Coronary artery disease can be very serious since it is one of the main causes of death in Western society, especially in men. The main cause is arteriosclerosis, calcification and inflammation of the blood vessels that supply blood, oxygen and nutrients to the heart. It can cause angina pectoris, arrhythmias, heart attack and heart failure.
Causes of coronary artery disease
Various factors
When there is damage to the walls of the arteries, there may be an accumulation of fat and cell waste products or a blockage produced by platelets when trying to repair the injury. The following stand out as the main causes of coronary artery disease or lesions:
– Aging.
– Sex (it affects more men than women, although cases are increasing in women after menopause).
– Family history.
– Smoking.
– High blood pressure.
– Hypercholesterolemia.
– Diabetes.
– Bad diet.
– Excess stress.
– Lack of physical activity or sedentary lifestyle.
The main coronary arteries are:
– The left coronary artery, which carries blood to the left ventricle and left atrium of the heart and divides into the anterior descending artery, which supplies most of the cardiac territory, and the circumflex artery.
– The right coronary artery that feeds the right ventricle, the cells that regulate heart rate (sinoatrial node) and atrioventricular node. It divides into the right posterior descending artery and the acute marginal artery.
Symptoms of coronary artery disease
Chest pain and difficulty breathing
The main symptom of coronary artery disease is chest pain (angina). It can be of variable intensity. You may also feel oppression in the heart, a heaviness, under the sternum; on the neck; the arms; the stomach and upper back.
They may also be symptoms: fatigue, feeling short of breath, and general weakness.
Diagnosis of coronary artery disease
Various tests
The first step in diagnosis is a physical examination, description of symptoms, medical history, and a blood test. To confirm suspicions you can request:
– An electrocardiogram to record electrical impulses in the heart and look for evidence of a previous heart attack.
– An echocardiogram to get images of the heart and see how it receives blood flow.
– Holter monitoring to record anomalies that may occur in daily activity. The patient must wear a portable monitor for 24 hours.
– Stress test to check symptoms during physical exercise.
– Nuclear stress test to measure blood flow at rest and under stress.
– Magnetic resonance imaging with heart stimulation using medications.
– Cardiac catheterization and angiogram to see blood flow through the heart thanks to a dye that allows narrowings and blockages to be seen.
– Computed tomography to detect calcifications.
Treatment and medication of coronary artery disease
Lifestyle changes and medication
The first recommendation when faced with coronary artery disease is to make changes in lifestyle by adopting healthy habits: balanced diet, physical exercise, weight loss, less stress, not smoking… in addition, at a pharmacological level, you can prescribe: medications to reduce blood cholesterol such as statins, niacin, fibrates and bile acid sequestrants.
An anticoagulant will reduce the tendency of the blood to form clots. Beta blockers slow down the heart rate and reduce high blood pressure. There are also calcium channel blockers; angiotensin inhibitors, a hormone that causes vasoconstriction; and, for acute pain, nitroglycerin to temporarily dilate the arteries and reduce the effort of the heart to achieve proper blood flow.
At a surgical level, the most common procedures are:
– STENT placement or coronary angioplasty; prosthesis to open the interior space of the artery and facilitate the passage of blood. They may be coated with medications to prevent the artery from becoming blocked again.
– Coronary artery bypass; grafting a blood vessel from another part of the body to correct blockage in the coronary arteries.
Prevention of coronary artery disease
Healthy habits
Helping keep arteries strong and free of plaque is leading a healthy lifestyle:
– No smoking.
– Stay physically active.
– Follow a diet low in fat and salt and rich in vegetables, fruits and whole grains.
– Avoid overweight and obesity.
– Avoid stress.
– Rest adequately.
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