Coronary artery disease and other cardiovascular diseases

Coronary artery disease (CAD) is the most common type of heart disease.

Responsible for the onset of the disease is when the arteries in charge with supplying blood to the heart muscle become hardened and narrowed due to a buildup of cholesterol and other material (plaque) on the inner walls of the arteries. This buildup is what determines atherosclerosis. The more the buildup increases in size, the harder it becomes for the heart to get the blood and oxygen it needs.

This can lead to chest pains (angina) or heart attack. Most heart attacks occur when a blood clot suddenly interferes by cutting off the heart’s blood supply altogether, causing permanent heart damage. Over time, coronary artery disease can also weaken the heart muscle and contribute to heart failure (the condition in which the heart cannot supply the body with the blood it needs) and arrhythmias (issues with the rhythm or rate of the heart beat).

Causes

CAD is thought to begin with damage or injury to the inner layer of a coronary artery, even as early as childhood

This damage may be due to certain factors:

 

Smoking

High blood pressure

High cholesterol levels

Diabetes or insulin resistance

Sedentary lifestyle – being overweight, obese or simply physically inactive

 

Other risk factors:

Age

Sex – men are generally at greater risk of CAD

Family history

High stress

Symptoms and signs

Chest pain (angina):

Feelings of pressure or tightness in the chest

It usually occurs on the left side or in the middle of the chest

The pain usually goes away in a matter of minutes

Especially in women the pain may be felt as fleeting or sharp in the neck, arm or back

 

 

Shortness of breath:

Or extreme fatigue due to low levels of oxygenized blood

Heart attack:

A completely blocked coronary artery may lead to a heart attack

Crushing pressure in the chest

Pain in the shoulder or arm

May be accompanied by shortness of breath and sweating

 

Women are more likely to experience less common signs such as:

Neck or jaw pain

 

There are cases of heart attack manifesting with no apparent signs

Advice

Lifestyle changes:

Quit smoking

Adopting a healthy diet

Regular exercise

Lose excess weight

Reduce stress

Medications:

Cholesterol-modifying medications to decrease low-density lipoprotein (LDL – ‘bad cholesterol’) levels and to also decrease the primary material making up the buildup blocking blood access to the heart

Aspirin to reduce the tendency of the blood to form clots (although in cases where other blood thinners are being administered or in cases of bleeding disorders, aspirin may be avoided)

Beta blockers to reduce the heart’s rate and reduce blood pressure

Nitroglycerin tablets, sprays or patches to reduce chest pain by temporarily dilating coronary arteries

Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to decrease blood pressure

Surgical interventions to restore and improve blood flow:

Angioplasty and stent placement – a long thin tube (catheter) is introduced into the narrowed part of the artery, in order to ensure access of a wire with a deflated balloon to pass through. The balloon is then inflated, compressing the deposits (buildup) against the walls of the artery, while a stent is introduced and left in the artery to ensure it remains open

Coronary artery bypass surgery – a graft is created from another vessel and is used to bypass blocked coronary arteries, allowing blood to flow around the blocked or narrowed artery (requiring open-heart surgery, the intervention is reserved for multiple cases of narrowed coronary arteries)

MISCONCEPTIONS
  • Being too young to worry about heart disease

    High blood pressure is easy to spot – it is in fact called “the silent killer”

    Chest pain is always present in heart attacks – not always the case

    Diabetes treatment is enough to ensure that heart attacks will not occur – false, since the reasons for diabetes occurrence are similar to those leading to heart disease

    Heart disease runs in the family so nothing can be done to prevent it – lifestyle changes dramatically impact the risk of developing heart disease

    Cholesterol levels need to be tested only after a certain age

    Leg pain is not indicative of heart disease – it could be a sign of peripheral heart disease

    Variation in heart beat is abnormal

    Exercise should be avoided after having a heart attack – exercise should be taken up as quickly as possible and tailored specifically for improving heart disease

Statistics

According to the World Health Organization, fact sheet No317, updated January 2015:

Cardiovascular diseases (CVDs) are the number one cause of death globally: more people die annually from CVDs than from any other cause

An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6.7 million were due to stroke

Over three quarters of CVD deaths take place in low- and middle-income countries

Out of the 16 million deaths under the age of 70, 82% are in low and middle income countries and 37% are caused by CVDs

People with cardiovascular disease or who are at high cardiovascular risk (due to the presence of one or more risk factors such as hypertension, diabetes, hyperlipidaemia or already established disease) need early detection and management using counselling and medicines, as appropriate

Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies

Did you know?

Alternative supplements may reduce blood pressure or cholesterol level:

Flax and flaxseed oil

Fish oil

Other dietary sources of omega-3 fatty acids: canola oil, soybeans, soybean oil

Alpha-linolenic acid

Artichoke

Barley

Beta-sitosterol

Blond psyllium

Cocoa

Coenzyme Q10

Garlic

Oat bran

Sitostanol

 

World Heart Day is an annual event taking place on the 29th of September

 

Famous personalities with CVDs: Larry King, Bill Clinton, David Letterman, Elizabeth Taylor, Toni Braxton, Barbara Walters, Robin Williams