The heart’s clogged pipes

Coronary artery disease can lead to a number of life-threatening conditions

According to the World Health Organization (WHO), in 2008 7.25 million people died from coronary artery disease (CAD) around the world, and it is the number one killer of men and women in the United States. CAD is caused by the hardening of the coronary arteries, responsible for supplying the heart with blood necessary for it to function. Though many risk factors for CAD are out of our control, including gender, family history and age, many others aren’t.

The heart’s plumbing

The heart is a very strong muscular pump with pipes (blood vessels) that lead to it and from it, and requires oxygen-rich blood to function, carried to it by the coronary arteries. And just as your kitchen sink, over time, becomes clogged with food, grease and rust, the same happens with the pipes of the heart, by something called plaque. (The technical word for this is atherosclerosis.) This plaque hardens and narrows the coronary arteries, limiting the amount of blood the heart receives. This is coronary artery disease. If the blood supply to the heart is completely cut off, a heart attack occurs. Over time CAD can lead to heart failure and arrhythmias.

Signs of trouble

Initially CAD does not present any symptoms, but as the arteries become narrower, the first sign that something may not be quite right with the heart is angina, or chest pain. Another symptom of CAD is shortness of breath, to the point of extreme fatigue during exertion. (If you struggle to catch your breath walking up a flight of stairs and then need to sleep three hours to recover, it might be time to check in with your physician.) Unfortunately the most obvious symptom of coronary artery disease is one you hope to avoid—a heart attack.

Risk factors

High blood pressure, high cholesterol, diabetes, and being obese all contribute to increasing the chances of a person developing coronary artery disease. Smoking is another factor. If there is family history of heart disease, it is important to maintain a healthy lifestyle to combat the power of genetics. Losing as little as ten kilograms can reduce a person’s blood pressure by 20 mmHg systolic and dramatically reduce the chances of developing diabetes, a gateway to a multitude of serious diseases.

Fixing a broken heart

If lifestyle changes don’t work, the most common and simplest approach to treatment of coronary artery disease is through medication, often a combination to tackle the various symptoms of CAD, including beta-blockers to treat angina, statins for high cholesterol and heparins to prevent blood clots. Your cardiologist may recommend a dosage of aspirin to help prevent a heart attack or stroke if you are at risk for either.


For patients with severe blockages or debilitating angina, a catheter may be inserted through a blood vessel and then expanded to open up the blocked artery (angioplasty). Sometimes a stent—a small mesh tube—is placed in the artery to prevent future blockages after an angioplasty. If this procedure fails or complications occur, a coronary artery bypass grafting (CABG, pronounced just like the vegetable) is carried out to graft a healthy blood vessel onto the blocked artery, bypassing it altogether.

Sources:

• http://www.mayoclinic.com/health/coronary-artery-disease/DS00064
• http://my.clevelandclinic.org/heart/disorders/cad/default.aspx

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• Skipping hearts
• The silent killer
• To medicate or not to medicate
• To pump or not to pump?
• The fight for his life
• The pressure is on

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