One of the major medical conditions in the world today is coronary artery disease. This is a disease that occurs when the arteries have a buildup of plaque that restricts free flow of blood.
Coronary heart disease (CHD) is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle.
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
Sourced from: http://www.nhlbi.nih.gov/health/health-topics/topics/cad
Coronary artery disease, CAD is one of the main causes of deaths in the United States. It triggers heart attacks among other heart conditions thus the need for it to be treated quickly. One mode of treatment is through medical management.
Manage heart disease through lifestyle changes and understanding the symptoms of heart attack. Decrease risk factors by not smoking, keeping cholesterol in check, exercising, managing stress and eating healthfully. Take prescribed medications and see a cardiologist regularly.
Medical Management of Coronary Artery Disease
Medications can relieve the heart from working so hard. Nitroglycerin widens arteries, aspirin can prevent clots, beta blockers improve blood flow, Ranolazine helps chronic angina, ace inhibitors improve survival after heart attack, lipid management helps control cholesterol that can block arteries.
A type of medicine given in the hospital through the veins (intravenous) to break up blood clots. Heart attack (caused by a blood clot in a coronary artery) and ischemic stroke (caused by a blood clot in an artery in the brain) are the two main conditions for which thrombolytic medications may be prescribed.
A first line treatment to lower high cholesterol in patients with or at risk for coronary artery disease, statins also provide additional benefits to the blood vessels that result in a decrease incidence in cardiovascular events.
The other type of treatment for CAD is by-pass surgery. The common term is this method of treatment is called grafting. It is because healthy blood vessels from other parts of the body are taken and grafted to the coronary artery.
Coronary artery bypass grafting, or “CABG” (pronounced “cabbage”), is a common heart procedure. A surgeon takes a section of a healthy blood vessel from your leg, chest, or arm. The vessel is then connected (grafted) to your coronary artery slightly past the site of the blockage. This creates a new path for blood to flow around (bypass) the blockage in the artery so it can get to your heart. Patients undergoing bypass are put under general anesthetic and are not awake during surgery. Two bypass surgical procedures for coronary artery disease are: (1) beating heart surgery and (2) arrested heart surgery.
- Beating heart surgery – Also known as off-pump surgery, beating heart surgery is done while the heart is beating. This often requires special equipment that allows the surgeon to operate on the heart while it is moving. Beating heart surgery is appropriate for certain patients.
- Arrested heart surgery – Most CABG surgeries are done through an incision in the chest while the heart is stopped and a heart-lung machine takes over the job of circulating the blood. This is called arrested heart surgery or conventional bypass surgery.
Minimal invasive surgery is also another method of treatment for CAD. Only small incisions are made and there is less pain. The risk of infection is also low.
There are three basic approaches to making cardiac surgery less invasive. First a partial cut of the breastbone (partial sternotomy) or a cut between the ribs (thoracotomy) can be substituted for full division. This usually results in a smaller incision, less pain, less breathing difficulties, and less risk of infection. Second, almost all coronary bypass surgery and a few other procedures do not require stopping the heartbeat and, therefore, do not require use of the heart-lung machine. This should reduce the risk of emboli, inflammatory, and immune reactions.
Such surgery is called “off-pump” or “beating heart” surgery, and when used for coronary bypass, “OPCAB” (off-pump coronary artery bypass).
Lastly, one can approach some problems by traversing the body’s arterial system (access is through a groin with a needle) to deliver a device, most commonly some form of stent. The “endovascular” (within the vessel) approach can be used to treat many forms of aneurysm, and to deliver aortic valve replacement devices. The most common form of endovascular procedure is the coronary stent, which cardiologists perform in great number.