What Are The Signs Of Coronary Artery Disease And How Do You Treat It?

Expert Author
Arun Villivalam General Practitioner Los Gatos, CA

Dr. Arun Villivalam is a general practitioner practicing in Los Gatos, CA. Dr. Villivalam does not specialize in one area of medicine, however provides routine health care services. General practitioners typically have regular, even life-long patients who they provide health care services to. Dr. Villivalam provides services... more

Heart disease refers to an umbrella of heart conditions and has been the leading cause of death in America. The most common type of heart disease is coronary artery disease (CAD) also called coronary heart disease or ischemic heart disease. 

Coronary artery disease (CAD) refers to damage to the coronary arteries, which carry blood to the heart.  Further complications such as a  heart attack, arrhythmia, or heart failure may result from CAD.

Types

There are two primary CAD types:

1. Stable ischemic heart disease: This is a chronic form of CAD, which progresses gradually over the years. The narrowing of the coronary arteries happens slowly as the heart receives less oxygen-rich blood with time. Even if the patient experiences some symptoms of CAD, they’ll be able to manage the condition and carry on their daily routine with no problem.

2. Acute coronary syndrome: This condition occurs suddenly, leading to a medical emergency. There is an instant formation of plaque buildup in the heart arteries that forms a blood clot, blocking the blood from reaching the heart. This blockage can lead to a heart attack. 

Symptoms

Coronary artery disease is called a “silent killer” as it may not show any symptoms in some people until they get a heart attack. It can also go unnoticed for years unless you pay close attention, such as the rapid beating of the heart while exercising. 

The common symptoms are:

Causes

Coronary artery disease is the narrowing or blocking of the coronary arteries that supply oxygen-rich blood to our heart. 

CAD occurs because of atherosclerosis. Atherosclerosis is a process that is triggered by the buildup of plaque or atheroma on the walls of coronary arteries and inflammation. Plaque comprises deposits of cholesterol, fats, calcium, waste products, and fibrin, a substance that helps the blood clot. 

The plaque buildup narrows and stiffens the coronary arteries over time, partially or totally blocking the blood, oxygen, and nutrients from reaching the heart muscle. This is called myocardial ischemia which can lead to chest pain (angina) and heart attack.

There are also certain risk factors that can damage the coronary arteries and cause coronary artery disease such as:

  • Age
  • Genetics 
  • Obesity
  • Diabetes or insulin resistance
  • High blood pressure (hypertension)
  • High levels of lipoprotein (a), a fat made by the liver
  • High cholesterol 
  • Sedentary lifestyle 
  • Smoking or tobacco use
  • Excess alcohol use
  • Sleep quantity and quality  
  • Thrombosis or blood clot in a vein or artery

If you’re at a high risk of coronary artery disease, talk to your doctor for further investigation and diagnostic tests. 

If left untreated, CAD can lead to the weakening of the heart and further complications, such as: 

The complications of CAD are a medical emergency that can turn fatal as the heart dies because of the lack of blood. The patient needs immediate medical attention to restore the blood flow to the heart and save his or her life.

Diagnosis

We diagnose CAD with a personal consultation with the patient where we inquire about the symptoms, family history, and other risk factors. Based on our assessment, we recommend one or a few tests for diagnosis. Some of them are: 

Treatment

Treatment for CAD comprises lifestyle changes, medications, surgery to restore blood flow to the heart, and cardiac rehabilitation.  

Lifestyle changes include quitting smoking, eating a heart-healthy diet, limiting alcohol consumption, and regular exercise. 

Depending on the stage of your CAD condition, there are medications that your primary care doctor in Los Gatos may recommend to help manage the risk factors and treat the symptoms of CAD.

Surgery is another option to treat CAD. There are two main surgical procedures that we recommend to our patients.

  • Coronary angioplasty or percutaneous coronary intervention (PCI) with or without stent placement: Coronary angioplasty is a minimally invasive surgical treatment that is done to open clogged coronary arteries. Our cardiologist guides a catheter to the narrowed coronary artery and inflates a tiny balloon to reopen and widen the blocked artery and improve the blood flow. They may also insert a small wire mesh tube (stent) to help the artery stay open during the angioplasty procedure. Some stents slowly release medication to help continue to keep the arteries open. 
  • Coronary artery bypass graft surgery (CABG): CABG is an open-heart surgery done in patients with several narrowed coronary arteries. Our cardiologist takes a healthy blood vessel from another part of the body and creates a whole alternative path for the blood flow around the narrowed blocked heart arteries. This detour helps restore the blood flow into the heart and saves lives. 

Our doctors recommend a cardiac rehab program for patients recovering from a heart attack, heart failure, or any heart disease that requires surgery and extensive medical care. The supervised rehab program helps prevent another cardiac event through a combination of education, counseling, diet, and exercise by our healthcare team. The team comprises our cardiologists, exercise specialists, nutritionists, physical therapists, and mental health counselors. 

Regular medical checkups are necessary, as some CAD cases show no symptoms in the early stages. Early detection facilitates early treatment for better heart health. 

If you need a consultation for your heart condition, call us at 408-520-6040 or schedule a visit at visitlosgatosdoc.com.