Description The blood vessels t...
Description
The blood vessels that supply the heart are called the coronary arteries. Coronary artery disease (CAD) is the narrowing of these arteries by fat and calcium build up called plaques. This is also called coronary atherosclerosis. The following characteristics lead to an increased chance of having CAD: smoking, obesity, family history of CAD, high blood pressure, elevated cholesterol, diabetes, sedentary lifestyle, and kidney disease. Sometimes a plaque of atherosclerosis can suddenly rupture. That can cause a blood clot to develop and suddenly block the blood supply to the part of the heart that gets blood from the blocked artery. If that part of the heart muscle dies for lack of blood, it is called a heart attack. Symptoms of coronary artery disease can vary widely and in some patients like the elderly, diabetics and women there is no chest pain.
Symptoms
Chest pain (typically described as squeezing, crushing, or band like)—called angina. Some people may have little or no chest pain (elderly, diabetics, or women). Chest pain that comes on with exercise and goes away with rest. Other symptoms include: jaw pain, arm pain, back pain, abdominal pain, shortness of breath, sweating, nausea, vomiting, apprehension, fainting, dizziness.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. A coronary angiogram can definitively identify the coronary artery blockage. A high resolution chest CT scan can also demonstrate the blockages. CT scans can also detect other diseases that can symptoms similar to those of a heart attack. An echocardiogram and an EKG (electrocardiogram) can help detect signs of CAD, and help diagnose a heart attack.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, D-Dimer, Electrocardiogram (EKG), Troponin, X-ray
Specialists:
Cardiology, Interventional Cardiology, Cardiovascular Surgery
Workup:
A history and physical exam will be performed. A coronary angiogram can definitively identify the coronary artery blockage. A high resolution chest CT scan can also demonstrate the blockages. CT scans can also detect other diseases that can symptoms similar to those of a heart attack. An echocardiogram and an EKG (electrocardiogram) can help detect signs of CAD, and help diagnose a heart attack.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, D-Dimer, Electrocardiogram (EKG), Troponin, X-ray
Specialists:
Cardiology, Interventional Cardiology, Cardiovascular Surgery
Treatment
Treatment of CAD is aimed at reducing the plaque buildup in the arteries. The best therapy includes controlling blood pressure and cholesterol, exercising, not smoking, and keeping diabetes under control. Medications used to treat CAD are aspirin, high blood pressure pills, nitroglycerin, and statins to lower cholesterol. Treatment for a heart attack is aimed at improving the blood flow to the heart, treating life threatening arrhythmias, and maximizing the heart function. During a heart attack, clot busting medication (alteplase/t-PA) often is used to break apart the blood clot that has stopped blood flow to one part of the heart. In people with angina (and sometimes in people having heart attacks), coronary (heart) artery blockages are reduced by the following: balloon angioplasty, stent placement, surgical bypass, blood thinners and anti-platelet medications (aspirin, abciximab/ReoPro, eptifibatide/Integrilin, clopidogrel/Plavix). When arrhythmias are present they are treated with medications (amiodarone, lidocaine), cardioversion or a pacemaker.