The first thing we need is a basic understanding of Coronary Artery Disease.  I hope to give you an explanation as well as a personal glimpse into what it is like to have it.  As I said on the index page I will not be giving credit here as that would be impossible.  I have collected this information from my doctor, pamphlets given to me and the Internet. DEFINITION Coronary Artery Disease [CAD] is a narrowing or blockage, of the arteries and vessels that provide oxygen and nutrients to the heart, caused by atherosclerosis. This accumulation of fatty materials on the inner linings of arteries creates blockages which restricts blood flow to the heart.  When it is completely cut off, the result is a heart attack. ETIOLOGY CAD is usually caused by atherosclerosis.  Cholesterol and other fatty substances accumulate on the inner wall of the arteries.  They attract fibrous tissue, blood components, and calcium and harden into artery-clogging plaques.  Atherosclerotic plaques often form blood clots that can also block the coronary arteries [coronary thrombosis]. Congenital defects and muscle spasms can also block blood flow.  Recent research indicates that infection from organisms may be responsible for some cases of coronary artery disease. RISK FACTORS Heredity - People whose parents have coronary artery disease are more likely to develop it.  African-Americans are also at increased risk because they experience a higher rate of severe hypertension than whites do. Sex - Men are more likely to have heart attacks than women are and to have them at a younger age.  Over age 60, however, women have coronary artery disease at a rate equal to that of men. Age - Men who are 45 years of age and older and women who are 55 years of age and older are more likely to have coronary artery disease.  Occasionally, coronary disease may strike a person in the 30s. Older people [those over 65] are more likely to die of a heart attack.  Older women are twice as likely as older men to die within a few weeks of a heart attack. Smoking High cholesterol High blood pressure Lack of physical activity. Diabetes Obesity Stress and Anger SYMPTOMS Although you can be without any noticeable symptoms, the following can be seen. Nervous agitation Rapid tiring Running out of breath Palpitations Angina pectoris Difficulty of breathing Hypertension Edema Dropsy Decline in performance TREATMENT Coronary artery disease can be treated many ways.  The choice of treatment depends on the severity of the disease.   Treatments include lifestyle changes and drug therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass surgery.  Coronary artery disease is a chronic disease requiring lifelong care.  Angioplasty or bypass surgery is not a "cure". People with less severe coronary artery disease may gain adequate control through lifestyle changes and drug therapy.  Many of the lifestyle changes that prevent disease progression also help prevent the disease from developing.  These include low-fat, low-cholesterol diet with weight loss if needed, exercise, and not smoking. Drugs relieve chest pain and complications of coronary artery disease, but they cannot clear blocked arteries. Nitrates [nitroglycerin] improve blood flow to the heart.  Beta-blockers [acebutelol, propranolol] reduce the amount of oxygen required by the heart during stress.  And calcium-channel blockers [verapamil, diltiazem hydrochloride] help keep the arteries open and reduces blood pressure.  Aspirin helps prevent blood clots from forming on plaques, reducing the likelihood of a heart attack.  Cholesterol-lowering medications are also indicated in most cases. Percutaneous transluminal coronary angioplasty and bypass surgery are invasive procedures to improve blood flow in the coronary arteries.  Percutaneous transluminal coronary angioplasty, usually called coronary angioplasty, is a non-surgical procedure.  A catheter tipped with a balloon is threaded from a blood vessel in the thigh into the blocked artery.  The balloon is inflated, compressing the plaque to enlarge the blood vessel and open the blocked artery.  The balloon is deflated, and the catheter is removed.  Coronary angioplasty is performed by a cardiologist in a hospital and generally requires a stay of one or two days.  Coronary angioplasty is successful about 90% of the time, but for one-third of patients the artery narrows again within six months.  The procedure can be repeated.  It is less invasive and less expensive than coronary artery bypass surgery. MY POINT of VIEW They added this newest diagnosis in August of 2002 so I have had little time to get used to it. Be sure to read about my Percutaneous transluminal coronary angioplasty in the update of July 31, 2002.

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