One of the most common diseases in the world, coronary artery disease is considered globally one out of four estimated deaths. Coronary artery disease is a term used when a plaque is formed in the artery of the heart and leads to a heart attack by a process of atherosclerosis. That’s why it is also called coronary heart disease. Here, a question arises: how did this disease happen and become a single cause of mortality globally? Let’s move on to this video to answer all the questions about this disease. 

CAD is the single cause of mortality in the United States. World Health Organization report of 2023 reveals that about 200 million people, including 110 million men and 80 million women, are affected by coronary artery disease. 

Heart attacks are the foremost symptom of coronary artery disease, which is also known as the silent killer because there are no other signs of CAD. Heart attacks can develop suddenly or gradually. These immediate or over-time signs occur when the arteries are unable to provide the heart’s muscles with enough oxygenated blood. Obesity, unhealthy diet, not enough physical activity, genetic history, and smoking are some common risk factors for CAD. A chest X-ray or an ECG could be used to diagnose this silent-killer disease. If someone has been diagnosed with this potentially fatal disease, they may be treated by making lifestyle changes, taking medication, or even undergoing surgery. 

What is coronary artery disease?

Coronary artery disease is a condition in which coronary arteries are blocked due to plaque formation. That plaque is bad cholesterol clots within the arteries, which do not allow enough oxygenated blood to cross them and reach the heart muscles, and this causes a heart attack. It could also be called coronary heart disease or ischemic heart disease. 

Symptoms of Coronary Artery Disease

  • At first, patients with coronary artery disease may not identify the symptoms of this disease, as it seems just like the heart is beating during exercise.
  • After a while, arteries continue to shorten due to plaque formation, resulting in a lesser supply of blood to the heart. These symptoms then become more severe and lead to chest pain, also known as angina—in this condition, a patient feels some type of pressure in the left side of the chest.
  • In some patients, this pain may also move to the arm, shoulder, or back pain. A patient may also feel as if they are losing their breath—that is known as dyspnea. 
  • As time passes, the clots in the arteries entirely block blood passage, which results in a heart attack. Symptoms of a heart attack may include chest pain, arm and shoulder pain, and sweating. Sometimes, it happens silently, without any noticeable signs.

In the US, a heart attack occurs every 40 seconds, with 1 in 5 of these attacks being silent. According to a 2021 survey, coronary artery disease causes two deaths out of every ten and typically affects adults under the age of 65. 

  • Obstructive coronary artery disease is a common and most famous type that occurs when arteries narrow down due to plaque formation, cutting down the blood flow to the heart, and ultimately, a sudden heart attack develops. 
  • The second type of coronary artery disease is non-obstructive CAD. This condition does not occur due to plaque; it is a state in which the coronary arteries have problems such as compression of heart muscles, the lining of arteries being damaged, and, in some cases, the small arteries malfunctioning. Non-obstructive CAD is most common in females. 
  • The third and most life-threatening type of coronary artery disease is spontaneous CAD. It’s a condition in which a hole/tear develops in the coronary artery wall that blocks the blood flow.

 Thus, it happens immediately sometimes and leads to a heart attack. Chest pain or pressure, jaw or neck pain, and shortness of breath are the main symptoms of this type.

Main causes of coronary artery disease

The foremost cause of coronary Artery Disease is atherosclerosis, a condition in which plaque develops in the arteries of the whole body. This plaque affects the flow of blood and leads to coronary artery diseases. Plaque is a deposit of cholesterol and waste calcium or fibrin; it forms clogs that narrow the arteries and stop the blood flow to specific body parts, especially the heart muscle. Hence, the heart does not get enough oxygen and nutrients. This condition is known as myocardial ischemia.

This whole process leads to chest pressure and, ultimately, to a heart attack. Sometimes, individuals may have a family history of coronary artery disease and are affected due to genetic mutations transferred to them through parents. Besides, numerous risk factors like high levels of low-density lipoproteins or LDL, also known as bad cholesterol.

Similarly, low levels of high-density lipoproteins or HDL, also called good cholesterol, smoking, anemia, diabetes, high fat diet, inadequate sleeping, hypertension or high blood pressure, alcohol abuse, obesity, chronic kidney disease, taking stress, and less exercise are also considered as risk factors of coronary artery disease.

Complications of CAD Lead to Heart Diseases

Complications of coronary artery disease lead to various other heart problems, such as heart failure. If heart’s right side is affected by CAD, when blood coming from body organs reaches heart, the heart cannot effectively pump this blood to lungs for oxygenation.

Consequently, the blood increases pressure in the veins, which causes fluid movement to tissues. This fluid buildup is known as edema and it results in swelling in various body parts, such as abdomen, liver, and legs. If this affects the left side of the heart, the oxygenated blood from lungs to heart cannot be effectively pumped to body organs, resulting in increased pressure on blood vessels that carry oxygenated blood from lungs to heart, ultimately shortening the breath during hard activities. 

A second complication of CAD is an irregular heartbeat. CAD is a condition in which the heart does not get enough oxygen, which affects some parts of the heart tissues and damages the heart rate. The heartbeat becomes faster or slower, which leads to heart rhythm problems. These problems sometimes cause blood clotting in the heart, and when this clot is pushed and reaches the brain, it causes a stroke. 

Diagnoses of Coronary Artery Disease

When a patient exhibits coronary artery symptoms, they have to go to the doctor. Doctors diagnose the disease first by taking physical measurements such as checking blood pressure, listening to the heart rate, and taking family history information.

After getting all this information, Doctors recommend one of the following tests: magnetic resonance imaging or MRI, Chest X-ray, calcium scan or echocardiogram. These diagnostic tests and the patient history can assist healthcare providers in confirming the presence of CAD.

Interventions or Treatment of Coronary Artery Disease

Patients with coronary artery disease may also benefit from medication and specific surgical procedures, such as percutaneous coronary intervention (PCI), sometimes referred to as coronary angioplasty.  In this condition, a patient’s artery blockage is removed by inserting a stent.   With this treatment, a patient gets back to normal within a week.

Coronary artery bypass – a surgery in which a new path is created for normal blood flow. It takes 12 weeks for a full recovery.

Preventions of Coronary Artery Disease

Changing lifestyle habits can prevent coronary artery disease. You have to avoid alcohol and smoking and eat a healthy diet, especially with low sodium-containing foods. Additionally, you can prevent coronary artery disease by managing certain life habits to keep your blood pressure, cholesterol level and diabetes under control.

Coronary artery disease (CAD) is still a major global health problem because of its increasing effect and prevalence. This complex illness, which is also referred to as the silent killer since it usually shows no symptoms in the early stages, is mostly brought on by atherosclerosis, which causes plaque to accumulate and then obstruct coronary arteries. While there is hope for treating CAD thanks to advances in diagnosis and therapy, such as percutaneous coronary intervention and coronary artery bypass surgery, it is still imperative to prioritize preventative efforts through lifestyle adjustments. People can greatly lower their risk of getting CAD and its related issues by addressing risk factors like smoking, a poor diet, and inactivity. This will ultimately improve heart longevity and overall wellness.

About the author

Dr. Madilyn Adams is a PhD in molecular medicine from Harvard University and has been working as a medical blogger for seven years.

References

https://www.cdc.gov/heartdisease/coronary_ad.htm#:~:text=Coronary%20artery%20disease%20is%20caused,This%20process%20is%20called%20atherosclerosis.

https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease

https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613

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