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Coronary
artery disease which is also known as coronary heart disease
affects more than 13 millions people in the United States
alone. It is considered as the number one killer of all
diseases that affect the heart. Coronary artery disease is
the atherosclerosis of the blood vessels supplying the
heart. The coronary arteries get blocked due to deposition
of cholesterol or calcification. The amount of blood
following to the heart gets decreased and the heart is
deprived of oxygen and vital nutrients.
Deposition of fat in the coronary arteries starts from
childhood itself. The deposits become thickened with advance
in age. Under ordinary conditions, the walls of coronary
arteries are smooth but with the deposition of cholesterol,
the cells lining the walls release chemicals that cause make
the walls sticky. As the walls become sticky, other
substances like proteins, inflammatory cells and calcium
salts get deposited on the walls. The fat combines with the
other substances and forms plaque. This plaque narrows the
blood vessels—a condition known as atherosclerosis.
The plaque is hard on the outer surface while it is soft
inside. Sometimes the outer surface gets torn and exposes
the soft inner surface. When the soft inside is exposed,
platelets cause the blood to clot in the area, resulting in
even more narrowing of the lumen. In some cases, the blood
clot breaks open by itself and blood supply to the heart is
restored. The blocked may also develop alternate pathways
for the flow of blood. This may be sufficient during normal
activity of the body, but this is not sufficient during
exercise.
In other cases, the blood supply to the heart is blocked
entirely and causes a disease called acute coronary
syndrome. Acute coronary syndrome actually refers to three
conditions:
Unstable angina which can lead to a heart attack
Non ST segment elevation myocardial infarction
ST segment elevation myocardial infarction
In some people, symptoms that they are going to have acute
coronary syndrome become evident very soon but in some
people the symptoms do not show up until something happens.
Another common disease is ischemia. When the lumen of the
blood vessels becomes very narrow, the blood flow is
restricted. This causes oxygen deprivation and leads to
cramps. This is called ischemia. The common symptom of
ischemia is chest pain. Ischemia occurs mostly when the
heart is need of extra oxygen supply. Ischemia is most
likely to occur during:
Physical exertion
Eating
Excitement
Exposure to extreme cold conditions
Coronary artery disease can be diagnosed using diagnostic
tests like electrocardiogram (ECG or EKG), exercise stress
tests, electron beam CT scans and cardiac catheterization.
Coronary artery disease can be treated by reducing the risk
factors, through medication and surgical procedures.
Reducing risk factors involves making suitable changes to
lifestyle. Smoking should be avoided at all costs. Intake of
foods containing high fat content should be reduced.
Diabetics should take extra care and keep their blood
glucose levels under control. Exercising also helps decrease
coronary artery disease. Medications are usually specific to
the heart problem. Surgical procedures used to treat
coronary artery disease are balloon angioplasty, stent
placement and bypass surgery. These surgical procedures do
not cure coronary artery disease, but they increase the
amount of blood and oxygen delivered to the heart muscle.
Lifestyle changes are needed to prevent coronary artery
disease in the future
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