ࡱ> gif5@ v"bjbj22 .6XXvFFFFb,T3$B<~ 2222222$J4R6200023NNN02N02N&Nt0k1 W(1F@RC12$30T3W18787(k1k1D872$L6N ,L22  D Coronary Artery Disease (CAD) (Coronary Heart Disease; Ischemic Heart Disease; Atherosclerosis of the Coronary Arteries) by  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0929311" Rosalyn Carson-DeWitt, MD Definition Coronary artery disease (CAD) is blockage of the arteries that feed the heart muscle. If the blockage is complete, areas of the heart muscle may be damaged and/or die from lack of oxygen. This can lead to a heart attack, otherwise known as a  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0911814" myocardial infarction. Coronary artery disease is the most common form of heart disease. Coronary Artery Disease  INCLUDEPICTURE "http://www.beliefnet.com/healthandhealing/images/si1480_ma.jpg" \* MERGEFORMATINET  Copyright 2005 Nucleus Communications, Inc. All rights reserved.  HYPERLINK "http://www.nucleusinc.com" \t "_blank" www.nucleusinc.com Causes Causes include: Thickening of the walls of the arteries feeding the heart muscle Accumulation of fatty plaques within the coronary arteries Narrowing of the coronary arteries Development of a blood clot within the coronary arteries that blocks blood flow Risk Factors A risk factor is something that increases your chance of getting a disease or condition. Major Risk Factors: Sex: Male (men have a greater risk of heart attack than women) Age: 45 and older for men; 55 and older for women Heredity: strong family history of heart disease  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0911647" Obesity and overweight Smoking  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0929738" High blood pressure Sedentary lifestyle  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0911789" High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0911902" Diabetes Other Risk Factors: Stress Excessive alcohol use Symptoms CAD may progress without any noticeable symptoms. Symptoms include:  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0912056" Angina  intermittent chest pain that often has a squeezing or pressure-like feeling, that may radiate into the shoulder(s), arm(s), or jaw. Angina usually lasts for about two to 10 minutes, and is often relieved with rest. Angina can be triggered by: Exercise or exertion Emotional stress Cold weather A large meal If angina is unrelieved by rest or nitroglycerin, is severe, begins at rest (with no activity), or lasts more than 15 minutes, these are warning signs of unstable angina or a heart attack. Accompanying symptoms may include: Shortness of breath Sweating Nausea Weakness Diagnosis If you present to the emergency room with chest pain, some tests will be done right away to see if you are having an episode of angina or a heart attack. If you have a stable pattern of angina, other tests may be done more electively to determine the severity and extent of your disease and to create a treatment plan. The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include: Blood Tests to look for certain substances in the blood; helps the doctor determine if you are having angina or an acute heart attack  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0930616" Electrocardiogram (ECG, EKG) records the heart's activity by measuring electrical currents through the heart muscle; can reveal evidence of past heart attacks, acute heart attacks, and heart rhythm problems  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0914805" Echocardiogram  uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart; gives information about the structure and function of the heart  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0914868" Exercise Stress Test records the heart's electrical activity during increased physical activity Thallium Stress Test thallium is used to scan the myocardium, the muscle layer of the heart Nuclear Scanning radioactive material is injected into a vein and observed as it is absorbed by the heart muscle Electron-beam CT Scan a type of x-ray that uses a computer to make pictures of the inside of the heart  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0914783" Coronary Angiography  x-rays taken after a dye is injected into the arteries; allows the doctor to look for abnormalities in the arteries Treatment Treatment may include: Nitrate Medications Nitroglycerin is usually given during an acute attack of angina. It can be given as a tablet that dissolves under the tongue or as a spray. There are also longer-lasting types that can be used to prevent angina before you participate in an activity known cause it. These may be given as pills or applied as patches or ointments. Blood Thinning Medications A small, daily dose of aspirin has been shown to decrease the risk of heart attack. Warfarin is also used for some patients. Ask your doctor before taking aspirin daily. Beta-blockers and Calcium-channel Blockers These may help prevent angina. Cholesterol-lowering Medications May prevent the progression of coronary artery disease, and may even improve existing coronary artery disease. Surgery Patients with severe blockages in their coronary arteries may benefit from: Coronary bypass graft Atherectomy Coronary angioplasty with or without stenting Prevention To reduce your risk of getting coronary artery disease: Maintain a healthy weight. Begin a safe exercise program with the advice of your doctor. If you smoke, quit. Eat a healthful diet, low in saturated fat and rich in whole grains, fruits, and vegetables. Appropriately treat your high blood pressure and/or diabetes. Appropriately treat high cholesterol or  HYPERLINK "http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=%09%09%09%09%09%0911767" triglycerides. RESOURCES: American Heart Association  HYPERLINK "http://www.americanheart.org" \t "_blank" http://www.americanheart.org Heart and Vascular Diseases Homepage Nation Heart, Lung, and Blood Institute  HYPERLINK "http://www.nhlbi.nih.gov/health/public/heart/index.htm" \t "_blank" http://www.nhlbi.nih.gov SOURCES: Griffith's 5-Minute Clinical Consult. 2001 ed. Lippincott Williams & Wilkins, 2001. National Heart, Lung, and Blood Institute. 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