long, thin catheter (small flexible tube) into an artery in your arm or leg, up to your heart, and into your coronary arteries and then injecting contrast material that is seen on x-ray
CT (computed tomography) scan Computed Tomography A CT scan uses a large machine shaped like a large donut to take x-rays from many angles. A computer then takes the x-rays and creates many detailed pictures of the inside of your body. Each... read more —an imaging test to look for hardening of the coronary arteries
How do doctors treat coronary artery disease?
Doctors treat the problem that's causing your coronary artery disease, which is usually hardening of the arteries. They may:
Give you medicine to lower the workload on your heart, such as blood pressure medicine
Give you medicine to lower your cholesterol level
Ask you to change any unhealthy behaviors that may hurt your heart—for example, smoking, not exercising, and eating a poor diet
Sometimes do a procedure to open a blocked artery
Depending on how much your coronary arteries are blocked, doctors may do a procedure to clear your artery. They may do angioplasty or bypass surgery (also called coronary artery bypass grafting or coronary artery bypass surgery).
The doctor puts a small, flexible tube (catheter) into an artery in your upper leg (groin) or in your wrist
The catheter is pushed up the artery to your heart and then into one of your coronary arteries
A small balloon on the tip of the catheter is inflated
The balloon pushes the blockage open
Then the doctor slips a wire mesh tube (stent) off the end of the catheter into the blocked area
The wire mesh tube helps hold the blocked area open
During bypass surgery:
Doctors take a piece of healthy artery or vein from another part of your body
They sew one end of that piece of artery or vein to your aorta (the major artery that takes blood from your heart to the rest of your body)
They sew the other end to your blocked artery past the point of the blockage
Your blood then flows through this new route, bypassing the blockage
How can I prevent or reverse coronary artery disease?
Change behaviors that may hurt your heart
Stop smoking—this is the most important way to prevent or reverse coronary artery disease
Eat healthy foods, such as fresh fruits and vegetables and other high-fiber foods
Eat less fat from meats, dairy, and processed foods (such as frozen pizza or microwaveable dinners)—talk to your doctor about how much and which types of fat you should eat
Lose weight if you're overweight
Stay active by using weights or walking
Stop using illicit drugs—this can be hard to stop, so talk to your doctor or a counselor about how to get help
Take your medicines correctly
Remember to take any medicines prescribed by your doctor, such as for high cholesterol High Cholesterol Cholesterol is a type of fat. Fats are also called lipids. Cholesterol is a type of lipid—an essential element contained in all human cells. However, excess lipids and other fatty substances... read more , high blood pressure High Blood Pressure Each heart beat pushes blood through your arteries. Arteries are the blood vessels that carry blood from your heart to your body. Blood pressure is the pressure of blood in your arteries. Without... read more , or diabetes Diabetes Diabetes is a disease in which your blood sugar (glucose) levels are too high. You get diabetes if your body's normal way of controlling blood sugar isn't working right. There are 2 types of... read more
If you have had a heart attack, ask your doctor about taking a low dose of aspirin every day to help prevent a second heart attack
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