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Coronary Artery Disease
Sharon Parmet, MS, Writer; Tiffany J. Glass, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2004;292(20):2540. doi:10.1001/jama.292.20.2540.

Coronary artery disease means narrowing of the coronary arteries (arteries that supply blood to the heart). This narrowing is due to a buildup in the walls of the arteries of plaque (deposits made up of cholesterol, other fats, and calcium)—a process called atherosclerosis (hardening of the arteries). If a plaque becomes delicate and breaks, a blood clot will quickly form that can block blood flow in the artery and may lead to a myocardial infarction (death of the heart muscle area supplied by the blocked artery), often referred to as a heart attack.




SYMPTOMS


  • Coronary artery disease can develop slowly without any symptoms.

  • Angina—chest pain that can radiate to (or sometimes is limited to) the shoulders, arms, or jaw. Angina usually lasts several minutes and may be related to activity, exercise, large meals, cold, or stress. If angina lasts more than 15 minutes, there is a risk that a heart attack may be occurring.

  • Heart attack symptoms include severe chest pain, shortness of breath, sweating, and nausea. Symptoms can be different in men and women, with women more likely to experience unusual fatigue after activity rather than chest pain.


  • If you or anyone you know experiences heart attack symptoms, call immediately for emergency medical evaluation.





    DIAGNOSIS


    Several tests can be performed in an emergency department to determine if a heart attack is occurring. Blood tests can detect certain substances in the blood that are released during a heart attack. An electrocardiogram (ECG, EKG) can reveal heart attacks and heart rhythm problems.



    TREATMENT


  • Nitrate medication (such as nitroglycerin) can be taken to help stop angina attacks.


  • Blood—thinning drugs, such as aspirin, can help reduce the risk of blood clots.


  • Statins (a kind of cholesterol-lowering drug) and beta-blockers (a kind of blood pressure—lowering drug) can prevent heart attacks and premature deaths.


  • Percutaneous coronary intervention (PCI)—a thin balloon is threaded into the blocked artery and inflated, pressing the plaque and widening the artery to increase blood flow; a stent (a small flexible tube) is then placed in the artery to keep it open.


  • Coronary artery bypass graft (CABG) surgery—uses a vein from another part of the body to bypass a severely blocked coronary artery.






  • FOR MORE INFORMATION


  • American Heart Association
  • 800/AHA-USA-1 (242-8721)
    http://www.americanheart.org

  • National Heart, Lung, and Blood Institute
  • 301/592-8573
    http://www.nhlbi.nih.gov



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