Coronary Artery Disease (CAD)

Coronary artery disease (CAD) is the most common type of heart disease. It is sometimes called coronary heart disease or ischemic heart disease.

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What is Coronary Artery Disease and Its Risk factors?

Coronary heart disease (CAD), in other words, atherosclerosis, is the leading cause of death and disease worldwide. The disease can develop at any age. In the presence of many risk factors such as risky genetic background, smoking, hypertension, diabetes, hyperlipidemia, sedentary lifestyle, stress, and obesity, the disease occurs at an early age and progresses more rapidly.

Once CAD develops, it tends to progress and cause problems. For this reason, combating these risk factors is extremely important in preventing the emergence of the disease and slowing down or even stopping the disease progression rate in those who develop the disease.

What are the Symptoms of Coronary Artery Disease?

Coronary artery patients may not have any complaints before the stenosis in the vessels reaches a severe level. The most common symptom of CAD is chest pain.

Symptoms often manifest as pain, burning, and pressure in the left side of the chest due to exertion or stress. Other symptoms include shortness of breath, palpitations, dizziness, and nausea.

How to Diagnose Coronary Artery Disease?

Classical methods to diagnose the disease include electrocardiography (ECG), exercise tests, echocardiography, myocardial perfusion, scintigraphy (thallium scintigraphy), and coronary angiography.

What is coronary angiography, and how is it done?

Coronary angiography (CA) is still the gold standard for evaluating anatomical coronary artery disease. The risk of significant complications, including death, in coronary angiography is approximately 2%.

Magnetic resonance angiography (MRA) and multi-slice computed tomography (MSCT) are alternative diagnostic methods for diagnosing cardiovascular diseases. However, today, no diagnostic method can fully replace coronary angiography.

CA is performed by entering through the groin vein (femoral artery) or wrist (radial artery) to visualise the heart vessels. First, local anaesthesia is applied to the puncture site, and then a sheath is inserted into the vein.

These procedures are painless. An opaque substance (dye) is administered to the coronary vessels through the catheter, and a film of the coronary vessels is taken. After the procedure, the vascular sheath is removed. Angiography from the groin vein (femoral artery) requires bed rest for at least 4-6 hours after the procedure. However, in radial artery angiography, the patient can stand up after 30 minutes.

What is Coronary Balloon Stent, and how is it applied?

Balloon stent procedures are similar to coronary angiography from the patient's perspective. It is done with local anaesthesia. The patient is awake during the procedure and usually does not feel pain. These procedures open narrowed or blocked vessels.

It can be done immediately following coronary angiography of the patient with coronary artery disease, or it can be done later in some exceptional cases, such as in kidney patients. A balloon placed in the narrowed coronary artery area is inflated there and generally waited for 30-60 seconds. When the balloon is deflated, the vessel remains open. A stent is used to maintain the opening obtained after the balloon procedure.

Frequently Asked Questions

1How common is coronary artery disease?

Coronary artery disease (CAD) is the most common heart disease, affecting millions of people worldwide.

2Is coronary artery disease hereditary?

Coronary artery disease ( CAD) is a multifactorial disease caused by the interaction of environmental and genetic factors. The hereditary of CAD is estimated to be 40 % to 60%, indicating that genetics play an important role in its development.

3How do I know if I have coronary artery disease?

Symptoms of coronary artery disease may include chest pain (angina), shortness of breath, fatigue, palpitations, and sometimes, even no symptoms at all. Diagnosis typically involves a combination of medical history, physical examination, and various tests such as electrocardiogram (ECG), stress test, or coronary angiography.

4When is coronary artery disease diagnosed?

Coronary artery disease is diagnosed when symptoms manifest, or during routine screenings if risk factors such as high blood pressure, high cholesterol, smoking, diabetes, or family history of CAD are present.

5How quickly can CAD progress?

The progression of coronary artery disease varies from person to person and depends on factors such as lifestyle, genetics, and medical management. In some cases, it can progress slowly over many years, while in others, it can advance rapidly.

6What happens if CAD is untreated?

If left untreated, coronary artery disease can lead to serious complications such as heart attack, stroke, heart failure, or even sudden cardiac death. It is essential to manage CAD through lifestyle changes, medication, and sometimes, medical procedures.

7How long can a CAD patient live?

With appropriate management, including lifestyle modifications, medication adherence, and medical interventions like angioplasty or bypass surgery, many CAD patients can live long and productive lives. The prognosis varies depending on the severity of the disease and the effectiveness of treatment.

8How long does it take to recover from CAD?

After undergoing PCI (angioplasty), individuals typically resume normal activities within approximately one week. In contrast, following CABG (bypass surgery), patients usually remain hospitalized for more than a week. After discharge, it may take between six to 12 weeks for a complete recovery.

9Is high blood pressure considered coronary artery disease?

High blood pressure, or hypertension, is a significant risk factor for developing coronary artery disease. However, it is not synonymous with CAD. Hypertension contributes to the progression of atherosclerosis, which can lead to the development or exacerbation of CAD.

10Can coronary artery disease be reversed?

While it is not possible to completely reverse coronary artery disease, it can be managed effectively to alleviate symptoms, slow disease progression, and reduce the risk of complications. Lifestyle changes such as regular exercise, a heart-healthy diet, smoking cessation, medication adherence, and sometimes, medical procedures like angioplasty or bypass surgery can help in managing CAD. Early detection and intervention are crucial for optimal outcomes.