The heart pumps oxygen-rich blood through the extensive network of arteries throughout the body. The blood carries oxygen and other nutrients, needed by organs in the body. In coronary artery disease (CAD), or coronary heart disease, fatty deposits build up on inner layers of coronary arteries. These blood vessels are on the outside of the heart and take blood to the heart muscle itself. These fatty deposits, or plaque, may form in teenage years and continue to thicken and enlarge throughout life. This thickening, called atherosclerosis, narrows the arteries and can reduce or block blood flow to the heart.
More than 12 million Americans have CAD, the number one killer of both men and women in the country.
Risk factors include high cholesterol levels in blood, high blood pressure (hypertension), inactivity, smoking, obesity, diabetes, and a family history of CAD.
If too little oxygenated blood reaches the heart, chest pain called angina occurs. Angina is generally described as tightness or heaviness in the chest but symptoms vary from person to person. A complete block of the blood supply can cause a heart attack, with damage to the heart muscle. Symptoms of CAD depend on how severe the disease is. Some people with CAD have no symptoms, some have mild chest discomfort, and some have more severe angina. Other symptoms include feelings of heaviness, tightness, and pressure in the chest; pain in the arms, shoulders, jaw, neck, or back; shortness of breath; and nausea.
The health care provider will take a complete medical history and do a physical examination and blood tests. Other tests include an electrocardiogram (ECG or EKG), which records the heart’s electrical activity, and a stress test (also called treadmill or exercise ECG). The health care provider may also order nuclear scanning, which uses a radioactive dye to show healthy and damaged parts of the heart. Coronary angiography (takes x-ray pictures of arteries by inserting a flexible tube called a catheter from a blood vessel in the groin area and guiding it into the heart) may be done if the stress test or nuclear scanning reveals a possible blocked coronary artery
Controlling risk factors is crucial for preventing and treating CAD. Lifestyle changes include eating a low-fat diet and losing weight (if overweight), following a good exercise program, quitting smoking, controlling blood sugar (glucose) if diabetic, and reducing blood pressure.
Drugs are often prescribed to lower blood pressure, lower cholesterol, and increase coronary blood flow. More severe CAD may need coronary angioplasty, a procedure to widen arteries, which may include using a stent (special device to keep the artery open). In some cases the health care provider may advise coronary artery bypass surgery, in which blood vessels from another part of the body (e.g., legs) are used to create a new route around blocked arteries.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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