INTRODUCTION:
Coronary artery disease is a common underdiagnosed clinical problem which can be life-threatening. Males are slightly more affected and the disease usually affects the elderly but young are not immune. Major risk factors are smoking, diabetes, high blood pressure, alcohol, obesity and stress. The artery supplying blood and nutrition to the heart muscles is called the coronary artery.
And blockade in these arteries is called Coronary Artery Disease which results in less blood flow to the heart muscle. In the majority of times, the blockade is caused by cholesterol deposits on the inner walls of the coronary artery and sometimes due to the formation of the blood clot. More than 70% narrowing of the coronary artery usually gives rise to symptoms. A heart attack occurs when one of the coronary arteries is 100% occluded due to superimposed clot formation in a partially occluded coronary artery.
SYMPTOMS:
The most common symptom is central chest pain radiating towards the left arm, back and jaw area. The person affected usually feels heavy pressure on the chest associated with suffocation and choking type of sensation. The chest pain associated with uneasiness and profuse sweating is the classical warning symptom of a heart attack. Vomiting and reeling of the head can happen during an attack of chest pain. Sudden cardiac arrest (stoppage of heart activity) can be the first symptom of a severe heart attack. These symptoms are classical features of complete occlusion (100%) of one coronary artery. Fifty percentage of victims of a heart attack may not reach the hospital because it is life-threatening. So a person experiencing these type of symptoms should contact doctors or health care providers immediately without any delay.
Angina (central chest heaviness on walking or climbing stairs and getting relief with rest) is the most common symptoms of heart disease with blockade is more than 70% and less than 100%. Other symptoms are shortness of breath, sudden unconsciousness and chest pain after food, acidity and easy fatigue.
DIAGNOSIS:
Consulting a cardiologist and following his advice is the best possible approach for a correct diagnosis of the underlying problem and thereby take appropriate action. One should never undergo any test or try to analyze the results of the test on his own by reading something from the internet or by the advice of friends.
Tests which are helpful to diagnose coronary artery disease are ECG, ECHOCARDIOGRAM, TREADMILL TEST, STRESS ECHOCARDIOGRAM, STRESS THALLIUM, CT CORONARY ANGIOGRAM, CORONARY ANGIOGRAM, AND SOME BLOOD TEST LIKE DIABETES PROFILE AND LIPID PROFILE. A coronary angiogram is the gold standard for diagnosis of these patients and provides guidance for future treatment options.
TREATMENT OPTIONS:
Self-medication is strict to be avoided and one should always consult a professional before any treatment. Absolute abstinence from smoking is desirable. The supervised exercise program is an essential part of treatment. Packaged food and processed food should be avoided. The diet should consist of home cooked food with less carbohydrate more fiber and more vegetable. Medicines to increase blood circulation to heart, to increase thinning of blood so that the tendency of blood to clot becomes low, medicines to reduce blood cholesterol level and anti-diabetic medications to keep blood sugar in control are an essential part of treatment.
Coronary angioplasty and stenting is a relatively safe procedure to treat blocked arteries. The stents, thin metallic springs coated with medicine are implanted in the blocked portion of the diseased artery thereby keeping the artery patent and establishes blood flow to heart muscles. Coronary artery bypass surgery is an option in patients with multiple blockades in multiple arteries. To conclude coronary artery disease can be life-threatening but treatable. Suspecting heart problem and taking advice from a professional will reduce heart attack related deaths
Dr. Pradeep Kumar Nayak I Senior Consultant – Cardiology I Dharamshila Narayana Superspeciality Hospital, Delhi