Cardiovascular disease
What is coronary artery disease?
Every organ needs an adequate blood supply through the vessels to work properly, and the heart is no exception.
The heart is supplied with blood through the coronary arteries, and when cholesterol builds up inside them and narrows them, various heart problems can arise.
It feels like a heavy or squeezing sensation deep in the center of the chest, spread over a wide area. Some people feel angina elsewhere, anywhere between the navel and the jaw, and it is often mistaken for indigestion, toothache or shoulder pain. When the coronary arteries that supply blood to the heart muscle become narrowed or blocked by lesions such as atherosclerosis or thrombus, the blood supply to the heart is compromised. At rest the heart is not working hard, so even if a coronary artery is narrowed or partly blocked there is no major problem with blood supply and no particular symptoms are felt. When the heart has to work harder, however, it needs more blood than usual, and the narrowed coronary artery cannot deliver the required volume. Blood flow and oxygen supply to the heart muscle then become insufficient, and angina occurs with symptoms such as chest pain and shortness of breath.
It occurs when coronary artery spasm reduces blood flow.
Myocardial infarction is a condition in which a coronary vessel is suddenly blocked by a thrombus or spasm, completely cutting off the supply of blood and oxygen to all or part of the heart and causing necrosis of the heart muscle. It leads to serious complications such as chest pain, reduced cardiac contractility and arrhythmia, and is a dangerous disease that can cause sudden death.
All coronary artery disease results from insufficient blood supply to the heart, so these conditions are collectively called ischemic heart disease.
Causes of coronary artery disease
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Aging
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Hyperlipidemia
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Hypertension
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Smoking
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Obesity
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Family history
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Stress
Coronary artery disease tests
The doctor takes a history and, if the problem appears to be cardiac, performs an electrocardiogram. A chest X-ray, blood tests and echocardiography may also be performed as needed, and if there is a problem with the coronary arteries, or even if they appear normal but coronary artery disease cannot be ruled out from the circumstances, coronary angiography is performed.
Coronary artery disease treatment
A stent is a small mesh of metal alloy shaped into a tube so that it can be placed inside a blood vessel. In the past, a balloon was mainly inflated inside the coronary artery to widen the vessel, but this had the drawback that the vessel often became blocked again within a few months. Placing a stent inside the widened coronary artery keeps the artery open. Drug-eluting stents, which release medication that prevents narrowing, are now used, so the rate of restenosis after the procedure has fallen markedly. As in coronary angiography, a catheter is passed along a vessel in the wrist or groin up to the coronary artery and the stent is deployed there; so when narrowing of the coronary artery is found during angiography, it is usual to proceed directly to stent insertion in the same session.
When the stenosis is severe, coronary artery bypass surgery may be performed instead of stent insertion. As the name suggests, it is surgery that creates a bypass around the coronary artery, taking a spare healthy vessel from the chest or the leg and grafting it onto the heart. Unlike interventional procedures such as stent insertion, it is performed under general anesthesia.
Post-treatment precautions
- Treatment results and duration may vary depending on individual symptoms.
- Temporary side effects may occur after treatment and vary with each individual's condition.
