Coronary Artery Disease

Coronary Artery Disease is a general term used to describe a chronic disease of the coronary arteries on the surface of the heart.  These vessels can become narrowed or blocked with plaque over years.  Risk factors for CAD are: smoking, heredity, high cholesterol, high blood pressure, sedentary lifestyle, diabetes, obesity, and stress.  The 3 main coronary arteries are:  Left main and anterior descending artery, the Right coronary artery, and the Circumflex artery. CAD includes varying degrees of angina, and myocardial infarction.  Treatment may include medications, coronary artery bypass surgery, Percutaneous transluminal coronary angioplasty (PTCA) with or without stent   ( a small hollow tube inserted into the artery to maintain patency)

Angina Pectoris

Angina is the name given for chest tightness or fullness that occurs when the blood supply to the heart muscle does not get enough oxygen.  It can also feel like indigestion.  The blood flow to the heart muscle is reduced because fat and other substances are built up in the walls of the arteries in your heart.  This build up acts like scale or rust on the inside of a pipe.  It reduces the amount of blood that can flow through the artery.  It typically comes on with exercise, strong emotions, and extreme temperatures.  It generally goes away in a few minutes when you rest.  The discomfort can be in your chest, arms, neck, jaws, or shoulders.  See your doctor for further testing.  This may include:  a chest x-ray, treadmill test, ultrasound EKG, and/or cardiac catheterization.  Angina is a warning that a myocardial infarction (heart attack) could occur in the future. Nitroglycerin may be used to provide quick relief from angina attacks by dilating the affected arteries.

Myocardial Infarction (MI)

A myocardial infarction or “heart attack” occurs when blood flow to the heart muscle is slowed or stopped for 15 to 30 minutes or longer.  At this point there is damage to the heart muscle.  This happens when there is a fatty buildup in the coronary arteries that is 100%.  It can also result from a blood clot in the artery or a spasm.  Whichever happens, the result is the same: not enough blood and oxygen reaching the heart muscle.  The symptoms are similar to Angina, only lasting longer, and may include symptoms of shortness of breath, nausea, sweating and cold clammy skin.  If chest tightness or pressure lasts longer than a few minutes or is not relieved by resting, call 911.  It is important that you get to a hospital quickly.  If Nitroglycerin has been prescribed to you, place one under the tongue while sitting or laying down ( NTG can make you dizzy).  A second may be taken in 5 minutes if the pain is not relieved, and a third, 5 minutes later.  Medications, clot busters, or emergency procedures may be used to establish blood flow in the coronary arteries.

Hypertension (High Blood Pressure)

Blood pressure is how hard blood pushes against the walls of the blood vessels as it flows through the body.  The top number is your systolic pressure.  This is the force of blood in your vessels when your heart beats. The bottom number is your diastolic pressure.  This is the force of blood between beats (or at rest).120/80 and above is considered pre-hypertension.  140/90 and above is considered hypertension.  The causes of hypertension are lack of exercise, diet, excess weight, age, and heredity.  High blood pressure is often called the “silent killer” because there are no obvious symptoms.  Hypertension can lead to strokes, heart attacks, kidney disease, and eye disease.  Have your B/P taken regularly, and see your doctor if your pressure approaches 140/90.  It can be controlled.