Coronary Atherosclerosis: Symptoms, Complications and Treatment

Contents

In this article we will look at:

• What is coronary atherosclerosis?
• How does coronary atherosclerosis occur?
• Who is prone to coronary atherosclerosis?
• What are the symptoms of coronary atherosclerosis?
• How is coronary atherosclerosis diagnosed?
• What are the complications of coronary atherosclerosis?
• What is the treatment for Coronary Atherosclerosis?

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What is coronary atherosclerosis?

Coronary atherosclerosis is a condition which affects the arteries that supply oxygen-rich blood to the heart. In this condition, plaque builds up on the inner artery walls and over time the arteries get clogged and harden. The hardened arteries are not able to dilate to their full capacity to let the blood flow through into the heart.

How does coronary atherosclerosis occur?

The coronary arteries or blood vessels carry oxygenated blood to the heart.

Over time, a combination of cholesterol, fat, calcium and other substances found in the blood accumulate in the walls of the arteries forming deposits called plaque. The plaque narrows the arteries and hardens them. The hardened arteries are unable to dilate to their fullest capacity, thereby reducing the flow of oxygen and blood supply to parts of the heart. At times, due to the plaque, the arteries can get completely blocked, which results in heart attack or heart failure. The plaque also tends to burst, forming blood clots, which block the blood flow to the heart. This can cause chest pain, also known as angina, or a heart attack.

Who is prone to coronary atherosclerosis?

The factors which can put people at a risk of developing coronary atherosclerosis include:

• leading a sedentary lifestyle
• excessively smoking and drinking
• diabetes
• high levels of cholesterol
• an unhealthy diet
• high blood pressure/hypertension
• depression

Tobacco consumption is a major concern, with almost 40% of the heart patients in India being chain-smokers. 38% of the heart patients suffer from high blood pressure/hypertension, while 30% of them also suffer from diabetes.

What are the symptoms of coronary atherosclerosis? How is coronary atherosclerosis diagnosed?

Patients with clogged arteries complain of :

• severe chest pain, which gets worse with emotional stress or vigorous physical activity
• irregular heart palpitations
• shortness of breath
• nausea
• dizziness and weakness

Diagnosis

Clogged arteries can be diagnosed using several methods such as:

• General Physical Exam: During the general physical check-up, the doctor using the stethoscope, listens for an abnormal whooshing sound made by the heart which indicates poor blood flow due to plaque.
  
  
  
• Angiography: which uses dye and special x-rays to reveal blocked arteries
  
  
  
• Computed Tomography (CT) Scan: which are computer generated pictures of the narrowed and hardened arteries
  
  
  
• Electrocardiogram (ECG/EKG): which scans the electrical impulses of the heart and displays how fast, or irregular the heartbeat is.
  
  
  
• Echocardiograph: utilizes sound waves to create moving images of the heart and shows how the heart is working.

What are the complications of coronary atherosclerosis?

The complications of coronary atherosclerosis include:

• chest pain or angina
  
  
  
• irregular heartbeat
  
  
  
• limited blood flow to vital organs, and hands and legs, thus affecting the efficient functioning of the different parts of the body
  
  
  
• heart attack
  
  
  
• heart failure
  
  
  
• sudden death
  
  
  
• erectile dysfunction
  
  
  
• claudication or pain in the legs while walking

What is the treatment for Coronary Atherosclerosis?

Medical Treatments

If medicines are not able to restore normal blood flow through your arteries, your cardiologist may suggest the following procedures:

• Balloon Angioplasty: In the balloon angioplasty procedure the doctor inserts a thin tube called catheter into your blocked, or narrow plaque-ridden artery. Then, he inserts a wire with an attached deflated balloon through the catheter into the blocked area. Once inside, the balloon is inflated and deflated a number of times, which forces open the blocked area, as the plaque is compressed against the arterial walls. The wire with the balloon is then pulled out and the blood flow through the artery returns to normal.

• Coronary Intravascular Stent Placement: Depending on the severity of your condition, a stent may be placed in the blocked area of the artery by the doctor, so that the area continues to remain open and blood can flow through with ease. The stent is like a wire mesh tube, made of metal, which keeps the artery open at all times. Stents can be placed in multiple locations depending on the number of blocked arteries. The stents remain for life in the arteries.

• Coronary Artery Bypass Graft Surgery (CABG): Not all blocks in the arteries can be treated with angioplasty. If you have multiple blocks or have blocks which are inconveniently placed, the doctor may advise coronary artery bypass grafting. This is a process, in which, the doctor will take a healthy artery, or vein, from any part of the body, including, legs, chest, or the wrist, and graft or connect one end of the vein above the blocked artery, and the other end below the block. This way, the blood flows through the newly grafted artery and goes around or bypasses the blocked part of the coronary artery to reach the heart.

Exercise

The plaque build-up in the arteries is caused largely by, LDL or bad cholesterol. There is also good cholesterol or HDL which acts more or less like a scavenger, hunting for bad cholesterol through the arteries and pushing it all down to the liver, where they are broken down and eliminated from the body as waste. Exercising regularly promotes blood circulation, and helps the good cholesterol or HDL to grow, which automatically brings down the level of bad cholesterol, thereby bringing down the risk of any heart disease. Exercising strengthens the muscles and few people are aware that the heart too is a muscle. In addition, exercising also promotes the growth of new blood vessels, which can bypass the blocked blood vessels making blood circulation easier and smoother throughout the body.

It is advisable to consult with your cardiologist, regarding which kind of exercises will suit you the most before starting an exercise regimen.