Coronary artery disease (CAD), also known as coronary heart disease (CHD) or coronary atherosclerosis, involves the progressive narrowing of the arteries that nourish the heart muscle. Often there are no symptoms, but if one or more of these arteries become severely narrowed, angina may develop during exercise, stress, or other times when the heart muscle is not getting enough blood. Your coronary arteries are the major blood vessels that supply your 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 your coronary arteries, causing your heart to receive less blood. A complete blockage, caused either by accumulated plaques or a ruptured plaque, can cause a heart attack. Because coronary artery disease often develops over decades, it can go nearly unnoticed until it produces a heart attack. Symptoms of CHD include (1) Chest pain (angina): You may feel pressure or tightness in your chest, as if someone were standing on your chest. The pain, referred to as angina, is usually triggered by physical or emotional stress. In some people, especially women, this pain may be fleeting or sharp and noticed in the abdomen, back or arm. (2) Shortness of breath: If your heart can't pump enough blood to meet your body's needs, you may develop shortness of breath or extreme fatigue with exertion. (3) Heart attack. If a coronary artery becomes completely blocked, you may have a heart attack. The classic symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. Women are somewhat more likely than men are to experience less typical signs of a heart attack, including nausea and back or jaw pain. Risk Factors
Coronary heart disease has a lot of causes. It 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, and radiation therapy to the chest. There are risk factors for this disease that can be helped and some that can’t be avoided. The risk factors that cannot be avoided are (1) Increasing age, (2) Gender, and (3) Heredity (including race). Age is a risk factor because over 83 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks. Gender is a risk factor because men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, it's not as great as men's. Heredity/race is a factor because children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. Heart disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is partly due to higher rates of obesity and diabetes. Most people with a strong family history of heart disease have one or more other risk factors. Risk factors that are basically lifestyle choices however, include: (1) tobacco smoke, (2) high blood cholesterol, (3) high blood pressure, (4) physical inactivity, (5) obesity, (6) weight, (7) diabetes mellitus, (8) stress, and (9) intake of too much alcohol. Prevention and Control
One of the best things to do to help prevent this disease is to see your health care provider regularly. The same lifestyle habits that can help treat coronary artery disease can also help prevent it from developing in the first place. Leading a healthy lifestyle can help keep your arteries strong, elastic and smooth, and allow for maximum blood flow....
References: 1) www.nhlbi.nih.gov -- National Heart, Lung, and Blood Institute
2) www.americanheart.org -- American Heart Association
3) www.acc.org -- American College of Cardiology
4) Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation. 2007; Published online before print February 19, 2007.
5) Smith SC Jr, Allen J, Blair SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation. 2006 May 16;113(19):2363-72. Erratum in: Circulation. 2006 Jun 6;113(22):e847.
6) Morrow DA, Gersh BJ. Chronic coronary artery disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald 's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 54.
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