Coronary artery disease
Coronary artery disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing deposits (plaque) in your arteries and inflammation are usually to blame for coronary artery disease.
When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.
Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack. But there’s plenty you can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.
If your coronary arteries narrow, they can’t supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause any coronary artery disease symptoms. As plaque continues to build up in your coronary arteries, however, you may develop coronary artery disease signs and symptoms, including:
- Chest pain (angina).You may feel pressure or tightness in your chest as if someone were standing on your chest. This pain referred to as angina usually occurs on the middle or left side of the chest. Angina is generally triggered by physical or emotional stress.
The pain usually goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be fleeting or sharp and felt in the neck, arm or back.
- 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.
- Heart attack.A completely blocked coronary artery will cause a heart attack. The classic signs and 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 and symptoms of a heart attack, such as neck or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.
When to see a doctor
If you suspect you’re having a heart attack, immediately call 911 or your local emergency number. If you don’t have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort.
If you have risk factors for coronary artery disease — such as high blood pressure, high cholesterol, tobacco use, diabetes, a strong family history of heart disease or obesity — talk to your doctor. He or she may want to test you for the condition, especially if you have signs or symptoms of narrowed arteries.
Development of atherosclerosis
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:
- High blood pressure
- High cholesterol
- Diabetes or insulin resistance
- Sedentary lifestyle
Once the inner wall of an artery is damaged, fatty deposits (plaque) 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 the plaque 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.
Risk factors for coronary artery disease include:
- Simply getting older increases your risk of damaged and narrowed arteries.
- Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.
- Family history.A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55 or if your mother or a sister developed it before age 65.
- People who smoke have a significantly increased risk of heart disease. Exposing others to your secondhand smoke also increases their risk of coronary artery disease.
- High blood pressure.Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel through which blood can flow.
- High blood cholesterol levels.High levels of cholesterol in your blood can increase the risk of formation of plaque and atherosclerosis. High cholesterol can be caused by a high level of low-density lipoprotein (LDL) cholesterol, known as the “bad” cholesterol. A low level of high-density lipoprotein (HDL) cholesterol, known as the “good” cholesterol, can also contribute to the development of atherosclerosis.
- Diabetes is associated with an increased risk of coronary artery disease. Type 2 diabetes and coronary artery disease share similar risk factors, such as obesity and high blood pressure.
- Overweight or obesity.Excess weight typically worsens other risk factors.
- Physical inactivity.Lack of exercise also is associated with coronary artery disease and some of its risk factors, as well.
- High stress.Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for coronary artery disease.
- Unhealthy diet.Eating too much food that has high amounts of saturated fat, trans fat, salt and sugar can increase your risk of coronary artery disease.
Risk factors often occur in clusters and may build on one another, such as obesity leading to type 2 diabetes and high blood pressure. When grouped, certain risk factors put you at an even greater risk of coronary artery disease. For example, metabolic syndrome — a cluster of conditions that includes elevated blood pressure, high triglycerides, low HDL, or “good,” cholesterol, elevated insulin levels and excess body fat around the waist — increases the risk of coronary artery disease.
Heart Disease is one of the top killers in our modern world, we will continue this article in next edition.
Stay healthy until we meet again.