How is Coronary Artery Disease Diagnosed?

When you visit your doctor, he/she will take your medical history, ask you questions to understand your symptoms which will be followed by listening to your heart beat with a stethoscope. He/she may order tests to determine whether you have CAD and to what extent. The results of these tests can also help determine your treatment decisions. These tests may include:

• Routine blood tests to check the level of fats, cholesterol, sugar and proteins in your blood. These are risk factors for heart disease that can be modified with lifestyle changes and, if needed, medication.
• Electrocardiogram (ECG), which records your heart’s electrical activity and shows how fast or evenly the heart is beating. It can also show whether there is enough blood supply to the heart or if it is already damaged.
• Echocardiogram to look at the structure and overall functioning of your heart.
• Stress testing, which involves exercising, usually on a treadmill or stationary bike (or taking medicine to simulate exercise if you are unable to be active), to non-invasively evaluate blocked arteries in the heart.
• Chest X-ray to look at the heart and lungs and to see if there are abnormalities that might explain your symptoms.
• Computed tomography (CT) scan of the heart that shows pictures of the heart’s arteries and whether there is a build up of plaque, even in the early stages before the plaque hardens.
• Coronary angiography is done in the cardiac catheterization laboratory, and involves threading a thin tube or catheter into an artery, usually in the wrist or leg, and up to the heart. The test goes into the body to directly evaluate the arteries of the heart. It is usually recommended when a non-invasive test is not possible or a patient’s symptoms strongly suggest CAD.

How can you prevent CAD?

When you visit your doctor, s/he will take your medical history, ask you questions to understand your symptoms which will be followed by listening to your heart beat with a stethoscope. He/she may order tests to determine whether you have CAD and to what extent. The results of these tests can also help determine your treatment decisions. These tests may include:

To improve your heart’s health, you need to ascertain:

• Don’t smoke and avoid second-hand smoke. Quitting smoking can quickly reduce the risk of another heart attack or death.
• Eat a heart-healthy diet that includes plenty of fish, fruits, vegetables, beans, high-fibre grains and breads, and olive oil.
• Get regular exercise. Your doctor can suggest a safe level of exercises for you.
• Control your cholesterol and blood pressure.
• Manage your diabetes.
• Lower your stress level. Stress can damage your heart.
• If you have talked about it with your doctor, take a low-dose aspirin every day. But taking aspirin isn’t right for everyone, because it can cause serious bleeding. So, consult your physician.

TREATMENT FOR CAD

Treatment for coronary artery disease usually involves lifestyle changes and, if necessary, medication and certain medical procedures.

Lifestyle changes

Making a commitment to the following healthy lifestyle changes can go a long way toward promoting healthier arteries:

• Quit smoking.
• Eat healthy foods.
• Exercise regularly.
• Lose excess weight.
• Reduce stress.

Medication

The main way to prevent heart damage during an attack is to restore blood flow quickly. When a heart attack is first detected and confirmed, your doctor may put you on medication to help unclog the arteries and restore blood flow to the heart. The level of blockage and extent of damage to the heart muscle will then determine the treatment your doctor recommends.

Surgical Treatment

After performing some tests and understanding your condition, your doctor will decide if you require surgery. Depending on the extent and location of the blockage, your doctor may recommend a coronary balloon angioplasty, coronary artery stenting or Coronary Artery Bypass Graft surgery (CABG) procedures carried out for heart attack.

• Angioplasty and stent placement (Percutaneous Coronary Intervention)

Coronary angioplasty or Percutaneous Coronary Intervention (PCI) is a common procedure in treating blocked arteries and it is a minimally invasive procedure that uses a catheter to place a small device (such as a balloon or stent) within a blocked blood vessel to open the blockage and re-stablish the blood flow. Your doctor will study the rate of your blood flow and the severity of your symptoms to decide if angioplasty is the right treatment for you.

Procedure

During coronary angioplasty, doctors insert a long, thin tube (catheter) through an artery, usually in your leg or groin. This catheter is equipped with a balloon that is inflated to open up blocked areas where blood flow to the heart has been reduced or cut off. This minimally invasive procedure is sometimes combined with the insertion of a stent to help keep the artery open and decrease the chance of a second blockage. The angioplasty recovery time is usually very short. You’ll normally be able to leave the hospital the day after the surgery and you can resume normal activity in a week’s time. But it’s important to follow your doctor’s instructions to continue to stay healthy.

STENTS USED FOR TREATING CORONARY ARTERY DISEASE

Stents help keep coronary arteries open and reduce the chance of a heart attack.

Do you know, what does the stent do in heart patients?

• Bare-metal stents: It’s a metal tube specially designed to prevent blockage from happening again after angioplasty.
• Drug-eluting stents: It’s a bare metal stent coated with a drug, which releases drug from the stent into the arterial wall over time, when a re-blockage is most likely to happen.

• Coronary Artery Bypass Grafting (CABG)

CABG is a procedure that helps improve blood flow to the heart. Surgeons sometimes use it as an alternative to be treating people who can’t have a coronary angioplasty for many technical reasons.