Coronary artery disease symptoms, risk factors, diagnosis and treatment guidance.

Overview

What is coronary artery disease (CAD)?

Coronary artery disease is a common heart condition where blood flow through the main vessels supplying the heart is reduced. This is usually caused by a buildup of fats, cholesterol and other substances in these vessels.

How common is CAD?

• CAD is the main cause of heart attacks
• It affects around 30 million people in India
• Early detection of CAD can help manage this condition better and decrease the risk of heart attack or stroke

Who is commonly affected?

CAD is more common in:

• Older people
• Men
• Those with close family members with heart disease
• Smokers
• Those with high blood pressure, cholesterol issues, diabetes, obesity, kidney disease

What causes CAD?

• CAD is mainly caused by the buildup of cholesterol and fats in your blood vessels which can decrease the blood flow to the heart, damaging it.
• This buildup can occur due to:
• Poor sleep
• Smoking/alcohol consumption
• High level of stress
• Not getting enough exercise
• Poor diet

Symptoms of CAD

• Chest pain
• Shortness of breath
• Tiredness

These symptoms might not be noticeable at first, but can get more severe and frequent as the blood vessels become narrower

Warning signs of a severe condition

• Nausea
• Chest pain
• Pain/discomfort spreading to the shoulder, arm, back, neck or jaw
• Dizziness

Diagnosis

• Blood tests to look at your blood sugar and cholesterol levels
• A test to see how well your heart is beating
• Echocardiography to view how well your heart is pumping blood
• Exercise stress test to check how well your heart works during exercise
• Angiogram in which the doctor inserts a thin, flexible tube through your blood vessels to look for any blockages

Treatment

Treatment for CAD may include:

• Lifestyle changes such as not smoking, eating healthy and exercising more.
• Medicines to help lower your cholesterol levels or prevent thickening/clotting of blood
• Heart procedure or heart surgery.

What is a coronary artery bypass graft (CABG)?

CABG or a heart bypass is a surgery done to restore blood flow to your heart by taking blood vessels from other parts of your body to bypass the blocked artery. It is the most common form of heart surgery in the world.

What happens before the surgery?

• Your doctor will run several tests including blood tests, X-rays, echocardiogram, etc.
• They will also review all the medicines you are taking
• You will be asked to fast several hours before the surgery

What happens during a CABG?

• You are put into a deep sleep
• The chest is opened through a cut in the middle of the chest
• Heart may be temporarily stopped and a machine is used to circulate your blood during the procedure. Sometimes this surgery can be done on a beating heart
• A healthy blood vessel (from leg, arm, or chest) is taken and used to bypass the blocked artery
• This new path restores the blood flow to the heart
• The chest is closed up with stitches

Type of anaesthesia: General

Duration of surgery: 3-6 hours

Benefits of this surgery

• Best choice for severe cases of CAD or if you have multiple blocked arteries
• Improved blood flow to the heart
• Considerable reduction in chest pain
• Lower risk of heart attack in the future

What are the possible risks of CABG?

After this surgery, you may experience/suffer from

• Irregular heart rhythms
• Bleeding
• Infections
• Confusion
• Kidney problems
• Stroke

Post-surgery care

• You will first be shifted to the ICU for around 1-2 days depending on your condition
• When the doctors feel you are ready, you will be shifted to a general ward
• You will be given medicines for managing pain and preventing any blood clots

Usual length of hospital stay: 5-7 days; longer if your condition was very severe

Recovery time

• Usually about 6-12 weeks
• You can drive after around 4-6 weeks if your doctor allows

Lifestyle & Prevention

Recommended diet

• Fruits and vegetables daily
• Whole grains (brown rice, oats)
• Lean proteins (fish, dal, legumes)
• Limit fried, processed, and sugary foods
• Reduce salt intake
• Limit consumption of sugar

Long-term care

• Regular follow-ups with doctor
• Take medicines regularly (do not stop suddenly)
• Monitor blood pressure, sugar, cholesterol
• Keep a healthy weight
• Sleep well and reduce/manage stress
• Limit alcohol consumption

When to contact a doctor?

Warning signs

• Chest pain
• Trouble breathing
• Dizziness or lightheadedness
• Fainting
• Weakness on one side of your body
• Slurred or distorted speech
• Fever or chills
• Fast heart rate or breathing

Myths and Facts

Frequently Asked Questions (FAQs)