Coronary Artery Disease

Coronary artery disease is atherosclerosis of the coronary arteries, producing blockages in the vessels which nourish the heart itself. Without adequate blood flow from the coronary arteries, the heart becomes starved of oxygen and vital nutrients it needs to work properly. Your coronary arteries are blood vessels on the heart. Before your teen years, fat can start to deposit in the blood vessel walls. As you get older, the fat builds up. This causes injury to your blood vessel walls. In an attempt to heal itself, the fatty tissues release chemicals that promote the process of healing but make the inner walls of the blood vessel sticky.

Then, other substances, such as inflammatory cells, proteins, and calcium that travel in your bloodstream start sticking to the inside of the vessel walls. The fat and other substances combine to form a material called plaque, which can narrow the flow of blood in the artery (atherosclerosis).

Some plaque is fragile, cracking or tearing, exposing the soft, fatty inside. When this happens, platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots accumulate on the injured vessel wall. This causes the artery to narrow even more. Sometimes, the blood clot breaks apart by itself, and blood supply is restored. Over time, the inside of the arteries develop plaques of different sizes.

Eventually, a narrowed coronary artery may develop new blood vessels that go around the blockage to get blood to the heart. However, during times of increased exertion or stress, the new arteries may not be able to supply enough oxygen-rich blood to the heart muscle, causing ischemia of the heart. Coronary artery disease can progress to a point where ischemia occurs even at rest.

In other cases, the blood clot may totally block the blood supply to the heart muscle, causing what is called an acute coronary syndrome.

Some people have symptoms that tell them that they may soon develop an acute coronary syndrome, others may have no symptoms until something happens, and still others have no symptoms of the acute coronary syndrome at all.

Ischemia of the heart can be compared to a cramp in the leg. When someone exercises for a very long time, the muscles in the legs cramp up because they’re starved for oxygen and nutrients. Your heart, also a muscle, needs oxygen and nutrients to keep working. If its blood supply is inadequate to meet the heart muscle’s needs, ischemia occurs, and you may feel chest pain or other symptoms.

The most common symptom is of coronary artery disease is angina, called or angina pectoris, or simply chest pain. Angina can be described as a discomfort, heaviness, pressure, aching, burning, numbness, fullness, squeezing or painful feeling. It can be mistaken for indigestion or heartburn. Angina is usually felt in the chest, but may also be felt in the left shoulder, arms, neck, back, or jaw.

Other symptoms that can occur with coronary artery disease include: shortness of breath, palpitations, a faster heartbeat, weakness or dizziness, nausea and sweating.

Learn to recognize your heart disease symptoms and the situations that cause them. Call your doctor if you begin to have new symptoms or if they become more frequent or severe. If you or someone you are with experience chest discomfort, especially with one or more of the symptoms listed above, don’t wait longer than a few minutes (no more than 5) before calling 9-1-1 to get help.

If you have angina and have been prescribed nitroglycerin, call your doctor or have someone take you to the nearest emergency room if pain persists after taking two doses (taken at five-minute intervals) or after 15 minutes.

Emergency personnel may tell you to chew an aspirin to help break up a possible blood clot, if there is not a medical reason for you to avoid aspirin.