CORONARY ARTERY DISEASE

(Coronary Atherosclerosis; Ischemic Heart Disease)

 Basic information

description

Coronary artery disease is due to hardening and narrowing of the coronary arteries that provide the blood supply to the heart. There are three main coronary arteries. When any or all become narrowed, they can no longer provide adequate oxygen for heart cells. The disorder often affects adults of both sexes over age 40. It is less common in women before menopause.

FREQUENT SIGNS & SYMPTOMS

• Usually no symptoms occur in the early stages.
• Angina pectoris (burning, squeezing, heaviness, or tightness in the chest that may extend to the left arm, neck, jaw, or shoulder blade).
• Irregular heart rate .
• Shortness of breath with exercise or lying down. May sleep propped up on pillows.
• Swelling of feet or ankles.
• Heart attack.

causes

Atherosclerosis. This is a build-up of plaque on the artery walls. Plaque is made up of fat (e.g., cholesterol), calcium, and other substances found in the blood.

risk increases with

• Increasing age.
• Smoking.
• Hypertension (high blood pressure).
• Diabetes.
• Family history of coronary artery disease, diabetes, high blood pressure, or atherosclerosis.
• Poor nutrition, especially too much fat in the diet.
• Previous heart attack or stroke.
• Lack of exercise. Overweight.
• Hostile or impatient personality type.
• Elevated cholesterol or LDL (low density lipoprotein) and/or low level of HDL (high-density lipoprotein).

PREVENTIVE MEASURES

• Don't smoke. Exercise regularly. Eat a low-fat, low-salt, high-fiber diet.
• One aspirin a day (if medically advised).
• Reduce stress level when possible.
• If you have diabetes, hypertension, or high cholesterol, adhere to the treatment plan, including diet limits.
• Maintain ideal body weight.

expected outcomes

Symptoms can usually be controlled with treatment and prolong life and improve its quality.

possible complications

• Heart attack or stroke, congestive heart failure, kidney disease, or heartbeat irregularity problems .
• Sudden death.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam. Medical tests may include electrocardiogram (measures electrical activity of the heart), echocardiogram (measures sound waves), exercise-tolerance test, coronary calcium scoring, radionuclide stress test, blood studies, x-rays of the chest, and coronary angiogram (cardiac catheterization).
• Treatment may include drug therapy, lifestyle changes, and surgery.
• Lifestyle changes include diet changes, losing weight, exercising, stopping smoking, and stress control.
• Counseling for stress problems may be helpful.
• Stop smoking. Find a way to quit that works for you.
• Surgical treatment may be needed in some patients. Balloon angioplasty can open narrowed vessels. Vein graft bypass can help restore blood to the heart. A stent may be placed in the artery to keep it open.
• End-stage coronary artery disease can still be cured with a heart transplant (in rare cases).
• To learn more: American Heart Association, local branch listed in telephone directory, or call (800) 242-8721; website: www.americanheart.org.

medications

• Nitroglycerin, anticoagulants, drugs for angina pectoris and blood-vessel spasms, and drugs to increase the blood supply to the heart may be prescribed.
• Cholesterol-lowering drugs are usually prescribed.
• Vitamin supplements may be recommended.

activity

20 to 30 minutes of aerobic exercise each day (if able).

diet

Eat a low-fat, high-fiber diet that includes fruits and vegetables. Begin a weight loss diet, if overweight.

 notify our office if

• You or a family member has symptoms of coronary artery disease.
• After diagnosis, symptoms worsen or new or unexplained symptoms occur .

Special Notes: