Coronary artery disease: Symptoms and causes



The coronary arteries are the blood vessels supplying your heart with blood, oxygen and nutrients. If they are damaged, they you can develop a coronary artery disease, commonly called heart blockage.



What happens when you have a coronary artery disease?




Plaque (deposits made of cholesterol) builds up in your coronary arteries. It narrows the vessels affects the blood flow to your heart. This is known as atherosclerosis. It can occur in other arteries as well, such as the carotids that supply the brain. This also causes inflammations.


As your blood flow decreases, so does the level of oxygen going to your heart. You may feel a shortness of breath, suffer chest pain (angina) and if the arteries get fully blocked, it can cause a heart attack.


Heart blockages can have different impacts according to the coronary artery that is affected. A right coronary occlusion would affect the bottom of the left ventricle as well as most of the right ventricle, since they are the parts of the heart supplied by this artery.


Angina feels like a pressure in your chest and is usually located in the middle or on the left side of the chest. It usually occurs if you are physically or emotionally stressed but does not last long. It can happen that the pain spreads into your back or your arm for example.


Shortness of breath happens because your heart cannot pump enough blood. It usually goes with extreme fatigue.


Heart attacks occurs once the arteries are entirely blocked but you would usually experience other symptoms before the heart attack.


Other signs of clogged arteries are night sweating, dizziness, heart palpitations or pain in the leg.


If you have any reason to suspect you have a coronary arteries disease, consult a doctor to do a cardiological examination. If you suspect you are having a heart attack or may have one soon, call 911!


What can cause coronary artery disease?




Drawing of the heart, the coronary arteries and what happens inside when there is a blockage

Source: National Heart, Lung and Blood Institute




Although atherosclerosis can start very young, external factors can increase risks such as smoking, a high level of bad cholesterol, diabetes, high blood pressure or a lack of physical exercise.


Risks also increase with age (above for men and above for women usually). Also, men are much more at risk than women, especially at a younger age.


If close relatives had a heart disease, especially at a young age, you are more at risk as well.


Some other factors such as sleep apnea, high triglycerides, preeclampsia, an excess of alcohol of consumption or autoimmune diseases are possible according to the Mayo Clinic.




What are the risks of a coronary artery disease?




Narrow coronary arteries can cause severe disagreements such as chest pain or shortness of breath, especially during special efforts.


A coronary artery disease can cause more severe conditions such as arrhythmia (an abnormal heart rhythm) because of the irregular and insufficient blood supply to the heart.


In case of severe atherosclerosis, if the plaque breaks away, it can create a coronary embolism, which means an external body is blocking the way. It can also comes from blood clots.


If the plaque breaks and blocks the artery, then the heart would be damaged and that is when you have a heart attack.


If your heart is damaged following a heart attack or cannot be supplied with enough oxygen or nutrients, it might not stay able to pump enough blood and that is a heart failure.




How can coronary artery diseases be treated?




Doctor, having a look at an heart on a screen

Source: Henderson Hospital



Various drugs can help people suffering from a coronary artery disease.


A solution is to act on the cause by using medication that decrease the amount of bad cholesterol in the blood.


Beta blockers slow the heart rate, which means your blood pressure is lower and your heart needs less oxygen. It can prevent future heart attacks, especially if you have already had one.


Angiotensin-converting enzyme (ACE) and angiotensin II receptor blockers (ARBs) decrease blood pressure as well, preventing coronary artery disease from progressing.



When needed, the doctors can choose a more invasive treatment.

An angioplasty (or stent placement) allows clearing the artery walls by inserting through a catheter a balloon which once inflated compresses the plaque against the walls. A stent is usually left in the artery so it stays open. Then stent can also release medication in the arteries.


In critical cases when more than one coronary arteries are blocked, the surgeon can use vessels from the rest of your body to supply the heart with blood through another way. This requires an open-heart bypass surgery.




If you suspect any issue with your coronary arteries or with your blood flow around your heart, consult your GP. If you cannot have a quick appointment, find a private GP in London. You may then be referred to a private cardiologist.





Julia from Findoc