The heart is a strong, muscular pump that circulates 3,000 gallons of blood through the body daily. The heart needs its own blood supply in order to pump efficiently. Coronary artery disease, or CAD, refers to blockage of the arteries that supply the heart. According to the Texas Heart Institute, the most common cause of CAD is the build-up of plaque within the artery walls due to atherosclerosis. When plaque blocks the coronary arteries, blood supply to the heart decreases.
Medical Management
Coronary artery disease is diagnosed through a series of medical tests performed by your physician, including an electrocardigram and echocardiography. The first line of treatment is typically medication. The Cleveland Clinic states that medications can relieve some of the heart's workload. The medication prescribed will depend on the severity of CAD and other health factors. Aspirin can help prevent the formation of blood clots, nitroglycerin acts to relax the arteries and allow better blood flow, beta blockers and calcium channel blockers also improve blood flow, while ACE inhibitors help increase the survival rate following a heart attack. Along with heart medication, antihyperlipemic medication may be prescribed to lower cholesterol.
Catheter Procedures
Transluminal angioplasty, also called balloon angioplasty, is a common procedure performed to treat severely blocked coronary arteries. According to Columbia University Medical Center, transluminal angioplasty is also used to treat blocked arteries in other parts of the body. A long catheter is threaded up through the artery to the spot where the blockage occurs. It has a balloon-like tip that is inflated, opening the artery, flattening the plaque and increasing blood flow. An atherectomy may then be performed, which slices or vaporizes away part of the plaque.
Cardiac catheterization is performed in a similar fashion: a catheter is threaded up to the heart through the femoral artery. An x-ray is taken to determine where the blockage is and if necessary, a stent, a small mesh tube impregnated with medication, is inserted to hold the artery open. These procedures are considered non-invasive and are performed under local anesthetic.
Coronary Artery Bypass Grafting Surgery
According to New York-Presbyterian, coronary artery bypass grafting surgery is the most common surgery performed to treat coronary artery disease. Another blood vessel from the patient's own body, usually from the thigh or chest, is removed and grafted above and below the blockage, creating a bypass around it. This acts to restore proper circulation to the heart. Coronary artery bypass is major surgery, requiring general anesthetic. During this procedure, the heart is stopped and the blood shunted through a heart-lung machine while the grafting is done.
Therapeutic Lifestyle Changes program
If you have high cholesterol along with CAD, your physician may recommend a therapeutic lifestyle changes program, or TLC. According to the National Heart Lung and Blood Institute, TLC consists of eating a heart-healthy diet, including lots of whole grains with soluble fiber, certain fruits, vegetables and fish, while restricting sodium and alcohol intake. The other two parts of the TLC program are weight management and physical activity.
