Coronary Artery Disease: Causes, Symptoms, Diagnosis and Treatment

August 15, 2022 | by Yashaswi Pathakamuri | Posted in Diseases

Coronary Artery Disease: Causes, Symptoms, Diagnosis and Treatment

Coronary artery disease is the most common type of heart disease. It occurs when the coronary arteries become narrowed or blocked. The narrowing of coronary arteries can be caused by plaque buildup, which is a combination of fat, cholesterol, calcium and other substances. Plaque buildup narrows the blood vessels and restricts blood flow to the heart muscle.

CAD is a condition caused by the buildup of cholesterol on artery walls, which become inflexible, leading to the narrowing of blood vessels and starving other organs such as the heart.

This can lead to chest pain (angina), shortness of breath, dizziness or lightheadedness, especially when you are active. This can also lead to a heart attack (myocardial infarction).

This article will provide more information about of coronary artery disease, symptoms, treatments, possible causes as well as their complications.

What is Coronary Artery Disease?

Coronary artery disease is the most common type of heart disease, accounting for about 75% of all cases. It is a long-term condition where the arteries that supply blood and oxygen to the heart muscle become narrowed, often due to a build-up of fatty material called plaque.

There are two main types of coronary artery disease:

1) Coronary atherosclerosis

2) Coronary vasospasm

Coronary Atherosclerosis

Coronary atherosclerosis is a disease in which plaque builds up inside the coronary arteries. It can lead to heart attacks and strokes. It can also lead to chest pain, shortness of breath, and heart failure.

The condition is caused by the accumulation of cholesterol-containing material on the inner walls of the artery, along with other substances such as fat, calcium, and cellular waste products. The buildup may result from injury to the artery wall or overproduction of cholesterol by cells lining the artery walls (the endothelium). The buildup typically occurs in two layers: an inner layer that consists mainly of cholesterol-containing cells called foam cells and an outer layer that consists mainly of smooth muscle cells and some other cells.

Symptoms may include:

  • Chest pain (angina)
  • Shortness of breath
  • Fatigue

Additional symptoms may be present in those with diabetes or kidney disease such as:

  • Numbness in hands and feet
  • Loss of sensation in legs
  • Poor healing after an injury, or erectile dysfunction.

Coronary Vasospasm

Coronary vasospasm is a condition in which the coronary arteries constrict or narrowing and the blood supply to the heart is reduced or cut off. They are caused by a sudden reduction in oxygen supply to the heart muscle. The narrowing of the coronary arteries can lead to a heart attack or angina.

Coronary vasospasm can be treated with medication, a procedure, or by inserting a stent into the narrowed artery.

Coronary vasospasms can be caused by various things, including:

  • Acute myocardial infarction (heart attack)
  • Stressful situations
  • Certain medications such as beta blockers and nitrates
  • Alcohol abuse
  • Smoking cigarettes or marijuana

Causes

The causes of Coronary artery disease are not fully understood. However, there are a number of risk factors that can contribute to the development of this condition.

Coronary artery disease is caused by atherosclerosis, a progressive narrowing of the coronary arteries due to accumulation of fatty substances called plaque. This accumulation can lead to blockages in the arteries and reduced blood flow to the heart, which can result in chest pain or angina

There are other factors that can also contribute to Coronary artery disease such as genetics, high cholesterol levels, smoking cigarettes, high blood pressure and diabetes mellitus.

Symptoms

Coronary artery disease, or CAD, is a condition in which the coronary arteries are narrowed by plaques.

Other symptoms include:

  • Dizziness
  • Fatigue
  • Nausea
  • Palpitations
  • Tingling sensation in the arm or leg

The most common symptom of coronary artery disease is angina (chest pain). Angina usually occurs at rest or during minimal physical activity. It can also occur after eating a large meal, during periods of high stress, or when doing something that increases your heart rate like climbing stairs.

Angina symptoms include:

  • Queezing
  • Heaviness
  • Tightening
  • Burning
  • Aching and pressure in the chest, neck, jaw, or arms
  • Pain in the abdomen or back
  • Shortness of breath
  • Nausea and vomiting
  • A cold sweat
  • Indigestion
  • Heartburn
  • Weakness
  • Dizziness
  • Uneasiness

Complications

The complications of coronary artery disease are often caused by the build-up of plaque inside the arteries. The plaque is made up of cholesterol and other substances that can form a hard, waxy substance on the inside walls of the artery. When this happens, it can restrict or block blood flow to an area or organ in your body.

There are two main types of complications for coronary artery disease: Acute and chronic.

  • Acute complications happen suddenly and often require emergency treatment to avoid death.
  • Chronic complications happen slowly over time and are not always detected until they have become serious.

Complications are a major cause of death in patients with coronary artery disease.

The common complications are:

  1. Heart failure: It is the most common complication of coronary artery disease. This is because when your heart muscle doesn’t get enough blood flow, it can’t pump enough blood to the rest of your body. This causes fluid to build up in your lungs and other organs.
  2. Heart attack: A heart attack occurs when there is a sudden blockage in one or more of the arteries that supply blood to the heart muscle. The patient may have chest pain, nausea, vomiting, or shortness of breath before having a heart attack or stroke.
  3. Stroke: It is caused by a clot that blocks blood flow to part of the brain.

Diagnosis

Coronary artery disease is the most common type of heart disease. It is caused by a buildup of plaque in the arteries that supply blood to the heart. CAD is the leading cause of death in the United States.

CAD can be diagnosed by a variety of tests, including coronary angiography, stress testing, cardiac catheterization, ECG and ultrasound.

  • Electrocardiogram: ECG measures electrical activity within the heart and helps detect irregularities in this activity that may indicate coronary artery disease or other heart problems. This is usually done by attaching electrodes to your chest and legs.
  • Ultrasound: It uses sound waves to produce images of structures deep within the body such as the heart or blood vessels. It is an important tool for diagnosing coronary artery disease because it provides information about how well your blood vessels are functioning and whether they are blocked or narrowed.
  • Blood tests: Doctors can run these tests to measure your blood cholesterol levels, especially if you’re at risk of high blood cholesterol.
  • Coronary catheterization: It is a procedure in which a thin tube called a catheter is inserted into the blood vessels of the heart. A doctor will use this procedure when they suspect that there is something wrong with your heart. They will also use this procedure if you have chest pain, shortness of breath, or other symptoms that might indicate cardiovascular disease.
  • CT scans: They are the noninvasive way to detect coronary artery disease. They use an X-ray machine and computer imaging technology to create cross-sectional images of the heart and the blood vessels that carry blood from the heart to the rest of the body. CT scans can be used for diagnosis, treatment planning, and follow up. They can help doctors identify blockages in coronary arteries, which may require surgery or other treatments such as angioplasty or stenting.

Treatment

The most common treatment for coronary artery disease is with medications, but surgery is also an option.

Surgery

Surgery involves opening up the chest and using a catheter to place a stent in the blocked artery. The catheter is inserted through an artery in the groin or arm and threaded up to the blocked area of the heart. The stent will keep the artery open, so blood can flow through the heart normally again. The outcome of surgery depends on whether the blockage is permanent or temporary and is decided by individual doctors.

Medications

Medications for coronary artery disease are drugs that are used to treat or prevent coronary artery disease. There are several types of medications that can be used to manage the symptoms of coronary artery disease. These include lipid-lowering agents, antiplatelet agents, and anticoagulants.

There are two types of medications for coronary artery disease:

  • Drugs that help to dissolve or prevent plaque from building up in the arteries (such as statins and beta-blockers).
  • Drugs that help to prevent blood clots from forming (such as aspirin and warfarin).

There are many drugs available for treatment of coronary artery disease. The drugs can be categorized into two types:

  1. Non-statin drugs: They block the production of cholesterol and reduce its absorption from food.
  2. Statin drugs: They lower cholesterol levels by inhibiting an enzyme called HMG-CoA reductase.

The choice of drug depends on a person’s age, life expectancy, risk factors, and other medical conditions.

Prevention

There are many ways to prevent CAD from happening. These include lifestyle changes and medications that help to lower cholesterol levels. To better control blood cholesterol levels, consider:

  • Being more physically active
  • Limiting alcohol intake
  • Avoiding smoking
  • Adopting a diet with less sugar, salt, and saturated fats

Risk Factors

The risk factors for CAD are smoking, high blood pressure, high cholesterol, obesity, diabetes mellitus, physical inactivity and a family history of CAD.

The following factors increase a person’s risk of developing CAD:

  • High blood pressure, or hypertension
  • High levels of low-density lipoprotein, or “bad,” cholesterol
  • Low levels of high-density lipoprotein, or “good,” cholesterol
  • Diabetes in the body cannot effectively remove sugar from the bloodstream
  • Having obesity or overweight can raise the risk of heart attack by 60%. Another study found that being overweight or obese increased the risk of stroke by 40%.
  • smoking can increase inflammation and also cholesterol deposits in the coronary arteries.
  • A family history of CAD, with early onset (before 55 years for male relatives, before 65 years for female relatives)

The risk factors for CAD are not always clear-cut. For example, people who smoke may also have high blood pressure and high cholesterol levels.

Summary

Coronary artery disease (CAD) occurs when the blood-carrying capillaries that supply the heart muscle develop cholesterol deposits. These deposits narrow, weaken, or impair the ability of arteries to carry oxygen-rich blood. Arteries also stiffen and inflammation increases.

CAD can be difficult to diagnose and may lead to a heart attack or stroke. However, people can take steps to reduce their risk of CAD by getting regular exercise, adopting a healthy diet, and avoiding or quitting tobacco.

If you have chest pain and you are also finding it difficult to breathe, seek immediate medical attention. This could be symptoms of a heart attack.

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