Coronary artery illness, or CAD, is really a condition in which a fatty substance called plaque builds up inside the walls of the arteries that supply the heart. The plaque begins to form when the inner layer of tissue in the artery is damaged by smoking, diabetes, high blood pressure, personality factors, or some other trigger. When the deposit of plaque grows big sufficient to narrow or block the flow of blood through the artery, the heart muscle becomes starved for oxygen, producing angina, difficulty breathing, or a full-blown heart attack.
The buildup of plaque that leads to coronary artery disease can begin as early as childhood. Arteries in the human body are blood vessels that carry blood away from the heart, in contrast to veins, which carry blood toward the heart. Arteries have three layers of tissue: an outer layer made of connective tissue, a middle layer made of smooth muscle, along with a thin inner layer of cells that serve as a lining to the artery.
This inner layer smoothes the flow of blood, which allows the heart to pump the blood further. The coronary arteries branch off from the base of the aorta, the big trunk artery at the top of the heart. They're the only source of blood supply to the heart muscle itself, which is why a blockage in these arteries is such a critical scenario. If the thin inner layer of a coronary artery is damaged, the body tries to heal it by covering it with a layer of plaque.
Over time, the plaque deposit can turn out to be thicker, to the point where blood no longer flows smoothly via that component of the artery and the heart muscle becomes ischemic. Ischemia is really a condition in which a portion of heart muscle (or any other tissue) is not receiving sufficient blood simply because of the blockage of an artery that ordinarily supplies it with blood. Ischemia in the heart can lead to angina a kind of chest pain that feels like squeezing or pressure and can move from the chest region to the arms, neck, jaw, or back. The plaque deposits within the damaged artery can also rupture or crack open.
Blood cells known as platelets move to the ruptured region and form blood clots that block the artery. The loss of the blood supply following the closure of the artery leads to the death of heart tissue. The death of component of the heart muscle is known as a heart attack, which doctors call a myocardial infarction or MI.
CAD is the leading trigger of death in the United States for both men and women. According to the American Heart Association, nearly fifteen million adults have some form of coronary artery illness. CAD generally develops in adults over thirty, and is typical in adults over sixty. Coronary artery disease accounts for 650,000 deaths in the United States each year 25 percent of deaths among adults over the age of thirty-five. Risk factors for coronary artery illness include:
Coronary artery illness is caused by a slow buildup over years or decades of plaque along the inner wall of a coronary artery. The plaque can block the flow of blood through the artery either by becoming thick enough to narrow the artery, or by rupturing and leading to the formation of a blood clot that blocks the artery. Coronary artery disease can progress (get worse) for years without producing any noticeable symptoms. When symptoms do appear they usually take three forms:
For some people, a heart attack is the first symptom of CAD. They'll be taken to a hospital emergency room, where they'll be asked to describe their symptoms. In addition to taking the patient's personal and family history of risk factors for CAD, the physician will also take the patient's temperature, blood pressure, and pulse. Listening to the patient's lungs and heartbeat via a stethoscope can help to rule out pneumonia or other diseases that may cause chest pain or difficulty breathing. The next step is diagnostic tests to rule out a heart attack, which include:
If the patient is having angina but does not appear to be having a heart attack, he or she will be asked to take a tension test. In a tension test, the patient walks on a treadmill or pedals a stationary bicycle while hooked up to an ECG machine, which measures the electrical tracings of the heart before, during, and after exercise. An additional kind of tension test is really a radionuclide tension test, in which a radioactive tracer element is injected into a vein while a unique camera records the amount of the trace element that reaches numerous parts of the heart.
CAD could be treated with a combination of lifestyle changes, medications, and possibly surgery. Lifestyle changes include quitting smoking, losing weight if needed, getting sufficient exercise, and coping more effectively with stress. The physician might prescribe one or more types of medications to treat CAD. These medications might prevent or delay the need for surgery:
In some cases the patient's doctor may suggest surgery in order to prevent a fatal heart attack. The two operations that are most commonly performed are coronary artery bypass surgery and coronary angioplasty. In bypass surgery, the surgeon takes a piece of a healthy artery from an additional part of the patient's body and sews it in location to go around a blocked coronary artery to restore normal blood flow to the heart. In a coronary angioplasty, the surgeon inserts a catheter with a special balloon tip into the coronary artery. When the catheter is in the correct position, the balloon is expanded, which reopens the blocked artery. The surgeon will then insert a stent, which is a tube made of metal mesh, to maintain the artery open. Some stents also contain a slowrelease medication.
The prognosis of CAD depends on the patient's age and also the number of risk factors in their family history, personal medical history, and lifestyle. The factors that doctors take into account in evaluating an individual patient's prognosis include the number of coronary arteries that are damaged; the patient's capacity for physical exercise or activity; a history of previous heart attacks or bypass surgery; and the severity of the patient's present symptoms particularly unstable angina or a heart attack.
Individuals who are at risk of CAD or been diagnosed with it can lower their risk of a heart attack by:
Coronary artery disease is expected to be a growing issue in the developed countries over the next a number of decades simply because of the aging of the general population, the increase in obesity and the rates of obesity-related diseases like diabetes, and also the high rates of smoking in many countries. In terms of prevention and treatment, new drugs to treat heart attacks are currently being studied as well as the effectiveness of using bone marrow or stem cells to help repair injured heart tissue. Some researchers are also looking at some genes on chromosome 17 as a feasible risk factor in CAD.
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