SIGNS OF CORONARY ARTERY DISEASE

If your coronary arteries narrow, they can’t supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause any coronary artery disease symptoms. As the plaques continue to build up in your coronary arteries, however, you may develop coronary artery disease signs and symptoms, including:
-Chest pain (angina). You may feel pressure or tightness in your chest, as if someone were standing on your chest. The pain, referred to as angina, is usually triggered by physical or emotional stress. It typically goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be fleeting or sharp and felt in the abdomen, back or arm.
-Shortness of breath. If your heart can’t pump enough blood to meet your body’s needs, you may develop shortness of breath or extreme fatigue with exertion.
-Heart attack. A completely blocked coronary artery may cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. Women are somewhat more likely than men are to experience less typical signs and symptoms of a heart attack, such as nausea and back or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.






SYMPTOMS OF MYOCARDIAL ISCHEMIA

Myocardial ischemia occurs when blood flow to your heart muscle is decreased by a partial or complete blockage of your heart’s arteries (coronary arteries). The decrease in blood flow reduces your heart’s oxygen supply.
Some people who have myocardial ischemia don’t experience any signs or symptoms (silent ischemia).
When myocardial ischemia does cause signs and symptoms, they may include:
-Chest pressure or pain, typically on the left side of the body (angina pectoris)
-Neck or jaw pain
-Shoulder or arm pain
-A fast heartbeat
-Shortness of breath
-Nausea and vomiting

When to see a doctor?
If you have chest discomfort, especially if it’s accompanied by one or more of the other signs and symptoms listed above, seek medical care immediately. Call 911 or your local emergency number. If you don’t have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options. Driving yourself puts you and others at risk if your condition suddenly worsens.






Angioplasty and Stent Implantation

Angioplasty is a widely used procedure that is performed for patients with cardiovascular disease. The procedure involves inserting a medical device, such as a balloon, into your heart to open the heart artery narrowed by plaque. It may involve placement of a stent (mesh tube) to help keep the vessel open. The stent may be coated with medicine.
Heart disease treated with angioplasty usually provides rapid relief of symptoms such as chest pain and/or shortness of breath. The majority of patients return to regular life activities without chest pain in a short time.
Angioplasty is used to:
-Restore blood flow to the affected area of the heart by treating narrowed coronary arteries
-Provide prompt relief of chest pain and/or shortness of breath after procedure
-Potentially reduce the risk of heart attack and prolong life compared to no treatment
Coronary Stents
Stents are tiny, expandable tubes made of metal mesh designed to open a blood vessel that is blocked by plaque. The angioplasty procedure opens the artery, and stents are placed and expanded to fit the size, shape and bend of the artery. The stent remains in the artery after the procedure to help keep the artery open. Over time, the artery wall heals around the stent.
There are two kinds of coronary artery stents.
-Bare-metal stents help keep the cleared artery open after angioplasty by supporting the artery wall after angioplasty. Bare-metal stents help to prevent the artery from re-narrowing.
-Photo of TAXUS Express Drug-Eluting StentDrug-coated stents are bare-metal stents with a special drug coating. These stents are also called drug-eluting stents, or DES. DES have the same support benefits as a bare-metal stent for keeping the artery open after angioplasty. In addition, the stent releases a drug over time to further reduce the chance of re-blockage.
Arteries commonly become blocked again about 7% of the time with drug-coated stents, compared to 25% for bare-metal stents.¹






Angina and Coronary Artery Disease

Angina is pain or discomfort that comes when your heart does not get enough oxygen. Angina is usually a symptom of a heart problem known as coronary heart disease (CHD), also called coronary artery disease (CAD)
Your heart is a muscle. It pumps oxygen-rich blood to your whole body. Your heart also needs oxygen to work. Blood vessels called coronary arteries carry blood with oxygen to your heart.
In healthy coronary arteries, blood flows freely to bring oxygen to the heart. In coronary heart disease, these arteries become stiff and narrow. This lowers blood flow and the amount of oxygen that gets to the heart.

With exercise or emotional stress, the heart works harder and needs more oxygen. Lower blood flow can lead to angina. You could feel discomfort or pain in the chest, arm, shoulder, back, neck, or jaw. When angina has been present for months or years without much change, it is called chronic stable angina. It most often goes away with rest or nitroglycerin.
If a clot forms in a coronary artery, it can further block blood flow. This can lead to chest pain known as unstable angina. It often occurs at rest. Unstable angina is a medical emergency and requires medical help right away.






Heavy Drinking can lead to Heart Disease

Drinking more than the daily unit guidelines regularly and over a long period of time can increase your risk of developing heart disease. This is because, drinking at this level can:
-Increase the risk of high blood pressure. Drinking excessive amounts of alcohol causes raised blood pressure which is one of the most important risk factors for having a heart attack or a stroke. Alcohol is thought to do this through its effects on the kidneys and the blood vessels. Increases in your blood pressure can also be caused by weight gain from excessive drinking.
-Weaken the heart muscle. This means the heart can’t pump blood as efficiently. It’s known as cardiomyopathy and can cause premature death, usually through heart failure.
-Lead to an enlarged heart. This is a sign that the heart is unable to effectively pump blood around the body, and is known as heart failure.
Video: Coronary Artery Disease






What is Myocardial Ischemia?

Myocardial ischemia occurs when blood flow to your heart muscle is decreased by a partial or complete blockage of your heart’s arteries (coronary arteries). The decrease in blood flow reduces your heart’s oxygen supply.
Myocardial ischemia, also called cardiac ischemia, can damage your heart muscle, reducing its ability to pump efficiently. A sudden, severe blockage of a coronary artery may lead to a heart attack. Myocardial ischemia may also cause serious abnormal heart rhythms.
Treatment for myocardial ischemia is directed at improving blood flow to the heart muscle and may include medications, a procedure to open blocked arteries or coronary artery bypass surgery. Making heart-healthy lifestyle choices is important in treating and preventing myocardial ischemia.






Risk Factors for Coronary Artery Disease

Risk factors for coronary artery disease include:
Age. Simply getting older increases your risk of damaged and narrowed arteries.
Sex. Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.
Family history. Especially if a close relative developed heart disease at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55, or your mother or a sister developed it before age 65.
Smoking. Nicotine constricts your blood vessels, and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis.
High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of your arteries.
High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis.
Diabetes. Diabetes is associated with an increased risk of coronary artery disease.
Obesity. Excess weight typically worsens other risk factors.
Physical inactivity. Lack of exercise also is associated with coronary artery disease and some of its risk factors, as well.
High stress. Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for coronary artery disease.






How Is Coronary Heart Disease Treated?

Treatments for coronary heart disease (CHD) include lifestyle changes, medicines, and medical procedures. Treatment goals may include:
-Relieving symptoms.
Reducing risk factors in an effort to slow, stop, or reverse the buildup of plaque.
Lowering the risk of blood clots forming. (Blood clots can cause a heart attack.)
Widening or bypassing clogged arteries.
Preventing complications of CHD.
Making lifestyle changes often can help prevent or treat CHD. Lifestyle changes might be the only treatment that some people need.
A healthy diet is an important part of a healthy lifestyle. Following a healthy diet can prevent or reduce high blood pressure and high blood cholesterol and help you maintain a healthy weight.