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Coronary Artery Disease

Overview

Coronary artery disease is commonly known as coronary heart disease. Coronary heart/artery disease developed as a result of plaque build up in the coronary arteries which further leads to a condition called atherosclerosis, simply known as blockages. The arteries are initially smooth and elastic. Due to the plaque they become narrow and rigid thus restricting the flow of blood to the heart. The heart thus has a deficit of oxygen and vital nutrients that are necessary to pump blood properly.

Symptoms

The most common of the symptoms of coronary artery disease is angina/chest pain. Angina can be described as a heaviness or pressure, an ache, burning sensation, numbness, fullness, squeezing or painful feeling. It is often mistaken for indigestion or heartburn. Angina is commonly felt in the chest, although sometimes it is felt in the jaw, arms, neck, left shoulder, or back.

Other common symptoms that occur with coronary artery disease include:

  • Shortness of breath
  • Palpitations (irregular heartbeats,skipped beats, or a "flip-flop" feeling in your chest)
  • A faster heartbeat
  • Weakness or dizziness
  • Nausea
  • Sweating

Causes

Coronary artery disease is primarily developed when cholesterol-laden plaque gets deposited in the blood vessel walls. This starts at a young age and as you get older, the plaque builds up thus inflaming the blood vessel walls and increasing the risk of blood clots and heart attacks. The plaques release certain chemicals that promote the process of healing but as a result make the inner walls of the blood vessel sticky. Other substances, such as inflammatory cells, lipoproteins, and calcium that travel through the bloodstream start sticking to the inside of the vessel walls. In due course, a narrowed coronary artery may develop new blood vessels that go around the blockage to get blood to the heart. Although, during times of increased exertion or stress, these newly developed arteries may not be able to supply enough oxygen-rich blood to the heart muscle.

In some cases, there may be a blood clot that will totally block the blood supply to the heart muscle, causing a heart attack, which is also referred to as ischemia. If a blood vessel to the brain is blocked by blood clot, an ischemic stroke can occur. If a blood vessel within the brain bursts as a result of uncontrolled hypertension (high blood pressure), a hemorrhagic stroke can occur.

Factors that are likely to cause damage are:

  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Radiation therapy to the chest as used for certain types of cancer

Coronary artery/heart disease can progress to a point where ischemia occurs even at rest and can occur without any warning signs in anyone with heart disease. It is more common in people with diabetes.

Risk Factors

There are various risk factors for coronary artery disease, the most important risks are:

  • Age : As an individual gets older, the risk of heart disease increases.
  • Sex : Men are more likely to develop heart disease. The risk of heart disease increases in women after menopause.
  • Family history : An individual is associated with a higher risk of coronary artery disease if a close relative (father or brother) developed heart disease before the age of 55 or if your sister or mother developed it before the age of 65.
  • Smoking : For men, the risk is triple that of non-smokers and for women it is almost six times that of non-smokers. Nicotine constricts the blood vessels while carbon monoxide damages the inner lining thus increasing the possibility if atherosclerosis.
  • High blood pressure : High uncontrolled blood pressure can lead to thickening, hardening, and narrowing of the arteries.

Other risk factors are diabetes, high stress ,obesity, high blood cholesterol levels and physical inactivity.

Complications

Coronary artery disease can lead to:

  • Chest pain (angina) : When the arteries are narrow, the heart does not receive enough blood when there is maximum demand, particularly during physical activity. This leads to chest pain (angina) or shortness of breath.
  • Heart attack : Complete blockage of the heart artery may trigger a heart attack if a cholesterol plaque ruptures and forms a blood clot. The lack of blood flow to the heart may cause damage to the heart muscles. The extent of damage depends on how quickly one receives treatment.
  • Heart failure :If the heart has been damaged by a heart attack or some areas of the heart are deprived of oxygen and nutrients due to reduced blood flow, the heart becomes too weak to pump enough blood to the various parts of the body. This critical condition is known as heart failure.
  • Abnormal heart rhythm (arrhythmia) :The heart's electrical impulses are affected by inadequate blood supply to the heart or damage to heart tissue causing abnormal heart rhythms.