The human heart is the most vital organ of the body. Several blood vessels carrying pure and impure blood have their origin from the heart. These tube-like vessels are elastic and smooth in nature allowing free flow of blood throughout the body. Coronary arteries are amongst such major vessels which supply oxygenated or pure blood to the heart muscles. Coronary artery disease develops when the lumen of these vessels get narrow or in simple words, the radius of the tube decreases due to deposits of the layer of plaque (atheroma). Plaques are nothing but cholesterol-laden deposits. As a result of narrow tubes, the pathway of free-flowing blood is obstructed and the amount of blood received by the heart decreases. Thus, creating a supply-demand gap.

Symptoms Experienced During Coronary Artery Disease

  • Chest Pain:
    – Most common symptom.
    – Severe chest pain generally in the middle or towards the left side of the chest which is referred to as angina.
  • Shortness Of Breath:
    – Due to decreased blood supply, the function of the heart decreases as a result lungs become waterlogged and breathlessness develops.
    – One can feel easily fatigable.
  • Heart Attack:

– If the plaque continues to deposit, the tube of the artery may get completely blocked and the blood supply to a part of the heart muscles becomes zero.
– As a result, an unfortunate event of a heart attack may occur.
– During a heart attack, one can experience severe pain in the chest, arms and shoulders and shortness of breath. If not treated urgently, a heart attack may cause death within no time.

Factors Causing Coronary Artery Disease

  • Lifestyle Disorder:
    – Excessive smoking and alcohol consumption.
    – Obesity.
    – High stress.
    – Unhealthy eating habits: Eating a high amount of saturated fats, trans fats, salt, sugar, junk foods.
    – Sedentary lifestyle.
  • Hypertension.
  • Diabetes:
    – A person with diabetes has a higher chance of developing coronary heart disease.
  • Family History:
    – A person with a family history of heart disease has a higher susceptibility to the disease.
  • Age And Sex:
    – The disease is more common amongst males and seen in elderly patients.

How It Is Diagnosed

  • ECG represents the electrical activity of the heart. Your doctor can look at the ECG changes and prescribe further tests to confirm the diagnosis, but sometimes ECG may be normal despite having severe heart disease.
  • Echo is used to evaluate the function of the heart, the condition of valves, and look for complications associated with coronary heart disease.
  • Treadmill test (stress test) – it is used as a screening test to detect ECG changes when the patient is under stress like walking on a treadmill.
  • Coronary angiography- this is the gold standard diagnostic test. It clearly visualises the blocks and also gives an estimation of the severity of the blocks.

Treatment

  • Angioplasty and stent placement: In this procedure, the blockage is opened using a balloon and a metal stent (nowadays, drug-eluting to prevent recurrence) is placed to re-establish blood flow in the distal vessel.
  • Coronary artery bypass grafting (CABG): This is a surgical approach where a healthy graft is harvested (arterial and venous) and the lesion is bypassed.
  • Medical Management:
    -In some cases, the percentage of blockage is less. In such patients, with stable coronary artery disease and normal cardiac function, no surgery or stenting is required. 
  • Regular follow-up with lifestyle modification and a prescribed dose of medications like aspirin, statins, beta-blockers, antihypertensives, antidiabetics, low salt and sugar intake allows the patient to live a healthy life.

Coronary artery disease is the most common cause of death in the world.  Every doctor has a different approach to the treatment. The majority of the time the treatment plan either has a surgical or stenting method.  In some patients, surgery is the better option for a prolonged and healthy life while in others stenting is suitable. It depends upon the percentage of blockage, the number of vessels involved, and the function of the heart.  Before getting the treatment, it is always wise to take a second opinion and be assured, as there can be more right options for the prescribed treatment option.