Coronary Artery Disease (CAD): What you need to know

Our heart also needs blood constantly. The heart is a muscle. So the veins that carry blood to those muscles are called "coronary arteries." When things like oil and cholesterol get stuck inside these veins, and the veins gradually become blocked, it is called " coronary artery disease (CAD). This is often the main reason for heart attacks.

How does CAD develop?

Imagine a road that is gradually narrowing. Traffic slows down a bit, but it doesn't stop. Just like that, things like oil and cholesterol build up inside the coronary arteries, and the arteries gradually narrow (plaque buildup). This is called " atherosclerosis ." This can happen gradually over years.

But, what if you suddenly put a big barrier in the middle of that road? All the vehicles would stop, right? Just like that, if this plaque suddenly bursts and a blood clot forms there, the artery will be completely blocked. Then the blood will not reach the heart muscles. That's what we call a heart attack.

Types of CAD

There are two main types of CAD:

1. Stable Ischemic Heart Disease : This is a long-term, progressive type. The arteries gradually become narrowed over many years. Although you may experience some symptoms, you can still lead a normal life.
2. Acute Coronary Syndrome: This is a dangerous condition that comes on suddenly.Fatty deposits in the arteries burst, forming a blood clot, completely cutting off blood flow to the heart. This is called a heart attack.

What are the symptoms? (Symptoms)

There may be no symptoms for a long time. But as the arteries become narrower, you may experience symptoms like:

• Chest pain/ difficulty (Angina): This is the most common symptom. You may feel a tightness or squeezing in your chest when you are tired, walking, or angry. This will subside with rest or medication (Nitroglycerin).
• Shortness of breath : You may feel tired and short of breath even after doing something small.

Sometimes, there may be no symptoms until a heart attack occurs. That's why it's called the "silent killer."

Causes and Risk Factors of CAD

Main cause: Atherosclerosis

Atherosclerosis is when things like cholesterol and calcium build up in the artery walls, gradually narrowing the arteries.

Risk Factors:

People with the following are more likely to develop CAD:

• Age: The risk is higher for men over 45 years of age and for women over 55 years of age.
• Family members: If family members (father, mother, siblings) have had heart problems at a young age.
• Genetics: If your family has this disease, you are more likely to develop it too.
• Lifestyle:
  • Eating too much oil and sugar.
  • Eating less vegetables and fruits.
  • Not exercising.
  • Smoking , drinking alcohol.
  • Being constantly stressed.
• Other diseases:
  • High blood pressure
  • Diabetes
  • High cholesterol
  • Obesity
  • Chronic kidney disease
  • HIV/AIDS
  • Sleep apnea
• Special issues related to women
  • Early menopause
  • Gestational diabetes

How is CAD diagnosed? (Diagnosis)

The doctor will examine you (physical exam), ask about your symptoms, and ask about your family history, and may perform the following tests:

• Blood tests: Check cholesterol and sugar levels.
• ECG (Electrocardiogram): A test that measures the electrical activity of the heart.
• ECHO (Echocardiogram): A scan of the heart.
• Stress Test: The heart's function is checked by having you walk on a treadmill.
• Angiogram: A dye is injected into the arteries of the heart and an X-ray is taken to see how much of the artery is blocked.
• CT Coronary Angiogram: This is also a test that uses a dye.
• Cardiac MRI: A test that takes clear images of the heart.
• Coronary Calcium Scan:They check how much calcium is in the coronary arteries.

Treatment of CAD

Lifestyle Changes:

• Stop smoking: This is the most important thing.
• Heart-healthy diet: Eat more vegetables, fruits, and whole grains. Reduce oil, meat, and sugar. The Mediterranean diet is a good example of this.
• Exercise: Ask your doctor for advice and walk for at least 30 minutes a day, at least 5 days a week.
• Weight management: Lose weight if you are overweight.
• Stress management: You can do things like yoga and meditation.

Medications:

• Cholesterol-lowering drugs (Statins)
• Medicines that prevent blood clotting (Aspirin, Clopidogrel)
• Antihypertensives
• Chest pain medication (Nitroglycerin, Ranolazine)

Procedures and Surgeries:

• Angioplasty and Stent: A tube is inserted into the blocked artery, inflated to open the artery, and a stent is placed to prevent it from closing again.
• Bypass Surgery (CABG): In addition to the blocked artery, another artery is used to create a path for blood to flow to the heart.

How to prevent CAD? (Prevention)

• Avoid smoking.
• Eat heart-healthy foods.
• Exercise often.
• Control your weight.
• Control high blood pressure, diabetes, and cholesterol.
• Manage stress.
• Ask your doctor about your risk of heart disease.

Living with CAD (Living with Coronary Artery Disease)

Mental Health

It's normal to feel sad, scared, and angry when you find out you have CAD. But it's not easy to live with these feelings. So if these things are bothering you, see a counselor. Or, join a support group with people who have CAD like you.

Cardiac Rehabilitation

Cardiac rehabilitation is very important for people with CAD. It teaches you how to exercise properly, what foods to eat, and how to manage stress. It is very helpful for people who have had a heart attack or have heart failure.

Regular check-ups

If you have CAD, you should see your doctor regularly. He or she will monitor your condition, make changes to your medications, and recommend any necessary tests. You may also be referred to a cardiologist.

Can CAD be completely cured?