Coronary Artery Disease Cause and What to Watch For

Coronary artery disease (CAD) is caused by a narrowing of the blood vessels that supply the heart muscle. This narrowing is due to a blockage in the artery that is primarily composed of cholesterol and inflammatory cells. If the narrowing becomes severe enough, it can cause problems with the heart function or cause a heart attack.

Symptoms that you may experience:

• Chest discomfort
  • Typically worse with activity
  • May spread into neck or arms
• Trouble breathing
• Unexplained nausea

There are two different categories of CAD:

1. Stable CAD: Symptoms typically occur with activity and relieved by rest. Usually due to a chronic blockage that may slowly progress.
2. Unstable CAD: Symptoms may occur at rest. Often due to a plaque/blockage that is unstable and suddenly gets worse.

How to Diagnose CAD

Several tests diagnose possible CAD, including an EKG, echocardiogram and CT scan of the cardiac arteries. We may recommend a stress test to examine the heart’s response while you are walking on a treadmill, or, if you are unable to walk, using drugs given through an IV. You may need a cardiac catheterization to examine how well your heart is working.

The choice of which cardiovascular diagnostic tests to perform depends on considerations including your risk factors, history of heart problems and current symptoms.

How to Treat CAD

Treating CAD often involves healthy lifestyle changes such as exercising, healthy eating, not smoking and managing diabetes. We may prescribe medications to help stabilize the disease and prevent buildup of additional cholesterol in the arteries. Procedures to open or bypass blocked arteries are sometimes needed.

• Medications
  • Blood thinners: Aspirin, Plavix, Effient, Brilinta
  • Cholesterol therapy: Statins, PCSK9 inhibitors, Zetia, Vascepa
  • Beta blockers, Nitrates, Calcium Channel Blockers, Ranexa
• Diabetes Management
• Diet
• Exercise
  • At least 150 minutes of exercise a week
• Smoking Cessation
  • Smoking cessation clinic
  • Chantix, Wellbutrin, Patches, Hypnosis
• Procedures to Fix Blocked Arteries
  • Angioplasty and Stent
    • Small tube placed in wrist artery or groin artery and small tubes taken up to heart. Pictures taken of the heart and the heart arteries. Blockages moved out the way with balloons that are temporarily inflated. Arteries are then kept open with small metal tubes called stents that are expanded into place on a balloon. Procedure done with mild sedation. Usually stay in hospital overnight.
  • Bypass Surgery
    • New arteries given to the heart. Requires open-heart surgery with full anesthesia support. Often stay in hospital 3-5 days.