Coronary Artery Disease

Overview

Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle (coronary arteries) become hardened and narrowed. The arteries harden and become narrow often due to the buildup of plaque on the inner walls or lining of the arteries (atherosclerosis). Blood flow to the heart is reduced as plaque narrows the coronary arteries. This decreases the oxygen supply to the heart muscle.

Causes of Coronary Artery Disease

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the U.S. for both men and women. Lifestyle changes to lower your risk include:

• Stop smoking
• Control diabetes
• Control blood pressure
• Be physically active
• Eat a low-saturated-fat, low-cholesterol diet

Symptoms of CAD

When blood flow and oxygen supply to the heart are reduced or cut off, you can develop:

• Chest pain (angina) or discomfort that occurs when your heart is not getting enough blood. If your angina symptoms return or you experience symptoms such as pain, fullness, tightness, or burning in your chest, arms, or neck, you need to let your physician know right away. It may mean that the blockage has reoccurred.
• A heart attack (myocardia infarction) happens when an artery is completely blocked and cuts off most or all blood supply to part of the heart. Cells in the heart muscle that do not receive enough oxygen-carrying blood begin to die. This can cause permanent damage to the heart muscle.

Over time, CAD can weaken your heart muscle and contribute to:

• Heart failure happens when the heart is no longer able to pump blood to the rest of the body effectively. Heart failure does not mean that your heart has stopped or is about to stop working. But it does mean that your heart is failing to pump blood the way that it should.
• Arrhythmias are changes in the normal rhythm of the heartbeats.

Treatments for CAD

• Medical therapy involves a number of different medicines that can be used to improve symptoms of coronary artery disease and to prevent future heart attacks.
• Coronary artery angioplasty is a non-surgical procedure that can be used to dilate (widen) narrowed or blocked arteries when symptoms are severe or when the blockage occurs in a dangerous location. A thin tube called a catheter with a deflated balloon on its tip is passed into the narrowed artery segment. After the balloon is inflated to widen the artery, the balloon is deflated and the catheter is removed.
• Stenting is a non-surgical procedure where a tiny metal coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open.
• Atherectomy is a non-surgical procedure that inserts a tiny device on the end of a catheter inside the artery and the plaque is "shaved" away.
• Coronary artery bypass surgery (or open heart surgery) is a surgical procedure for patients with extensive blockages.

For more information regarding the diagnosis and treatment of coronary artery disease or to make an appointment with a physician call 212-305-7060.

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