USF-COM Department of Family Medicine

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To The Heart of The Matter …(and how Coronary Artery Disease breaks it)

Coronary artery disease affects over 7 million Americans and is the main reason why every 34 seconds someone dies from blood vessel and heart disease! Think about it this way – more Americans die from this disease than all the people who die from cancer combined each year. This year over 500,000 Americans will die from heart attacks caused by this disease.

Coronary artery disease (CAD) breaks hearts because it’s a matter of life and death!!!!!!!!!!!!!!!!!!!!!!!!

What is CAD?

 All muscles in your body need a constant supply of oxygen. The heart is a muscle too and also needs its own supply of oxygen. The oxygen and nutrients that the heart needs is carried to the heart by arteries that lie on the outside surface of the heart. These arteries are called coronary arteries.

CAD occurs when fats such as cholesterol build up along the inner surface of these coronary arteries. This build up is called plaques, and it narrows the artery and may eventually block it altogether.


                           Normal Vessel                            Diseased Vessel
 

If the blood supply to the heart is cut off completely, then a person will suffer a heart attack. The part of the heart which doesn’t receive oxygen because the coronary artery is blocked, will die and the heart will always be damaged in that area.

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How do you know if you’re at risk for CAD?

Conditions that increase your risk of developing CAD are called risk factors. A lot of these risk factors you can change, but some cannot be changed. Even if you have no risk factors you still may develop CAD.

Factors YOU can change

Factors you cannot change Return to top of page

Symptoms of CAD

 CAD is a disease that progresses very slowly. Your first sign that something is wrong may be chest pain (angina), shortness of breath or even a heart attack! The first signs of angina may be heaviness, tightness, pain, burning, pressure, or squeezing, which is usually located behind the breast bone, but may also be felt in the jaw, arms or neck. Beware, some people have full-blown heart attacks without ever having any of these symptoms! So as you can see there is a huge range in the type of CAD that people experience. Some people may suffer from CAD that is severe enough to make normal daily activities difficult. Others may have mild or more severe pain which may be steady or come and go. Still others may have no symptoms at all!

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How do you test for CAD?

Because CAD differs from person to person there is no one simple test. The only certain way to diagnose how bad your CAD is, is to use coronary angiography. Your doctor may use some or all of the following procedures.

Electrocardiogram (ECG or EKG) looks at the heart with electric leads and gives the doctor a graph of how your heart beats as it rests and contracts. Any abnormal beats, poor blood flow or enlargement of the heart can be seen on the graph.

Stress Test is a test used by your doctor to record your heartbeat during exercise. Some heart problems only show up if the heart is working hard, so in this test an EKG is done before, after and during exercise on a treadmill.

Nuclear Scanning maybe used by your doctor to look at damaged areas of the heart and to check how well your heart is pumping blood. To do this test, some radioactive dye is injected into a vein and a special camera watches the dye move around the heart.

Coronary Angiography/Arteriography is a test used to look directly into the coronary arteries. A special tube is put into an artery of the arm or leg and passed into the arteries of the heart. Heart and blood vessels are filmed while the heart pumps, and your doctor can recognize problems with the way your heart pumps or blockages in your coronary arteries.

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How is CAD treated?

The treatment of CAD varies just like the disease itself. For some people, CAD is managed through changes in their lifestyle. Others may require medicine or even surgery to help control their disease. It is important to know that this is a lifelong process.

The single best way to treat CAD is to change your lifestyle. Changing your diet to one that is low in fat (especially cholesterol and saturated fat) will help reduce your risk of CAD. Also, it will reduce your risk of having a second heart attack if you’ve already suffered one. Reducing your fat is an effective way to loose weight and reduce your blood pressure.

Exercise is also very important.  Even small amounts of exercise can help to dramatically lower your risk of CAD and heart attack. If you suffer from CAD, your doctor will tell you which exercises are best for you.

Smoking is a major risk factor for CAD. Quitting smoking also dramatically lowers your risk of CAD and heart attack.
Medications are also used in the treatment of CAD. Because of the way CAD varies from person to person, there are lots of different medications available to treat this disease. Your doctor will know best which medicine is best for your type of CAD.

Surgery is a final option in treatment of this disease. Your doctor will have to assess how severe your CAD is and if surgical treatment would be best for you.

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Websites for more information on CAD