Talking About Coronary Artery Disease

Many people with heart failure also have coronary artery disease (CAD). So I thought it would be neat to investigate CAD. What is it? What causes it? How is it treated? Can it be prevented? Here’s what to know.

To understand CAD, we must have some basic anatomy.

Basic anatomy

Left heart: The left side of your heart receives freshly oxygenated blood from your lungs. It then pumps this blood through your arteries.¹

Arteries: These are blood vessels that contain oxygenated blood.¹

Aorta: This is your largest artery. Once blood leaves your left heart, it immediately travels through your aorta.¹

Coronary arteries: These arteries travel from your aorta directly to your heart. In this way, the first organ to receive a fresh supply of oxygen with each heartbeat is your heart. In this way, your heart feeds itself too. This is important, as your heart is a pretty important organ.^1-2

What is coronary artery disease?

It basically means that changes have occurred inside your coronary arteries. The change is often referred to as damage or, as the name implies, disease. Walls of blood vessels become thicker than normal. And this slows the flow of blood through them. This makes it so less oxygenated blood gets to the heart. Other terms for it are Coronary Heart Disease (CHD), Ischemic Heart Disease, and atherosclerosis.^1-6

Here are some related definitions:

Atherosclerosis: This is the main cause of CAD. It is sometimes referred to as “hardening of the arteries," or "narrowing of the arteries.” It is caused by plaque buildup along the walls of your arteries. This plaque contains cholesterol deposits. The plaque buildup occurs over a period of many years. It causes artery walls to become thicker than normal, making the opening (lumen) inside the artery narrow. This can become severe enough so that is obstructs and slows the flow of blood to the heart.^3,5

Myocardial Infarction (MI): A more common term for this is a heart attack. This is what occurs when a coronary artery becomes  almost completely or completely obstructed. This prevents oxygenated blood from getting to the area of the heart that the affected coronary artery feeds. Tissues in the affected area of your heart may die if it does not get enough oxygen.

Thrombosis. Atherosclerosis increases the risk that a clot may form along the walls of a an artery. This can also happen inside the coronary arteries. This clot may break loose and completely obstruct a coronary artery, causing a heart attack.^5-6

Ischemia. This is a medical term meaning tissue is not receiving enough oxygen.^{1, 5}

Angina. This is a medical term for chest pain. It is the feeling you get when your heart isn't getting enough oxygen. It can occur when a coronary artery is too narrow or completely blocked. This may be described as chest tightness, pressure, or pain. You can feel it in your chest. Although, it can also radiate to other areas such as your left arm, neck, back, or jaw.^4-6

Other complications: As CAD progresses, it can cause your heart to change rhythms. Both CAD and heart attacks may weaken the heart and cause heart failure. Other symptoms may include fatigue and shortness of breath with exertion.^4,6

What is the treatment?

This may include making lifestyle changes, such as eating healthy or quitting smoking if you smoke. It may also include your doctor prescribing medicine. There are also surgeries, such as heart bypass surgery. This is where veins from your legs, arms, or chest are removed. And they are then connected below and above the damaged coronary artery. This allows oxygenated blood to "bypass" the damaged area of the coronary artery.^4-8

What are other things to know?

Atherosclerosis starts when a fatty streak develops on the internal wall of arteries. This turns this wall a yellowish color. A combination of inflammation and plaque build-up makes the walls thicker than normal. These changes gradually occur over a series of many years. Initially there may be no symptoms. Although, when the narrowing becomes severe enough, this may cause angina.⁵

Genetics may play a role in heart disease. Although your lifestyle may also play a role in its development. Age, an unhealthy diet, smoking, other diseases, your environment, and hypertension (high blood pressure) are all suspected culprits increasing your risk for CAD.^4,6

Can it be prevented?

CAD is considered a preventable disease. Efforts can be made to reduce your risk. This may include managing other conditions, such as high blood pressure. It may involve eating a healthy diet and getting adequate exercise. It may include maintaining a healthy weight and not smoking. It may also include awareness of other risk factors for heart disease, such as a family history. Regular screening can lead to an early diagnosis, and this can lead to early treatment to slow the progression.^{4, 6, 9}

Researchers are working overtime

Heart disease is a very common ailment in the United States, and is the most common cause of death. CAD is the most common heart disease in the United States.^{6-7, 9}

Because of these facts, researchers are working overtime to learn more about it. They are searching for ways to prevent our children from ever getting CAD. They are working on creating better ways of screening people for it. And they are also working to develop or discover better treatments for helping those currently affected by CAD.