Coronary Artery Disease


Also called: CAD, Coronary arteriosclerosis, Coronary atherosclerosis

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.
CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. As the buildup grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain ( angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts' blood supply, causing permanent heart damage.
Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.

Angina

Angina is chest pain or discomfort you get when your heart muscle does not get enough blood. It may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw or back.
Angina is a symptom of coronary artery disease (CAD), the most common heart disease. CAD happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow.
There are three types of angina: stable, unstable and variant. Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. It is does not go away with rest or medicine. It is a sign that you could have a heart attack soon.
Not all chest pain or discomfort is angina. If you have chest pain, you should see your health care provider.

Heart Attack

Also called: Also called: MI, Myocardial infarction
Each year over a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get help immediately. It's important to know the symptoms of a heart attack and call 9-1-1 if someone is having them. Those symptoms include
Chest discomfort - pressure, squeezing, or pain
Shortness of breath
Discomfort in the upper body - arms, shoulder, neck, back
Nausea, vomiting, dizziness, lightheadedness, sweating
These symptoms can sometimes be different in women.
What exactly is a heart attack? Most heart attacks happen when a clot in the coronary artery blocks the supply of blood and oxygen to the heart. Often this leads to an irregular heartbeat – called an arrhythmia - that causes a severe decrease in the pumping function of the heart. A blockage that is not treated within a few hours causes the affected heart muscle to die.

Coronary Artery Bypass Surgery


Also called: Also called: Bypass surgery, CABG, Coronary artery bypass graft
If you have coronary artery disease (CAD), the arteries that supply blood and oxygen to the heart muscle become hardened and narrowed. If lifestyle changes and medicines don't help, your doctor may recommend coronary artery bypass surgery.
The surgery uses a piece of a vein from the leg or artery from the chest or wrist. The surgeon attaches this to the coronary artery above and below the narrowed area or blockage. This allows blood to bypass the blockage. Some people need more than one bypass.
You may need bypass surgery for various reasons. Another procedure for CAD, angioplasty, may not have widened the artery enough. In some cases, the angioplasty tube can't reach the blockage.
A bypass also can close again. This happens in more than 10 percent of bypass surgeries, usually after 10 or more years.

Stent Procedure

What is a stent and how is one used?

A stent is a wire metal mesh tube used to prop open an artery during angioplasty. The stent is collapsed to a small diameter and put over a balloon catheter. It's then moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a scaffold. This holds the artery open. The stent stays in the artery permanently, holds it open, improves blood flow to the heart muscle and relieves symptoms (usually chest pain). Within a few weeks of the time the stent was placed, the inside lining of the artery (the endothelium) grows over the metal surface of the stent.

When are stents used?
Stents are used depending on certain features of the artery blockage. This includes the size of the artery and where the blockage is. Stenting is a fairly common procedure; in fact, over 70 percent of coronary angioplasty procedures also include stenting.

What are the advantages of using a stent?
In certain patients, stents reduce the renarrowing that occurs after balloon angioplasty or other procedures that use catheters. Stents also help restore normal blood flow and keep an artery open if it's been torn or injured by the balloon catheter.

Can stented arteries reclose?
Yes. Reclosure (restenosis) is also a problem with the stent procedure. In recent years doctors have used new types of stents called drug-eluting stents. These are coated with drugs that are slowly released and help keep the blood vessel from reclosing. Stents that are not coated with drugs are called bare metal stents. As detailed below, it is very important that patients with either type of stent take their anti-clotting medicines as directed.

What precautions should be taken after a stent procedure?
Patients who've had a stent procedure must take one or more blood-thinning agents. Examples are aspirin and clopidogrel. These medications help reduce the risk of a blood clot developing in the stent and blocking the artery. Some recent studies have suggested that blood clots may develop later on (more than a year after stent placement) in the drug-eluting stents. Therefore it is really important to stay on your medications as long as your cardiologist recommends. Aspirin is usually recommended for life, and clopidogrel is generally used for one to 12 months (depending on the type of stent) after the procedure. Clopidogrel can cause side effects, so blood tests will be done periodically. If you are taking this medication, it is important that you don't stop taking it for any reason without consulting your cardiologist who has been treating your coronary artery disease..

For the next four weeks a magnetic resonance imaging (MRI) scan should not be done without a cardiologist's approval. But metal detectors don't affect the stent.

Custom Search