CORONARY ARTERY DISEASE

Coronary Artery Disease
Coronary artery disease results from a buildup of cholesterol and other substances within the arteries that supply the blood to the heart. This buildup is known as plaque, or atherosclerotic material. With time the involved arteries become narrowed until blood can no longer flow normally. The resulting decrease in flow is known as ischemia, and it causes angina pectoris, or chest pain. If flow becomes totally blocked, either by plaque or by a blood clot, the affected portion of the heart muscle will die. This process is known as a myocardial infarction, or heart attack, and accounts for at least 250,000 deaths per year. The classic symptom is severe, crushing chest pain that may radiate to the arms, neck, or jaw. In mild attacks the symptoms may resemble indigestion or heartburn.
If a heart attack is suspected, the patient can be treated with a thrombolytic drug, which will dissolve any blood clots that might be blocking a coronary artery. Further treatment may involve nitroglycerin, aspirin, blood-thinning agents, and drugs for controlling the heart's rhythm. If drug treatment is unable to relieve the patient's symptoms, percutaneous transluminal coronary angioplasty (PTCA) can be used to compress the plaque against arterial walls and open the blocked segment. Depending on the type of disease, the patient may undergo heart surgery to bypass the diseased vessel.
Coronary artery disease and other cardiovascular disorders can lead to congestive heart failure. The heart is unable to pump all of the blood returned to it by the veins, and the blood backs up and collects in various tissues, including the lungs. Although the heart continues to work, its efficiency is severely impaired. Congestive heart failure can usually be treated with drugs or surgery. If these methods fail, a heart transplant is an option for some patients.