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| Coronary Artry Disease |
Coronary artery disease
Coronary
artery disease
Overview
Coronary artery disease is a common heart
condition. The major blood vessels that supply the heart (coronary arteries)
struggle to send enough blood, oxygen and nutrients to the heart muscle.
Cholesterol deposits (plaques) in the heart arteries and inflammation are
usually the cause of coronary artery disease.
Signs and symptoms of coronary artery disease
occur when the heart doesn't get enough oxygen-rich blood. If you have coronary
artery disease, reduced blood flow to the heart can cause chest pain (angina)
and shortness of breath. A complete blockage of blood flow can cause a heart
attack.
Coronary artery disease often develops over
decades. Symptoms may go unnoticed until a significant blockage causes problems
or a heart attack occurs. Following a heart-healthy lifestyle can help prevent
coronary artery disease.
Coronary artery disease may also be called
coronary heart disease.
Symptoms
Symptoms may go unrecognized at first, or they
may only occur when the heart is beating hard like during exercise. As the
coronary arteries continue to narrow, less and less blood gets to the heart and
symptoms can become more severe or frequent.
Coronary artery disease signs and symptoms can
include:
·
Chest
pain (angina). You may feel
pressure or tightness in your chest. Some people say it feels like someone is
standing on their chest. The chest pain usually occurs on the middle or left
side of the chest. Activity or strong emotions can trigger angina. The pain
usually goes away within minutes after the triggering event ends. In some
people, especially women, the pain may be brief or sharp and felt in the neck,
arm or back.
·
Shortness
of breath. You may feel
like you can't catch your breath.
·
Fatigue. If the heart can't pump enough blood to
meet your body's needs, you may feel unusually tired.
·
Heart
attack. A completely
blocked coronary artery will cause a heart attack. The classic signs and
symptoms of a heart attack include crushing chest pain or pressure, shoulder or
arm pain, shortness of breath, and sweating. Women may have less typical
symptoms, such as neck or jaw pain, nausea and fatigue. Some heart attacks
don't cause any noticeable signs or symptoms.
When to see a doctor
If you think you're having a heart attack,
immediately call 911 or your local emergency number. If you don't have access
to emergency medical services, have someone drive you to the nearest hospital.
Drive yourself only as a last option.
Smoking or having high blood pressure, high
cholesterol, diabetes, obesity or a strong family history of heart disease
makes you more likely to get coronary artery disease. If you're at high risk of
coronary artery disease, talk to your health care provider. You may need tests
to check for narrowed arteries and coronary artery disease.
Causes
Coronary artery disease starts when fats,
cholesterols and other substances collect on the inner walls of the heart arteries.
This condition is called atherosclerosis. The buildup is called plaque. Plaque
can cause the arteries to narrow, blocking blood flow. The plaque can also
burst, leading to a blood clot.
Besides high cholesterol, damage to the
coronary arteries may be caused by:
·
Diabetes or insulin
resistance
·
High blood pressure
·
Not getting enough
exercise (sedentary lifestyle)
·
Smoking or tobacco use
Risk factors
Coronary artery disease is common. Age,
genetics, other health conditions and lifestyle choices can affect the health
of the heart arteries.
Coronary artery disease risk factors include:
·
Age. Getting older increases the risk of
damaged and narrowed arteries.
·
Sex. Men are generally at greater risk of
coronary artery disease. However, the risk for women increases after menopause.
·
Family
history. A family history
of heart disease makes you more likely to get coronary artery disease. This is
especially true if a close relative (parent, sibling) developed heart disease
at an early age. The risk is highest if your father or a brother had heart
disease before age 55 or if your mother or a sister developed it before age 65.
·
Smoking. If you smoke, quit. Smoking is bad for
heart health. People who smoke have a significantly increased risk of heart
disease. Breathing in secondhand smoke also increases the risk.
·
High
blood pressure. Uncontrolled
high blood pressure can make arteries hard and stiff (arterial stiffness). The
coronary arteries may become narrow, slowing blood flow.
·
High
cholesterol. Too much bad
cholesterol in the blood can increase the risk of atherosclerosis. Bad
cholesterol is called low-density lipoprotein (LDL) cholesterol. Not enough
good cholesterol — called high-density lipoprotein (HDL) — also leads to
atherosclerosis.
·
Diabetes. Diabetes increases the risk of coronary
artery disease. Type 2 diabetes and coronary artery disease share some risk
factors, such as obesity and high blood pressure.
·
Overweight
or obesity. Excess body
weight is bad for overall health. Obesity can lead to type 2 diabetes and high
blood pressure. Ask your health care provider what a healthy weight is for you.
·
Chronic
kidney disease. Having long-term
kidney disease increases the risk of coronary artery disease.
·
Not
getting enough exercise. Physical
activity is important for good health. A lack of exercise (sedentary lifestyle)
is linked to coronary artery disease and some of its risk factors.
·
A
lot of stress. Emotional stress
may damage the arteries and worsen other risk factors for coronary artery
disease.
·
Unhealthy
diet. Eating foods
with a lot of saturated fat, trans fat, salt and sugar can increase the risk of
coronary artery disease.
·
Alcohol
use. Heavy alcohol
use can lead to heart muscle damage. It can also worsen other risk factors of
coronary artery disease.
·
Amount
of sleep. Too little and
too much sleep have both been linked to an increased risk of heart disease.
Risk factors often occur together. One risk
factor may trigger another.
When grouped together, certain risk factors
make you even more likely to develop coronary artery disease. For example,
metabolic syndrome — a cluster of conditions that includes high blood pressure,
high blood sugar, excess body fat around the waist and high triglyceride levels
— increases the risk of coronary artery disease.
Sometimes coronary artery disease develops
without any classic risk factors. Other possible risk factors for coronary
artery disease may include:
·
Breathing
pauses during sleep (obstructive sleep apnea). This condition causes breathing to stop
and start during sleep. It can cause sudden drops in blood oxygen levels. The
heart must work harder. Blood pressure goes up.
·
High-sensitivity
C-reactive protein (hs-CRP). This protein appears in higher-than-usual amounts when
there's inflammation somewhere in the body. High hs-CRP levels may be
a risk factor for heart disease. It's thought that as coronary arteries narrow,
the level of hs-CRP in the blood goes up.
·
High
triglycerides. This is a type
of fat (lipid) in the blood. High levels may raise the risk of coronary artery
disease, especially for women.
·
Homocysteine. Homocysteine is an amino acid the body
uses to make protein and to build and maintain tissue. But high levels of
homocysteine may increase the risk of coronary artery disease.
·
Preeclampsia. This pregnancy complication causes high
blood pressure and increased protein in the urine. It can lead to a higher risk
of heart disease later in life.
·
Other
pregnancy complications. Diabetes
or high blood pressure during pregnancy are also known risk factors for
coronary artery disease.
·
Certain
autoimmune diseases. People who have
conditions such as rheumatoid arthritis and lupus (and other inflammatory
conditions) have an increased risk of atherosclerosis.
Complications
Coronary artery disease can lead to:
·
Chest
pain (angina). When the coronary
arteries narrow, the heart may not get enough blood when it needs it most —
like when exercising. This can cause chest pain (angina) or shortness of
breath.
·
Heart
attack. A heart attack
can happen if a cholesterol plaque breaks open and causes a blood clot to form.
A clot can block blood flow. The lack of blood can damage the heart muscle. The
amount of damage depends in part on how quickly you are treated.
·
Heart
failure. Narrowed
arteries in the heart or high blood pressure can slowly make the heart weak or
stiff so it's harder to pump blood. Heart failure is when the heart doesn't
pump blood as it should.
·
Irregular
heart rhythms (arrhythmias). Not enough blood to the heart can alter normal heart
signaling, causing irregular heartbeats.
Prevention
The same lifestyle habits used to help treat
coronary artery disease can also help prevent it. A healthy lifestyle can help
keep the arteries strong and clear of plaque. To improve heart health, follow
these tips:
·
Quit smoking.
·
Control high blood
pressure, high cholesterol and diabetes.
·
Exercise often.
·
Maintain a healthy
weight.
·
Eat a low-fat,
low-salt diet that's rich in fruits, vegetables and whole grains.
·
Reduce and manage
stress.
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