The coronary arteries are the blood vessels that supply blood to the heart. The heart is composed of muscle that is constantly working and needs a relatively high amount of oxygen in the blood in order to function correctly. Without it, the heart will fail. A completely blocked coronary artery causes a heart attack. A partially blocked coronary artery can cause pain and shortness of breath with activity. Several disease processes can affect the coronary arteries.
Atherosclerosis
Atherosclerosis refers to plaque build up and hardening of the arteries. Fatty material can collect in the walls of the coronary arteries. Once there, it attracts immune cells and calcium, hardening and narrowing the artery. The plaques can narrow the arteries so much that blood supply is restricted to the heart, causing chest pain with activity called angina. If one of the arteries is completely occluded it can cut off the blood supply completely, leading to a heart attack. Some of the risk factors for atherosclerosis include a family history of the disease, tobacco use, diabetes, age, high blood pressure and cholesterol.
Coronary Artery Spasm
Coronary artery spasm, also known as variant or Prinzmetal's angina, is a condition of the coronary arteries that can cause chest pain during activity or rest. In this disorder, the coronary arteries spontaneously narrow and then return to their normal state. The cause is unknown. Breathing rapidly, cocaine and tobacco are known triggers.
Vasculitis
Vasculitis refers to inflammation of the blood vessels. The inflammation in vasculitis is from the immune system affecting the blood vessels. There are many different types. Churg-Strauss syndrome is associated with allergies and asthma that tends to occur during middle age. The affected blood vessels tend to damage the nerves, lungs, kidneys, skin and heart. Giant cell arteritis tends to affect people over age 50, more often women. It frequently affects the temporal artery at the side of the head, causing headaches and can lead to blindness but can also affect the coronary arteries. Polyarteritis nodosa tends to affect older patients as well and affects the arteries of the gastrointestinal tract, nerves, skin, kidneys, genitals, eyes and heart.
References
- "Robbins & Cotran Pathologic Basis of Disease"; Vinay Kumar MBBS MD FRCPath, Abul K. Abbas MBBS, Nelson Fausto MD, and Jon Aster MD; 8th Ed 2009
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci et al.; 17th Ed 2008
