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CORONARY ARTERY DISEASE

What is a Coronary Artery Disease?

Coronary Artery Disease is a disorder that occurs when your coronary arteries are either diseased or damaged. Coronary arteries supply the heart with blood and oxygen. When plaque (arteriosclerosis) deposits in your coronary arteries the arteries narrow and the amount of blood and oxygen supplied to the heart are restricted. This decreased blood flow may lead to a heart attack.

What causes Coronary Artery Disease?

Cholesterol deposits in the coronary arteries, known as plaque, develop over many years. These deposits cause the artery to narrow, which results in a reduced amount of blood and oxygen flow to the heart. This reduction often ends in a heart attack. Because Coronary Artery Disease typically develops over a lifetime, there are many factors that may lead to damage of the arteries. These include:

  •  Diabetes
  •  High blood pressure and/or cholesterol
  •  Smoking
  •  Certain types of radiation

What are the symptoms of Coronary Artery Disease?

The beginning stages of Coronary Artery Disease do not typically cause noticeable symptoms. But as plaque continues to build in the arteries symptoms may begin to present, especially when the heart is working hard (like during exercise) to supply the heart with oxygen and blood. The most common symptoms of Coronary Artery Disease are:

  •  Angina, or chest pain; this pain typically feels like pressure or tightness in the chest and may be triggered by physical or emotional stress
  •  Shortness of breath due to lack of an oxygen-rich blood supply
  •  Heart attacks occur when the artery is completely blocked due to plaque

How is Coronary Artery Disease diagnosed?

Exempla Rocky Mountain Cardiovascular Associates identifies Coronary Artery Disease with some of the following tests:

  •  Electrocardiogram (EKG)
  •  Computed Tomography scan
  •  Stress testing
  •  Angiography

How is Coronary Artery Disease treated?

The specialists at Exempla Rocky Mountain Cardiovascular Associates work with each patient to treat Coronary Artery Disease though an individual treatment plan. Plans may include lifestyle changes, medications and/or Cardiac Catheterization Lab.

Lifestyle changes:

  •  Eating a healthy diet
  •  Reducing high blood pressure and cholesterol
  •  Maintaining a healthy body mass index
  •  Physical exercise
  •  Quitting smoking
  •  Reduce stress

Medications:

  •  Anticoagulants or blood thinners like Aspirin
  •  Ace inhibitors
  •  Beta blockers
  •  Calcium channel blockers
  •  Nitroglycerin
  •  Statins

Cardiac Catheterization Lab:

  •  Angioplasty
  •  Coronary Artery Stent Placement

Smoking is a major risk for several diseases including heart disease, stroke, and several cancers. Even low-tar cigarettes and light smoking can increase the risk of heart disease substantially. There are now several alternative approaches to helping people stop smoking. These include nicotine-replacement patches and gum as well as oral medication.

If you are able to stop smoking, your risk of a heart attack or stroke decreases within a few weeks. The risk goes down to that of a nonsmoker within about 2 years. In addition, a lot of patients comment that they feel healthier and have more energy after they've stopped smoking.

Hypothyroidism can increase blood cholesterol levels and that contributes to heart disease; however, if the hypothyroidism is being treated with a thyroid hormone, then the cholesterol returns to normal.

Birth control pills can cause a small increase in the risk of thrombosis and heart attack. That occurs mainly in people who have been on the pill for more than 10 years and who smoke cigarettes.

There is an increase in the risk of heart attack if a first-degree relative (parent or sibling) has had a heart attack or stroke. That is mainly seen when the relative has had a heart attack before the age of 45 if they are male, 55 if they are female. Obviously, you cannot change your family history, but a positive history should suggest the need to improve all the other risk factors like stopping smoking and decreasing cholesterol.

Heart disease is potentially reversible by attending to risk factors like cholesterol, blood pressure, and smoking. Several studies have shown, for example, that aggressive lowering of blood cholesterol with LDL levels below 100 can open up blocked coronary arteries at least partially. Perhaps I should explain that LDL cholesterol is the "bad" cholesterol component.

I would suggest a diet that is balanced among all the main food groups, with fat content making up no more than 30 percent of calories and most of that fat being unsaturated. I would not advise patients to eat a diet that is restricted in carbohydrates or fruits and vegetables, because this may adversely affect vitamin intake and blood cholesterol.

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