A to Z Disease

What Is Heart Disease?

Coronary artery disease, or CAD, is caused by a condition called "atherosclerosis," the gradual buildup of plaque in the blood vessels that feed your heart.

What Happens When Someone Has Heart Disease?

Heart disease, or Coronary Artery Disease (CAD), develops when plaque builds up in the arteries, blocking blood flow to the heart. Atherosclerosis is the slow, steady build up of deposits called plaque in your arteries, which can start as early as childhood. Plaque is made up of fat, cholesterol, calcium and other cellular matter circulating in your blood. Over time, this plaque will both narrow and harden arteries, including the coronary arteries that feed your heart. When the blood flow is restricted, angina, or chest pain, results. The plaque can also become brittle and break up, stimulating the formation of blood clots that block the flow of blood in the heart's arteries and cause a heart attack.

Symptoms of Heart Disease

It's possible to have heart disease but not experience any symptoms at all. This is called silent ischemia. If you do have symptoms, they may include:

* Pressure or Tightness in the Chest. This is usually brought on by physical activity or emotional stress, and usually ceases within a few minutes from stopping the stressful activity.
* Shortness of Breath and Extreme Fatigue. These typically develop upon physical exertion.
* Heart Attack. Unfortunately, this is often the first sign of the presence of heart disease. A heart attack occurs when an artery that feeds your heart muscle becomes completely blocked. This is usually caused by a blood clot or other debris in an already narrowed coronary artery. Pain from a heart attack is often described as a crushing or squeezing pressure in the chest and may feel similar to angina but lasts longer.

These symptoms may vary for women and men. In fact, women often feel no chest pain but may have a combination of the other symptoms, such as jaw pain, nausea and shortness of breath.

Risks for Heart Disease

Unfortunately, some people will be at greater risk than others. Risk factors include:

* Race. Hispanics, African Americans, American Indians and some Asian Americans are more at risk than other groups.
* Age. The risk increases with age.
* Family History of Heart Disease. Your risk increases if others in your family of origin have heart disease.
* Poor Lifestyle Habits. Smoking, poor diet, and lack of exercise contribute to heart disease.
* High Cholesterol, High Blood Pressure or Diabetes. Poor lifestyle habits can reinforce these conditions.

Diagnosing Heart Disease

Diagnosing CAD starts with an initial exam, where your general medical history is reviewed and some routine blood tests are taken. Your doctor may then order some additional tests. These include:

* Electrocardiogram. Often called an ECG or EKG, for short. This measures the electrical activity of your heart.
* Stress Test. This is essentially an EKG taken while you're exercising on a treadmill.
* Coronary Angiogram. This is also called 'arteriography.' A dye is injected through the heart vessels and then x-rays are taken to reveal the narrowed areas.

There are also other tests which produce 3D images of your heart.

Treating Heart Disease

Many people are able to manage coronary artery disease with lifestyle changes and medications. However, people with severe coronary artery disease may need coronary angioplasty or bypass surgery.

Lifestyle Choices

* Don't Smoke. Quitting smoking dramatically lowers your risk of a first or second heart attack.
* Manage Your Weight. Eat a "heart healthy" diet that is low in fat, especially saturated and trans fats. Also eat foods low in cholesterol. It's especially important to keep your cholesterol low after a heart attack to help lower your risk of having another one.
* Exercise Routinely. Even moderate amounts of physical activity--30 minutes a day—can lower your risk of death from coronary artery disease. Exercise decreases inflammation in the arteries and helps to control cholesterol. However, people with severe coronary artery disease may need to restrict their exercise somewhat. If you have coronary artery disease, check with your doctor to find out what kinds of exercise are best for you.
* Reduce Your Stress. To lower your risk, rethink workaholic habits. And find healthy ways to deal with stressful events and anger in your life. It's not easy, but it's so important you learn to manage your stress for your heart and overall health.
* Control Your Blood Pressure. Have it checked at least every two years. Your doctor may recommend more frequent measurement if you have blood pressure higher than 115/75 mm Hg or a history of heart disease. Your risk of heart disease rises significantly with increasing blood pressure.
* Get Regular Medical Check-Ups. Some of the primary risk factors for coronary artery disease, high blood cholesterol, high blood pressure and diabetes, have no symptoms. Heart disease itself may produce no symptoms. Your doctor can perform tests to see if you have these conditions. If a problem is found, you and your doctor can manage it early to prevent complications.

Medication Options

* Cholesterol-lowering drugs to reduce the build-up of plaque in the heart's arteries.
* Aspirin to thin the blood, which reduces its tendency to clot and block arteries.
* Beta blockers to slow the heart, which decrease your heart's need for oxygen.
* Calcium channel blockers, which relax the muscles that surround your coronary arteries and allow more blood to flow to your heart. They also help control high blood pressure.
* ACE inhibitors allow blood to flow from your heart more easily, decreasing your heart's workload.
* Diuretics open your blood vessels and lower blood pressure, which decreases the workload on the heart.

Surgery as An Option

If your symptoms are severe or your vessels are significantly narrowed, your doctor may also recommend surgery to improve the flow of blood within your arteries. The most common procedure that you may have heard about is called "angioplasty". This procedure is used to open up a severe blockage.

In an angioplasty, a small incision is made near a major blood vessel, so your doctor can insert a tube, called a catheter, and thread it up toward the blockage. At the end of the catheter is a balloon, which is pushed to the spot of the blockage. The balloon is inflated. Sometimes, a wire mesh tube, known as a stent, is put in place to open the artery. Medications carried by the stent lower your risk of developing a new blockage.

If angioplasty doesn't solve the problem, you may need another type of surgery, for example heart bypass surgery, which creates a new route for blood to flow around the blockage in the artery.

Your cardiologist is the best person to evaluate which of these and other treatments are the best ones for you.