Signs of Coronary artery disease (CAD)

Description

The blood vessels that supply the heart are called the coronary arteries. Coronary artery disease (CAD) is the narrowing of these arteries by fat and calcium build up called plaques. This is also called coronary atherosclerosis.The following characteristics lead to an increased chance of having CAD: smoking, obesity, family history of CAD, high blood pressure, elevated cholesterol, diabetes, sedentary lifestyle, and kidney disease. Sometimes a blood clot can develop in these plaques and suddenly block the blood supply to the heart causing a heart attack. Symptoms of coronary artery disease can vary widely and in some patients like the elderly, diabetics and women there is no chest pain.

Symptoms

Chest pain (typically described as squeezing, crushing, or band like), some people may have little or no chest pain (elderly, diabetics, or women). Chest pain that comes on with exercise and goes away with rest. Other symptoms include: jaw pain, arm pain, back pain, abdominal pain, shortness of breath, sweating, nausea, vomiting, apprehension, fainting, dizziness.

Tests

A history and physical exam will be performed. A coronary angiogram can definitively identify the coronary artery blockage. A high resolution chest CT scan can also demonstrate the blockages. CT scans can also rule out other diseases that can clinically mimic a heart attack. An echocardiogram can demonstrate a poorly functioning heart. An EKG (electrocardiogram) can sometimes show abnormalities with CAD.

Standard Workup

CBC
Chem 12
CT Scan
D-Dimer
EKG
Troponin
X-Ray

Treatment

Treatment of CAD is aimed at reducing the plaque build up in the arteries. The best therapy includes controlling blood pressure and cholesterol, exercising, not smoking, and keeping diabetes under control. Medications used to treat CAD are aspirin, high blood pressure pills, nitroglycerin, and statins to lower cholesterol. Treatment for a heart attack is aimed at improving the blood flow to the heart, treating life threatening arrhythmias, and maximizing the heart function. Coronary (heart) artery blockages are reduced by the following: clot busting medication (alteplase/t-PA), balloon angioplasty, stent placement, surgical bypass, blood thinners and anti-platelet medications (aspirin, abciximab/ReoPro, eptifibatide/Integrilin, clopidogrel/Plavixclopidrogel). When arrhythmias are present they are treated with medications (amiodorone, lidocaine), cardioversion or a pacemaker. For additional information contact the National Heart, Lung and Blood Institute Health Information Center at: http://www.nhlbi.nih.gov or call (301)592-8573 American Heart Association: (800)242-8721