The coronary arteries are the major blood vessels that supply our heart with blood, oxygen and nutrients. When these arteries become damaged or diseased - usually due to a buildup of fatty deposits called plaques - it's known as coronary artery disease.
These deposits can slowly narrow the coronary arteries, causing the heart to receive less blood. Eventually, diminished blood flow may cause chest pain (angina), shortness of breath or other symptoms. A complete blockage, caused either by accumulated plaques or a ruptured plaque, can cause a heart attack.
Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including:
- Smoking
- High blood pressure
- High cholesterol
- Diabetes
- Radiation therapy to the chest, as used for certain types of cancer
Once the inner wall of an artery is damaged, fatty deposits (plaques) made of cholesterol and other cellular waste products tend to accumulate at the site of injury in a process called atherosclerosis. If the surface of these fatty deposits breaks or ruptures, blood cells called platelets will clump at the site to try to repair the artery. This clump can block the artery, leading to a heart attack
Because coronary artery disease often develops over decades, it can go virtually unnoticed until it produces a heart attack. But there's plenty one can do to prevent and treat coronary artery disease
If the coronary arteries become narrowed, they can't supply enough oxygenated blood to the heart - especially when it's beating hard, such as during physical activity. At first, the restricted blood flow may not cause any coronary artery disease symptoms. As the fatty deposits continue to accumulate in the coronary arteries, however, one may develop coronary artery disease symptoms, including:
Chest pain (angina): A person may feel pressure or tightness in the chest, as if someone were standing on the 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 noticed in the abdomen, back or arm.
Shortness of breath: If the heart can't pump enough blood to meet the body's needs, it would result in development of shortness of breath or extreme fatigue with exertion.
Heart attack: If a coronary artery becomes completely blocked, that may cause a heart attack. The classic symptoms of a heart attack include crushing pressure in the chest and pain in the shoulder or arm, sometimes with shortness of breath and sweating. Women sometimes experience less typical signs of a heart attack, including nausea and back or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.
If you suspect you're having a heart attack, immediately call a local emergency number. If you don't have access to emergency medical services, try to reach the nearest hospital as soon as possible.
If you have risk factors for coronary artery disease - such as high blood pressure, high cholesterol, diabetes or obesity - talk to the doctor. He or she may want to test you for the condition, especially if you have signs or symptoms of narrowed arteries. Even if you don't have evidence of coronary artery disease, the doctor may recommend aggressive treatment of the risk factors. Early diagnosis and treatment may stop progression of coronary artery disease and help prevent a heart attack.
Lifestyle changes can help you prevent or slow the progression of coronary artery disease.
Stop smoking: Smoking is a major risk factor for coronary artery disease. Nicotine constricts blood vessels and forces the heart to work harder, and carbon monoxide reduces oxygen in the blood and damages the lining of the blood vessels. If you smoke, quitting is the best way to reduce the risk of a heart attack.
Control the blood pressure: Ask the doctor for a blood pressure measurement at least every two years. He or she may recommend more frequent measurements if the blood pressure is higher than normal or you have a history of heart disease.
Check your cholesterol levels: High cholesterol levels increase your risk of heart attack. Regular checks will ensure you are aware of your levels and work towards reducing if you have a high count.
Keep diabetes under control: If you have diabetes, tight blood sugar control can help reduce the risk of heart disease.
Exercise: Exercise helps you achieve and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure - all risk factors for coronary artery disease.
Eat healthy foods: A heart - healthy diet based on fruits, vegetables and whole grains - and low in saturated fat, cholesterol and sodium - can help you control the weight, blood pressure and cholesterol. Eating one or two servings of fish a week also is beneficial as fish contains omega fatty acids which are good for your heart.
Maintain a healthy weight: Being overweight increases the risk of coronary artery disease. Weight loss is especially important for people who have large waist measurements - more than 40 inches for men and more than 35 inches for women - because people with this body shape are more likely to develop diabetes and heart disease.
Manage stress: Reduce stress as much as possible. Practice healthy techniques for managing stress, such as muscle relaxation and deep breathing.
In addition to healthy lifestyle changes, remember the importance of regular medical checkups. Some of the main risk factors for coronary artery disease - high cholesterol, high blood pressure and diabetes - have no symptoms in the early stages. Early detection and treatment can set the stage for a lifetime of better heart health.
