BARI 2D | A Clinical Study

Coronary Artery Disease

The heart is an organ made up of muscle tissue that requires oxygen and blood to fuel its actions. The special blood vessels that feed the heart are called coronary arteries. They are so named because these vessels "crown" the heart. Coronary artery disease is a process of narrowing that occurs over time in these important vessels. This build-up of fats and plaques in arteries can exist and grow without any symptoms. Angina is a common warning sign of coronary artery disease.

What is angina?

Angina is described as a transient pain or discomfort due to a temporary imbalance between the demand for oxygen by the heart muscle and the ability of the coronary arteries to supply enough blood to meet that demand. Often angina is experienced during exertion which increases heart rate and blood pressure. As the narrowing in these blood vessels increase, the amount of exertion needed to cause anginal pain decreases. With severe coronary artery disease, angina can occur at rest. Symptoms of angina can be midsternal chest pain that is described as crushing, pressing, constricting, oppressing or heavy. It may radiate to one or both (more often the left) shoulders and/or arms. Neck, jaw, back and epigastric pain without midsternal chest pain can also be angina. It is a steady discomfort, most commonly lasting 2-15 minutes. It is usually relieved with rest and/or nitroglycerin tablets under the tongue or in spray form.

What is coronary artery disease?

Coronary artery disease (CAD) is a type of heart disease. It is caused by gradual blockage of the coronary arteries. These arteries supply the heart muscle with oxygen and nutrients. The health of your heart muscle depends on receiving enough oxygen and nutrients from the blood that flows through these arteries. In coronary artery disease thick patches (called plaques) of fatty tissue form on the inside of the walls of the coronary arteries. As the inside diameter of the arteries becomes increasingly narrowed by these plaques, the heart gets less oxygen and nutrients from the blood. The arteries may even become blocked by the plaques or a clot of blood. This progressive narrowing, and sometimes complete blockage, increases your risk for heart attack (myocardial infarction) and sudden death.

How is it treated?

Your treatment depends on many factors, such as your age, heart muscle function, and other health problems. Initial treatment may include changes to your diet and a monitored exercise program. Your doctor may prescribe medication to prevent chest pain.

If this initial treatment is ineffective over a brief time or if your coronary arteries are severely blocked, the blockages may need to be opened up or removed.

Angioplasty is a method of opening up, or dilating, a partially blocked artery. The cardiologist uses a thin tube (catheter) to do this. The procedure involves some risk, but the risk is less than that of coronary artery bypass surgery.

If you have very severe or multiple blockages, your doctor may recommend coronary artery bypass surgery. Bypass surgery allows the blocked areas of artery to be bypassed. Synthetic materials are used to connect the artery on either side of the blockage. (Instead of synthetic material, your surgeon might use one of your own veins, usually from your leg.)

New techniques for treating blocked arteries, particularly through the catheter, are under investigation.

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