DO YOU HAVE CORONARY ARTERY DISEASE?

The coronaries are the blood vessels that supply the muscles of the heart. Coronary artery disease (CAD) is the medical condition in which the coronary arteries become clogged by cholesterol plaques building up in their walls, causing them to stiffen, a process called “atherosclerosis.”

When these arteries become diseased, your heart muscles will not receive enough oxygen and nutrients, which puts you at risk of developing a myocardial infarction (heart attack). A heart attack is when part of the heart muscle dies after a coronary artery clogs up completely.

Coronary artery disease is a serious condition that develops over several decades, so the symptoms might not be noticed until it’s too late. If you’re at risk of developing coronary artery disease, you might want to learn more about the early symptoms in order to recognize them and seek proper care.

First, what causes coronary artery disease?

 As we already explained, the damage and buildup of plaque in your coronary arteries leads to their stiffening and impairs the blood supply to your heart, leading eventually to a heart attack. Here are the causes that doctors thing are directly related to developing coronary artery disease:

• Tobacco smoking: smoking has been proven to be toxic and damaging to your blood vessels, which include your coronaries.
• Hypertension (high blood pressure): hypertension, if not well controlled, can lead to stiffening and narrowing of the blood vessels.
• Hyperlipidemia (High blood lipids or cholesterol): hyperlipidemia, commonly referred to as “high cholesterol,” puts you at risk of developing atherosclerosis. High levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol, shifts the balance towards plaques forming in your vessel walls.
• Diabetes Mellitus: heart disease is the most common cause of mortality in diabetic patients. Uncontrolled blood sugar damages your vessel walls causing them to narrow down.
• Obesity: it’s a risk factor for a bunch of other diseases, like hypertension and diabetes.
• Sedentary lifestyle: when your heart is used to working at a resting activity level only, it does not develop any extra blood supply, and the already existing vessels start to narrow down.

These conditions and habits are directly responsible for damaging your coronary blood vessels and compromising the blood supply. After the arteries become damaged, platelets and other debris start to accumulate at the site of injury, causing a narrowing (stenosis) in the vessels. Other non-controllable risk factors include:

• Increased age: the older you get, the more you’re at risk of developing coronary disease
• Male gender: men are at higher risk, however, after menopause, the risk in women start to catch on to that in men
• Family history: a positive family history of coronary artery disease is highly predictive of developing the condition. Family history, however, means that the person is closely related to you (first-degree relative), and had developed coronary artery disease at a relatively young age (50s or 60s).

What are the symptoms of coronary artery disease?

So, if you have one or more risk factors, you might want to know more about the possible symptoms of coronary artery disease. Discovering the condition early on can help you take preventive measures to keep it from progressing. When the coronary arteries become too narrow, not enough blood will reach the muscles of your heart. This becomes especially problematic, and symptoms might become more apparent when your heart demands more oxygen, i.e., when you are doing physical exercise. The typical symptoms are:

• Chest pain (or angina pectoris): The feeling is described as a compressive pain in the middle of your chest and maybe a little to the left. It can even extend to your neck, jaw, or left shoulder. The pain is usually brief and happens after physical activity (like climbing the stairs), then disappears after 2 or 3 minutes. This often occurs after a particular amount of activity that the person knows, like, for example, after walking 100 meters, or after climbing two flights of stairs, or running for 30 seconds. Angina indicates that the oxygen demands in your heart are not being met by the diseased coronary vessels.
• Shortness of breath (dyspnea): this also happens on effort; when you are walking or climbing the stairs. A diseased heart cannot pump enough blood to meet the needs of your muscles, so your lungs need to work extra hard to take in more oxygen, and you start breathing heavily.
• Myocardial infarction (or heart attack): If a part of your heart remains deprived of blood and oxygen for more than a few minutes, you will have persistent angina. The pain will be in the middle or left of your chest and might extend to your left arm, shoulder, neck, and jaw. In addition to the typical pain, patients who get a heart attack become sweaty, feel very tired, nauseated, and short of breath. A heart attack is an emergency, and if you think that you might be having one, you must head to the nearest emergency department.

Coronary artery disease is serious and can cause you many problems if you fail to identify it and treat it. If you have any of the risk factors mentioned, or you ever experience chest pain or shortness of breath while exercising, it would be good to consult with your general practitioner or cardiologist to get a full cardiac workup.

If coronary artery disease is discovered early on, several preventive measures can be taken to avoid its progression. Diet, exercise, quitting smoking, and controlling your blood pressure and blood sugar can all help you slow down the process and keep a healthy heart for life.

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Sources:

• https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease
• https://www.ahajournals.org/doi/10.1161/CIR.0000000000000677
• https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000485
• https://www.uptodate.com/contents/chronic-coronary-syndrome-overview-of-care

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