Dr Swapnil Mate Cardiologist

What Are Coronary Arteries?

3-D echocardiography is done for those who :

The coronary arteries supply oxygen-rich blood to the heart muscle. The functioning of the arteries is responsible for the continuous flow of oxygen and nutrients to the heart. The left and the right coronary arteries originate from the aorta, where the left one arises from the left leaflet of the aortic valve and provides blood to the left side of the heart while the right coronary artery originates from the right leaflet of the aortic valve. The coronary arteries are the blood vessels that engulf the heart, regulating its normal function.

Signs And Symptoms

The signs and symptoms include :

Chest pain(angina) - described as a sensation of heartburn, tightness, pressure, or squeezing. Chest pain is the first and the most common symptom.
Shortness of breath - As the heart rate changes, the breathing pattern will also change simultaneously. If the heart is not pumping blood efficiently, this causes shortness of breath. Therefore, shortness of breath mainly arises due to low oxygen in the blood.
Sweating
Fatigues, dizziness
Nausea or vomiting
Cardiogenic shock due to defects in the ventricles of the heart
Heart palpitations(irregular beatings of the heart)
Cold sweats
Pain in the shoulders, jaw, neck, arms.
Heart attack, also known as Myocardial Infarction, is a condition that arises when blood flow to the coronary artery stops or reduces which causes damage or 'death' to the cardiac muscle(myocardium).

Risk Factors Associated With Coronary Artery Disease

The risk factors include :

Genetics - genes control every part of the circulatory system. If the parent went through narrowing of the arteries during their pregnancy, the child is mostly like to develop coronary artery disease since the child shares the DNA of its mother.
Increasing age - since during the period of late adulthood, the body's genetic programming reduces, the heart's capacity to pump blood throughout the circulatory system also reduces.
Smoking - actively smoking or increased exposure to smoke increases the risk of having coronary artery disease because smoking makes the blood sticky, and it is most likely to clot, which can obstruct the blood flow to the heart. It also lowers good cholesterol in the body.
High blood pressure - High blood pressure or hypertension makes the coronary arteries less elastic, which reduces blood flow to the heart. This makes the heart work harder, causing stiffening of the heart muscle and death of the cells present in the cardiac muscle.
Cholesterol - The total number of cholesterol in the blood also affects the heart. There are two types of cholesterol, High-density lipoprotein, and low-density lipoprotein. The high-density lipoprotein is good for the heart since it helps in removing cholesterol deposits from the coronary arteries and transports them to the liver, which then removes them from the body. The low-density lipoprotein transports cholesterol from the liver to other tissues and cells, which use this as energy. Low-density lipoprotein, along with triglycerides, gets deposited in the arterial wall, obstructing the blood flow to the heart. This can result in coronary artery disease.
Obesity - Obese individuals require more blood so that they can carry oxygen and nutrients to the tissues to function efficiently. This puts pressure on the heart to work harder, which stiffens the heart muscle, reducing blood flow.
Diabetes - When your body does not respond to insulin or does not produce much insulin, glucose remains in the bloodstream. This causes an increase in the blood sugar level. An increase in blood sugar damages the walls of coronary arteries due to fatty deposits in the walls.
Lack of physical exercise - Lack of physical activity increases blood cholesterol, blood pressure, and blood sugar levels.
Stress - A person can react to stress in ways that can contribute to a heart attack, for example, smoking, alcohol consumption. Overeating, etc.
Sleep - Not getting the required amount of sleep can lead to a possible occurrence of coronary artery disease because while sleeping, your blood pressure reduces, maintaining its optimum level. If a person does not get enough sleep or does not sleep at all, it puts pressure on the heart to work harder. This stiffens the heart muscle, causing damage to the tissues of the muscle.

Further Complications

Coronary artery disease, if not cured, can lead to serious medical conditions like:-

Heart Attack - Heart attack or myocardial infarction happens when blood supply to the heart suddenly stops. Myocardial infarction means the death of a heart muscle, which means a heart attack takes place when blood is not reaching the heart muscle, which causes the heart muscle to stop functioning or die. This mainly happens due to plague (cholesterol) deposits in the walls of the coronary artery, which block the passage of blood flow to the heart muscle. If the blood supply to a heart muscle is very low, it ruptures the entire pumping system of the heart, which includes blood vessels, arteries, capillaries, and veins. Symptoms of a heart attack include chest pain, shortness of breath. In some situations, the skin turns blue since the organs of the body are not getting enough blood.
Heart Failure - Congestive cardiac failure can take place when the heart has completely lost its ability to pump blood to other organs of the body. Heart failure results in developing excess fluid in and around the lungs, coughing blood, shortness of breath, swelling of the abdomen, legs, and ankles. Even though in some situations, a heart attack can be cured by restoring blood supply to the heart muscle, in the case of heart failure, the only treatment is replacing the heart or installing an artificial pacemaker which might help the heart to function well.
Cardiac Arrest - happens when there is a sudden loss of blood in the body due to failure of the heart to pump blood. It requires immediate action like performing CPR to restore the lack of oxygen in the body.
Acute coronary syndrome - occurs when there is a reduction in the blood flow to the cardiac muscle that decreases its functions or leads to death of the cardiac muscle tissues.
Arteriosclerosis - loss of elasticity of the walls of the coronary arteries.
Arrhythmia- a condition referring to abnormalities in heartbeats due to issues in the electrical conduction system of the heart. When the heart beats too slow, it is known as bradycardia, and when beats too fast, it is known as tachycardia.
Cardiomyopathy - this is referred to as defects in the cardiac muscle. Any defect in the cardiac muscle can interfere with the cardiac rhythm, leading to arrhythmia.

Prevention

This includes:-

Electrocardiography - electrocardiography measures the electrical activity of the heart by placing electrodes on the skin. This detects the minute changes that take place as a result of the contraction and relaxation of the cardiac muscle. This helps to check the electrical activity of the heart.
Echocardiogram - In this procedure, a device called a transducer is placed on the top of the chest and ultrasonic waves are sent to the heart bounce off and show the live image of the heart, using a monitor. Intravascular ultrasound uses a catheter instead of a transducer to capture the images of coronary arteries. This helps the specialists to see whether the blood flow is obstructed or not.
Blood Tests - blood tests like Low-Density Lipoprotein and High-Density Lipoprotein test, C-Reactive Protein test, International Normalized Ratio(INR) test, Blood pressure test, etc, are done to check the amount of glucose, cholesterol, sodium, and calcium deposits in the bloodstream.
Cardiac Stress test - this test is done by an exercise physiologist who checks the heart's response to vigorous exercises by monitoring the heart's electrical activity.
Genetic testing - this is done when the disorder is inherited from the parent. This is done only on first degree relatives, like father, mother, siblings, etc
Catheter Ablation - This procedure involves inserting a catheter through any blood vessels(femoral or radial artery). Electrical impulses are sent through the catheter to induce arrhythmia and local heating or freezing is done to destroy the tissue that is causing this condition.
SGLT2 inhibitors or gliflozins reduce blood glucose levels without activating the release of insulin from the pancreas. They also reduce blood pressure in diabetic patients.
GLP-1 helps reduce obesity, hypertension, and blood sugar levels.
PCSK9 inhibitors are also given to reduce cholesterol levels or low-density lipoprotein in the patient's circulatory system
High doses of omega-3 can help reduce triglycerides and cholesterol from the bloodstream.
Niacin, a B-vitamin, helps raise good cholesterol in the body.
Lifestyle changes - this involves adhering to a strict diet plan that does not include foods that are high in cholesterol. Quitting consumption of alcohol and smoking can lead to a speedy recovery. Engaging in physical activities regularly can improve cardiac health. It can also help lose weight since weight loss can keep cholesterol, blood sugar, and blood pressure at optimum levels.
Primary Angioplasty - People who are suffering from severe coronary artery diseases require this treatment if the condition worsens, This procedure involves widening the coronary artery walls where cholesterol deposits are present. The narrowed areas of the artery walls are widened by using a long, flexible tube (catheter) and placing it in between the plaque deposits. The catheter is inserted into the main blood vessel of the lower arm and passed carefully into the aorta (the artery that provides blood to the heart muscles from its blood supply). A balloon is placed at the tip of the tube in such a way that when it is blown, it forces the narrowed areas of the artery to wide open. This clears the passage of the coronary artery walls, allowing blood to flow to the heart.
Valvuloplasty - This treatment is given to infants who are suffering from heart disease. It is done by placing a catheter through the blood vessel into the heart. The balloon is placed at the tip of the catheter. When it is blown, it forces the valve to open. The balloon valvuloplasty is done in mitral, aortic, or pulmonary valves.
Coronary Thrombectomy - This treatment involves removing a blood clot(thrombus) from the blood vessel. The formation of blood clots can take place when a person has a heart attack. When the plague deposits in the heart or brain, the clotting process starts which obstructs the blood flow to the heart muscle. Since the heart muscle is not getting the oxygenated blood, the heart muscle stops functioning or dies.
Alcohol septal ablation - This procedure involves injecting alcohol(ethanol) into the part where the heart muscle has thickened. It kills the cells of the muscle and shrinks the diseased tissue and restores blood flow to the heart muscle.
Atherectomy - This treatment provides an alternative to coronary angioplasty where it cuts the plague from the wall of the coronary arteries, instead of pushing it into the wall

Dr. Swapnil Mate's Cardiology clinic specializes in treating coronary artery diseases and identifying the signs and symptoms that contribute to a possible heart failure. Their cardiology team is trained to eradicate the risk factors that hamper the cardiac health of the patient. Consult Dr. Swapnil Mate for the best medical assistance.

What Does The Term 'Coronary Artery Disease' Mean?