Coronary Artery Disease (CAD)

The coronary arteries are the vessels that carry oxygen-rich blood to the heart. When these arteries become filled with plaque, or if the plaque ruptures or breaks off, you may develop coronary artery disease, a dangerous condition that can lead to problems like heart attack, stroke, and death.

Erlanger offers cardiac specialists and cutting-edge technology for diagnoses and treatment of CAD.

Symptoms

• Angina – chest pain or discomfort that occurs when your heart muscle is not getting enough oxygen-rich blood. You may feel angina as pressure of squeezing in the chest, with pain radiating to the shoulders, arms, neck, jaw, or back. In some cases, angina can feel like indigestion.
• Shortness of breath/ heart failure – if the heart is not getting enough oxygen-rich blood, it will not pump correctly, leading to heart failure and fluid build-up in the lungs.
• Heart attack – when the flow of oxygen-rich blood to a section of heart muscle is cut off. The symptoms of heart attack are similar to angina (chest pain and pressure that can radiate to shoulders, arms, neck, and Jaw), but where angina symptoms may disappear with rest, heart attack symptoms do not. You may also feel dizzy or lightheaded, nauseas, feel a fluttering in the chest, or begin sweating. Heart attacks must be treated quickly to avoid serious long-term effects and death. Learn more about heart attack here.
• Heart Rhythm Disorders (Arrhythmias) – when the heartbeat seems too fast, or feel like it is skipping beats or fluttering. Some arrhythmias can cause your heart to suddenly stop beating, which is sudden cardiac arrest.

Causes / Risk Factors

Many of the causes and risk factors for coronary artery disease can be controlled through behavior modification. These include:

• Smoking
• High levels of certain fats and cholesterol in the blood
• High blood pressure
• High levels of sugar in the blood due to insulin resistance or diabetes
• Blood vessel inflammation
• Obesity
• Lack of physical activity
• Metabolic syndrome

Other causes of coronary heart disease include age and family history.

Diagnosis

If your doctor suspects coronary artery disease, he or she may order tests to confirm the diagnosis and see how far the disease has advanced. These tests may include:

• Blood tests – to check for cholesterol, blood sugar, and proteins in the blood.
• X-rays – pictures taken with a tiny amount of radiation.
• Electrocardiogram (ECG or EKG) - a test that measures the electrical activity of the heartbeat.
• Echocardiogram - an ultrasound movie of the inside of the heart.
• Cardiac catheterization - a minimally invasive procedure that allows the cardiologist to get direct information about the blood pressure and the heart’s blood flow.
• Angiogram - an X-ray movie that's taken while a special dye is injected into a cardiac chamber or major blood vessel.
• MRI – an image using magnet waves to look at the blood vessels connected to the heart and lungs.
• CT scan - multiple X-ray images to give a more detailed picture of the heart and lungs.
• Transesophageal echocardiogram - a special type of ultrasound movie of the heart done through a tiny tube inserted through the mouth that sends sound waves to a receiver that produces a picture.

Treatment Options

Percutaneous Coronary Intervention (PCI), commonly known as angioplasty, is a procedure used to treat narrowed arteries found in coronary heart disease.  

In some cases, patients will need surgery to repair, replace, or bypass the important arteries that lead to the heart.

Medications can be an important part of treating coronary artery disease, including drugs that lower fats in the blood, maintain a healthy blood pressure, or prevent blood clots.

Whatever treatment a patient requires, adopting a healthy lifestyle is a crucial part of the treatment plan. Healthy eating, exercise, limiting sodium and alcohol, quitting smoking, and managing stress are all extremely important for people with or at risk of coronary artery disease.

Outcomes

Each patient’s outlook depends on the severity of the disease, the procedures needed to treat it, and the patient’s commitment to a healthy lifestyle. If you follow your Erlanger doctor’s advice and treatment plan, you can reduce the risk of coronary artery disease and its effects.

Erlanger Cardiac Rehabilitation offers exercise and nutrition planning for those recovering from cardiac problems. Learn more about Cardiac Rehab.

Prevention

Some risk factors, like age, gender, and a genetic predisposition toward heart disease, cannot be changed. But in the vast majority of coronary artery disease cases, a healthy lifestyle can prevent the condition, or reduce the possibility of complications like heart attack and stroke.

A healthy diet low in saturated fats, and rich in fiber and nutrient-dense foods is the most important step you can take toward preventing heart disease. Being active, including regular exercise for the whole family is not only good for your heart, it can help with reducing stress, which is also a risk factor. The other crucial pieces are quitting smoking, limiting alcohol, and limiting sodium.

Erlanger Resources for CAD

Erlanger is on the forefront of cardiology therapies for adults and children. The following resources are available for patients with coronary artery disease.

• Children's Heart Disorders - Pediatric Cardiology through Children's Hospital at Erlanger
• Adult Heart Disorders - Erlanger Cardiology
• Heart Health and Rehabilitation - Cardiac Rehabilitation Program. 
• Clinical Research – The Erlanger Institute for Clinical Research (EICR) was created in 2013 to provide a platform of clinical research-related services for EHS-affiliated clinicians who are interested in, or have the opportunity to address their patient’s needs with novel solutions and approaches utilizing evolving new modalities and options through practical clinical research. Learn more about Cardiology Clinical Trials underway at Erlanger.