Treatment of corona artery disease

What is coronary artery disease (CAD)?

Coronary artery disease is also called CAD. It is the most common form of heart disease in the U.S. — and is the leading cause of death, too. It occurs when the coronary arteries (blood vessels) that carry blood to your heart get blocked with plaque. That plaque collection is called atherosclerosis. Plaque is made of elements including fat and cholesterol. Over time, plaque can harden inside the walls of your arteries. When it does, it blocks the flow of blood to your heart. That blockage can cause angina (squeezing pain or pressure in your chest), a heart attack, or death. Coronary artery disease can lead to other problems, too, including heart failure and arrhythmias. 

How is coronary artery disease diagnosed?

Your doctor will perform a physical exam and listen to your heart. He or she also will discuss your symptoms, family history, diet, activity level, and other medical conditions. There is no single test that can diagnose coronary artery disease. If you doctor suspects you have it, he or she may order one or more of the following tests.

• EKG (electrocardiogram). This is a painless, simple test that monitors your heart’s beat and rhythm. Also, it tests the strength and timing of your heart’s electrical signals. It involves putting electrodes (tiny pads attached to wires) on your chest. The pads are held in place by a sticky substance.
• Stress test. During this test, you will be asked to exercise to give your heart a workout. You will be connected to heart, blood pressure, and oxygen monitors during the test. These monitors can detect changes to your heart rate, rhythm, electrical activity, or blood pressure during the test. The staff will also monitor you for shortness of breath or chest pain. If you are unable to exercise for medical reasons, the staff will administer medicine to raise your heart rate. Your heart’s response to the workout may suggest to the doctor that you have possible blockages and need further testing.
• This test is painless. It’s a test that uses sound waves to see a picture of your heart while it’s beating. The picture will give doctors a look at the size and shape of your heart. Also, it shows your heart chambers and valves.
• Chest X-ray. This is an X-ray focused in the area of your heart. The X-ray can detect signs of heart failure.
• Blood tests. Your doctor will take a sample of your blood to send to the lab. The lab can test for certain conditions that raise your risk of coronary artery disease. These include testing certain fats, cholesterol, sugar, and proteins.

Cardiac catherization and coronary angiogram. This procedure is normally done if other tests show you have coronary artery disease. It’s performed in a hospital. You will get medicine before the test to make you sleepy. However, you may remain awake. During the test, a thin, flexible tube is inserted into a blood vessel in your arm, groin (upper thigh), or neck. The doctor will carefully move the tube to your coronary arteries, then inject a dye. An X-ray is used to monitor the dye as it travels through your coronary arteries. This helps the doctor see your blood flow through your heart and blood vessels. This test is generally painless.

What is angioplasty? 

An angioplasty is a surgical procedure to open the blood vessels that supply blood to your heart muscle. These blood vessels are also known as coronary arteries. Doctors often perform this procedure immediately after a heart attack.

The procedure is also called a percutaneous transluminal coronary angioplasty or percutaneous coronary intervention. In many cases, doctors insert a coronary artery stent after an angioplasty. The stent helps keep the blood flowing and the artery from narrowing again.

Having an angioplasty within the first hours after a heart attack may reduce your risk of complications. Timing can be crucial. The faster you receive treatment for a heart attack, the lower the risk of heart failure, other complications, and death.

Angioplasty can also relieve the symptoms of heart disease if you haven’t had a heart attack.