Coronary artery disease

Diagnosis

To diagnose coronary artery disease, a doctor will conduct a thorough examination that typically includes discussing your medical history and any symptoms you may be experiencing. Additionally, blood tests may be conducted to assess your overall health.

Tests

The following tests can be used to detect or track coronary artery disease:

• Electrocardiogram (ECG or EKG). The electrical activity of the heart is measured by this rapid and painless examination. It can demonstrate the heart rate. If you are experiencing or have had a heart attack, your provider can look at signal patterns to detect this.
• Echocardiogram. In this examination, the heart’s beating is visualized using sound waves. An echocardiography can demonstrate how the blood flows through the heart and heart valves.

Weak heartbeats could be the result of an oxygen shortage or a heart attack. This could indicate coronary artery disease or another illness.

• Exercise stress test. If you frequently experience symptoms when exercising, your doctor may ask you to walk on a treadmill or ride a stationary bike while getting an ECG. When you perform these exercises while having an echocardiogram, the exam is known as a stress echo. If you are unable to exercise, you may be prescribed drugs that stimulate the heart similarly to exercise.
• Nuclear stress test. Like an exercise stress test, this test combines ECG recordings with pictures. How blood flows to the heart muscle at rest and during stress can be seen in a nuclear stress test. IV administration of a radioactive tracer. On images, the tracer makes the heart arteries more visible.
• Heart Computed Tomography (CT) scan. Calcium buildup and blockages in the heart arteries can be seen on a heart CT scan. The arteries may become narrowed by calcium deposits.

During this test, dye may be infused via IV, which aids in producing precise images of the cardiac arteries. The examination is known as a CT coronary angiography if dye is utilized.

• Cardiac catheterization and angiogram. A cardiologist gently inserts a flexible tube (catheter) into a blood vessel, typically in the wrist or groin, during cardiac catheterization. The catheter is carefully guided to the heart. X-rays aid in guiding it. Through the catheter, dye flows. The dye highlights the obstructions and improves the visibility of blood vessels on the photographs.

A balloon on the catheter’s tip can be inflated to open an artery if you need to treat an artery blockage. Usually, an artery is kept open with the aid of a mesh tube (stent).

Treatment

Changing one’s lifestyle to stop smoking, eat better, and exercise more is typically the first line of treatment for coronary artery disease. Medication and treatments are sometimes required.

Medications

To treat coronary artery disease, a variety of medications are available, including

• Aspirin. Aspirin aids in blood thinning and the prevention of blood clots. For some persons, daily low-dose aspirin therapy may be suggested as the primary prevention of a heart attack or stroke.

Aspirin use on a regular basis may cause serious adverse effects, such as bleeding in the intestines and stomach. Aspiring should not be used prior to consultation with a doctor.

• Cholesterol drugs. Drugs can lower bad cholesterol and lessen the formation of plaque in the arteries. Statins, niacin, fibrates, and bile acid sequestrants are examples of such medications.
• Beta blockers. These medicines lower heart rate. Additionally, they lower blood pressure. Beta blockers may lower your risk of having another heart attack if you’ve already had one.
• Calcium channel blockers. If you are unable to use beta blockers or if they don’t work for you, one of these medications can be suggested. It can aid in reducing the symptoms of chest discomfort.
• Angiotensin-Converting Enzyme (ACE) inhibitors and Angiotensin II Receptor Blockers (ARBs). These drugs reduce blood pressure. They could prevent the progression of coronary artery disease.
• Nitroglycerin. Heart arteries are widened with this medication. It can lessen or reduce chest pain. You can get nitroglycerin as a tablet, spray, or patch.
• Ranolazine. This medicine helps those who are suffering from angina. It can be prescribed along with beta blockers or in place of them.

Surgeries or other procedures

A clogged artery occasionally needs to be treated surgically. Options include:

• Coronary angioplasty and stent placement. The goal of this surgery is to open blocked cardiac arteries. Percutaneous Coronary Intervention (PCI) is another name for it. A thin, flexible tube (catheter) is guided to the constricted section of the heart artery by the cardiologist. To help expand the narrowed artery and enhance blood flow, a small balloon is inflated.

During angioplasty, a tiny wire-mesh tube (stent) may be inserted into the artery. The artery is kept open by the stent. It lessens the possibility of the artery narrowing once more. Some stents help keep the arteries open by gradually releasing medication.

• Coronary Artery Bypass Graft surgery (CABG). To construct a new path for blood to flow around the blockages. This “detour” procedure reinstates blood flow to the heart. CABG is a surgical procedure performed on individuals with multiple narrowed heart arteries, typically involving open-heart surgery.