Coronary Artery Disease: Causes, Symptoms, Treatment and Cost

Fatty deposits or plaques form in the walls of the coronary arteries as a result of the ailment known as coronary artery disease (CAD). These plaques eventually block or reduce the flow of oxygen-rich blood to the heart muscle, which can lead to serious heart problems including a heart attack, angina (chest pain) and irregular heart rhythms.

Coronary artery disease may take many different forms, including:

• Atherosclerosis: This is the most common form of CAD where plaques with cholesterol and other fats build up in the vessel wall. As the vessel narrows, blood flow to the heart muscle is decreased, and a heart attack may occur if blood flow is totally stopped.
• Thrombosis: This is another form of CAD where a clot forms in one of the coronary vessels, blocking off more of the arteries and reducing blood flow even further.
• Spasm: Narrowing or blockages can also occur due to spasm in certain areas of the coronary vessels where no atheromatous plaques exist.
• Coronary Artery Anomalies: Congenital anomalies such as abnormal angulation, side-branch ostial stenosis and multiple segments stenosis can cause severe obstruction in certain branches leading to restricted blood flow as well as possible myocardial infarction (heart attack).

Main cause of CAD is poor lifestyle choices, such as:

• Smoking
• Consuming meals that are bad for you.
• Taking in food that is unhealthy for you to eat.
• Being overweight/obese.
• Other factors that contribute to CAD are:
• High levels of LDL (low-density lipoprotein) cholesterol.
• Triglyceride levels, which are a kind of blood fat, that are abnormally high.
• Diabetes and pre-diabetes, metabolic syndrome, and insulin resistance.
• High blood pressure (hypertension).
• Heredity and family history play a role in CAD as well; if someone has a parent or sibling with the disease, their risk increases.

• Chest pain or discomfort, often in the centre or left side of the chest (angina).
• Pain in different parts of the upper body, including both arms, the back, the neck, the jaw, or the stomach.
• Shortness of breath.
• Nausea, lightheadedness and breaking out in a cold sweat.
• Fatigue and difficulty exercising.
• Palpitations or a rapidly beating heart.

• Keep an appropriate weight and a regular exercise regimen.
• Maintain a nutritious diet.
• Avoid using cigarettes and other tobacco products.
• Minimize alcohol consumption.
• Manage stress levels and seek medical attention if needed.
• Get yearly medical exams to evaluate for cholesterol, blood pressure, glucose levels, and other issues.

• Echocardiography: Echocardiography is a kind of medical imaging that may identify coronary artery disease as well as monitor its progression. The approach does not involve the use of any invasive techniques and instead generates pictures of the heart by using sound waves. The pictures help doctors check the overall health of the heart.
• Cardiac Catheterization: This is an invasive diagnostic procedure which involves inserting a long, thin tube called catheter into an artery in your arm or groyne area. It is then threaded through the vascular system up to your coronary arteries. Once in place, contrast dye is injected to produce detailed images of obstruction and narrowing that could be causing coronary artery disease.
• Electrophysiologic Testing (EPT): An EPT is used to diagnose electrical disturbances that may lead to conditions such as irregular heart rate, palpitations, and faint spells typically associated with CAD.
• Blood Tests: Blood tests such as C-reactive protein (CRP) or cholesterol tests are used to calculate risk associated with CAD by measuring levels of proteins and fatty substances which could indicate blockages or clogging in the arteries that supply blood to the heart.
• CT Angiography/CTA Scan: This advanced imaging technique combines x-rays technology produced from multiple angles simultaneously while injecting contrast dye at same time producing 3D image providing detailed assessment of severity any occlusions / blocked vessels exist.

• Angina: Chest discomfort or pain that is brought on by a reduction in the amount of blood that is flowing to the heart.
• Heart Attack: When an artery is blocked and a sudden lack of oxygen damages heart muscle.
• Heart Failure: Struggling to pump enough blood, affecting the body’s organs & tissues.
• Arrhythmias: Irregular heartbeats caused by electrical disturbances in the heart’s rhythm.
• Pericarditis: An inflammation of the sac-like membrane that surrounds the heart, which is the primary symptom of this illness.
• Cardiomyopathy: Thickening or rigidification of the cardiac muscle leading to reduced contractility & other complications.

• Consuming garlic and ginger can help decrease cholesterol levels and reduce the risk of arterial blockage.
• A healthy lifestyle such as regular exercise and good sleeping habits can be beneficial for coronary artery disease sufferers.
• Plants-based supplements such as turmeric, ashwagandha, amla, guduchi and holy basil can have protective effects against heart problems caused by CAD.
• Acupuncture has been known to reduce blood pressure levels in CAD patients which may improve cardiac health.

• Consume a lot of fruits and vegetables, whole grains, foods that are rich in fibre, lean proteins like fish and chicken without the skin, legumes (beans), nuts, and seeds.
• If you use dairy or other fats for food preparation, select low-fat dairy products or unsaturated fats such as olive oil or canola oil instead of regular butter or lard.
• Also include omega-3 fatty acids found in fatty fish like salmon, herring, sardines or mackerel - two servings per week is recommended.

• Saturated fats: Avoid processed red meats, dairy products, and baked goods made with palm oil or coconut oil.
• Trans-fats: Avoid processed junk food and fast food items.
• Excess sodium: Avoid foods with more than 500 milligrams of sodium per serving, including canned soups, frozen dinners, condiments and cured meats.
• Refined carbohydrates: Avoid white breads and pastas, sugary breakfast cereals and desserts made with white sugar, corn syrup or other refined sweeteners.
• Added sugars: Avoid added sugars such as regular table sugar (sucrose), corn syrup and artificial sweeteners like aspartame or sucralose.

• Lifestyle changes: Lifestyle changes that can help people with CAD include eating a healthy, balanced diet, getting regular physical activity, quitting smoking, managing stress levels, and limiting alcohol consumption.
• Medications: Medications may be prescribed to help improve blood flow to and from the heart, reduce cholesterol levels, or lower blood pressure.
• Coronary artery bypass graft (CABG): This is a surgical treatment that includes removing a healthy blood vessel from one area of the body and using it to bypass the blocked artery and reestablish blood flow to the heart.
• Percutaneous coronary intervention (PCI): Also known as angioplasty, this procedure widens the narrowed artery using a balloon, stent or other device inserted with a catheter in order to improve blood flow to the heart.
• Transcatheter aortic valve replacement (TAVR): This is a technique that requires just a little amount of incision and blood loss, and it allows the natural valve to be replaced with an artificial one without the need for open surgery.
• Surgical valve repair: The damaged valve can be repaired or replaced in traditional open-heart surgery by cardiothoracic surgeons.

A patient suffering from Coronary Artery Disease should consult a Cardiologist.

Cardiologists are medical experts who have undergone specialised training in order to diagnose and treat conditions that are associated with the heart and circulation, such as coronary artery disease (CAD).

• Statins: These medications bring cholesterol levels down and minimise the likelihood of developing coronary artery disease. Examples include atorvastatin (Lipitor), rosuvastatin (Crestor), pravastatin (Pravachol).
• Antiplatelets: These drugs are used to reduce the risk of blood clots in people with coronary artery disease. Examples include aspirin, clopidogrel (Plavix), and prasugrel (Effient).
• Beta Blockers: These drugs are used to reduce the burden on the heart, as well as to slow the heart rate and lower blood pressure. This reduces the strain that is placed on the heart, which in turn reduces the likelihood of suffering a heart attack or stroke. Examples include metoprolol (Lopressor), propranolol (Inderal), atenolol (Tenormin).
• Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors): These medications are often recommended to patients diagnosed with coronary artery disease in order to manage congestive heart failure, which may be alleviated by lowering excessive blood pressure. Examples include lisinopril (Prinivil, Zestril), ramipril (Altace), captopril, and enalapril maleate(Vasotec).
• Calcium Channel Blockers: These medications relieve constricted arteries all across the body, increasing the amount of oxygen-rich blood that reaches the heart muscle and reducing the strain on it.

The recovery time after a diagnosis of coronary artery disease (CAD) varies depending on the severity of the illness, as well as the underlying medical conditions and other factors.

Generally, milder forms of CAD may require 6-12 weeks to treat, while more severe cases can take up to twelve months for full recovery.

No, the results of therapy for coronary artery disease (CAD) are not always long-lasting in every case.

Treatment can help manage the symptoms and prevent further progression of the disease, but it cannot always prevent it from recurring or worsening.

Risk factors such as high blood pressure, smoking, and diabetes can lead to further damage to the coronary arteries and cause recurrent episodes of chest pain or angina.

• Lifestyle changes: Healthy habits such as eating a balanced diet, exercising regularly, avoiding smoking, limiting alcohol consumption and reducing stress can prevent potential complications from CAD.
• Medication: Patients should take any prescribed medications for the condition and follow their doctor's instructions carefully.
• Monitoring: Regular checkups with a healthcare provider is essential to monitor blood pressure and lipid levels as well as ensure the patient's well being.
• Cardiac rehabilitation: Programs combined with lifestyle interventions can help reduce symptoms and risks of further cardiovascular events while helping patients manage their condition better in the long term by learning about coronary disease and adjusting to life afterwards.

• Treatments for coronary artery disease come at varying prices in India, and this is due to the fact that different kinds of therapies are necessary.
• Angioplasty and stenting can range from ₹2 to 3 lakhs.
• Valvuloplasty and related surgeries may cost up to 10 lakhs or more.
• Medications and supplements are usually around ₹1000 - 3000 per month.
• Cardiac rehabilitation programs are also offered at many major hospitals with a nominal fee starting from around ₹300 per visit.

• Stress: Anxiety, depression, and other physical & mental stress due to lifestyle changes, medications & procedures.
• Medications: Side effects like nausea, sweating, dizziness may occur with medication use.
• Procedures: Potential side effects from coronary artery stents or other arteries related procedures can include allergic reaction, infection and chest pain.
• Surgery: Potential risks from open heart surgery include infection, stroke and memory loss.

If you are experiencing any issues that are associated with coronary artery disease, then you should seek medical attention as soon as possible. These issues can lead to complications such as 'angina, heart attack, and pericarditis,' the treatments for which can last anywhere from a few months to several years depending on the gravity of the situation.