Coronary artery disease develops when the major blood vessels that
supply your heart with blood, oxygen and nutrients (coronary arteries)
become damaged or diseased. Cholesterol-containing deposits (plaque) in
your arteries and inflammation are usually to blame for coronary artery
disease.
When plaque builds up, they narrow your coronary arteries, decreasing
blood flow to your heart. Eventually, the decreased blood flow may cause
chest pain (angina), shortness of breath, or other coronary artery
disease signs and symptoms. A complete blockage can cause a heart
attack.
Because coronary artery disease often develops over decades, you might
not notice a problem until you have a significant blockage or a heart
attack. But there's plenty you can do to prevent and treat coronary
artery disease. A healthy lifestyle can make a big impact.
|
|
Symptoms
If your coronary arteries narrow, they can't supply enough oxygen-rich
blood to your heart — especially when it's beating hard, such as during
exercise. At first, the decreased blood flow may not cause any coronary
artery disease symptoms. As plaque continues to build up in your
coronary arteries, however, you may develop coronary artery disease
signs and symptoms, including:
Chest pain (angina). You may feel pressure or tightness in your chest,
as if someone were standing on your chest. This pain, referred to as
angina, usually occurs on the middle or left side of the chest. Angina
is generally triggered by physical or emotional stress.
The pain usually goes away within minutes after stopping the stressful
activity. In some people, especially women, this pain may be fleeting or
sharp and felt in the neck, arm or back.
Shortness of breath. If your heart can't pump enough blood to meet your
body's needs, you may develop shortness of breath or extreme fatigue
with exertion.
Heart attack. A completely blocked coronary artery may cause a heart
attack. The classic signs and symptoms of a heart attack include
crushing pressure in your chest and pain in your shoulder or arm,
sometimes with shortness of breath and sweating.
Women are somewhat more likely than men are to experience less typical
signs and symptoms of a heart attack, such as neck or jaw pain.
Sometimes a heart attack occurs without any apparent signs or symptoms.
When to see a doctor
If you suspect you're having a heart attack, immediately call 911 or
your local emergency number. If you don't have access to emergency
medical services, have someone drive you to the nearest hospital. Drive
yourself only as a last resort.
If you have risk factors for coronary artery disease — such as high
blood pressure, high cholesterol, tobacco use, diabetes, a strong family
history of heart disease or obesity — talk to your doctor. He or she may
want to test you for the condition, especially if you have signs or
symptoms of narrowed arteries.
Causes
Coronary artery disease is thought to begin with damage or injury to the
inner layer of a coronary artery, sometimes as early as childhood. The
damage may be caused by various factors, including:
Smoking
High blood pressure
High cholesterol
Diabetes or insulin resistance
Sedentary lifestyle
Once the inner wall of an artery is damaged, fatty deposits (plaque)
made of cholesterol and other cellular waste products tend to accumulate
at the site of injury in a process called atherosclerosis. If the
surface of the plaque breaks or ruptures, blood cells called platelets
will clump at the site to try to repair the artery. This clump can block
the artery, leading to a heart attack.
Risk factors
Risk factors for coronary artery disease include:
Age. Simply getting older increases your risk of damaged and narrowed
arteries.
Sex. Men are generally at greater risk of coronary artery disease.
However, the risk for women increases after menopause.
|
|
Family history. A family history of heart disease is associated with a
higher risk of coronary artery disease, especially if a close relative
developed heart disease at an early age. Your risk is highest if your
father or a brother was diagnosed with heart disease before age 55 or if
your mother or a sister developed it before age 65.
Smoking. People who smoke have a significantly increased risk of heart
disease. Exposing others to your secondhand smoke also increases their
risk of coronary artery disease.
High blood pressure. Uncontrolled high blood pressure can result in
hardening and thickening of your arteries, narrowing the channel through
which blood can flow.
High blood cholesterol levels. High levels of cholesterol in your blood
can increase the risk of formation of plaques and atherosclerosis. High
cholesterol can be caused by a high level of low-density lipoprotein (LDL),
known as the "bad" cholesterol. A low level of high-density lipoprotein
(HDL), known as the "good" cholesterol, can be a sign of
atherosclerosis.
Diabetes. Diabetes is associated with an increased risk of coronary
artery disease. Type 2 diabetes and coronary artery disease share
similar risk factors, such as obesity and high blood pressure.
Overweight or obesity. Excess weight typically worsens other risk
factors.
Physical inactivity. Lack of exercise also is associated with coronary
artery disease and some of its risk factors, as well.
High stress. Unrelieved stress in your life may damage your arteries as
well as worsen other risk factors for coronary artery disease.
Risk factors often occur in clusters and may build on one another, such
as obesity leading to type 2 diabetes and high blood pressure. When
grouped together, certain risk factors put you at an even greater risk
of coronary artery disease. For example, metabolic syndrome — a cluster
of conditions that includes elevated blood pressure, high triglycerides,
elevated insulin levels and excess body fat around the waist — increases
the risk of coronary artery disease.
Sometimes coronary artery disease develops without any classic risk
factors. Researchers are studying other possible factors, including:
|
|
Sleep apnea. This disorder causes you to repeatedly stop and start
breathing while you're sleeping. Sudden drops in blood oxygen levels
that occur during sleep apnea increase blood pressure and strain the
cardiovascular system, possibly leading to coronary artery disease.
High sensitivity C-reactive protein. High sensitivity C-reactive protein
(hs-CRP) is a normal protein that appears in higher amounts when there's
inflammation somewhere in your body. High hs-CRP levels may be a risk
factor for heart disease. It's thought that as coronary arteries narrow,
you'll have more hs-CRP in your blood.
High triglycerides. This is a type of fat (lipid) in your blood. High
levels may raise the risk of coronary artery disease, especially for
women.
Homocysteine. Homocysteine is an amino acid your body uses to make
protein and to build and maintain tissue. But high levels of
homocysteine may increase your risk of coronary artery disease.
Complications
Coronary artery disease can lead to:
Chest pain (angina). When your coronary arteries narrow, your heart may
not receive enough blood when demand is greatest — particularly during
physical activity. This can cause chest pain (angina) or shortness of
breath.
Heart attack. If a cholesterol plaque ruptures and a blood clot forms,
complete blockage of your heart artery may trigger a heart attack. The
lack of blood flow to your heart may damage your heart muscle. The
amount of damage depends in part on how quickly you receive treatment.
Heart failure. If some areas of your heart are chronically deprived of
oxygen and nutrients because of reduced blood flow, or if your heart has
been damaged by a heart attack, your heart may become too weak to pump
enough blood to meet your body's needs. This condition is known as heart
failure.
Abnormal heart rhythm (arrhythmia). Inadequate blood supply to the heart
or damage to heart tissue can interfere with your heart's electrical
impulses, causing abnormal heart rhythms.
Prevention
The same lifestyle habits that can help treat coronary artery disease
can also help prevent it from developing in the first place. Leading a
healthy lifestyle can help keep your arteries strong and clear of
plaques. To improve your heart health, you can:
Quit smoking
Control conditions such as high blood pressure, high cholesterol and
diabetes
Stay physically active
Eat a low-fat, low-salt diet that's rich in fruits, vegetables and whole
grains
Maintain a healthy weight
Reduce and manage stress |