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Understanding the Different Types of Coronary Artery Disease

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According to the American Heart Association, cardiovascular disease kills more than 800,000 people each year – that accounts for 1 in every 3 deaths[1]. Though cardiovascular disease is an umbrella term for a collection of different diseases, coronary artery disease is the most common type and the leading cause of death for both men and women in the United States.

Coronary Artery Disease (CAD) develops when the major blood vessels that supply blood to the heart either become damaged or diseased. In most cases, a combination of inflammation and accumulated plaque in the arteries is to blame. Because CAD can develop slowly over a period of years or decades, it can be easy to miss – you should also know that there are different types of coronary artery disease. Keep reading to learn the different types of CAD and how to protect yourself.

The Two Types of Coronary Artery Disease

When it comes to coronary artery disease, there are a few terms you are likely to hear – namely, arteriosclerosis and atherosclerosis. Both of these are technically types of coronary artery disease, but they are very different. Arteriosclerosis is a hardening of the arteries. Over time, high blood pressure inflicts damage upon the arteries which causes them to become harder and thicker – it can also lead to stiffness and a loss of elasticity in the artery. The more the arteries narrow, the less blood flows to and from the heart which can lead to symptoms of CAD and increase the risk of heart attack.

Atherosclerosis is technically a type of arteriosclerosis – the most common type. This condition is caused by an accumulation of plaque in the artery walls which, over time, causes the artery walls to thicken, stiffen, and lose elasticity. It is possible for a patient to have arteriosclerosis without also having atherosclerosis, but the two tend to go hand-in-hand. The combination of the two can cause a significant decrease in blood flow to the heart muscle which can produce symptoms of CAD[2].

What Are the Signs and Symptoms of CAD?

As your coronary arteries narrow over time, blood flow to the heart muscle becomes diminished, and that leads to the development of symptoms. One of the most common symptoms of coronary artery disease is chest pain or angina. Angina feels like a pressure or tightness in the chest, and it usually begins in the middle or on the left side. In most cases, chest pain subsides after a few minutes – especially when triggered by a stressful activity – or it can radiate to the neck, arms, or back.

Another symptom of CAD is shortness of breath. When your heart fails to pump enough oxygenated blood throughout the body, you may become extremely fatigued or have trouble breathing. If the blockage of a coronary becomes complete, it can result in a heart attack. The signs and symptoms of a heart attack typically include a crushing pressure in the chest, pain in the shoulder or arm, shortness of breath, and sweating. For women, these symptoms may be a little different and may include pain in the neck or jaw rather than the chest[3].

What Are the Treatment Options?

When it comes to treating coronary artery disease, there are several different approaches. In the long term, managing your risk factors is very important. Some of the causes of coronary artery disease include smoking, high blood pressure, high cholesterol, diabetes, insulin resistance, and a sedentary lifestyle. Having a family history of CAD is not something you can control, but you can lose weight if you are obese, stop smoking, manage diabetes, and improve your lifestyle and diet.

In addition to managing cardiac risk factors, treatment may also involve relieving the symptoms of coronary artery disease. Medications are frequently involved in the treatment of CAD and may include things like aspirin to reduce the risk of blood clots, medications to reduce cholesterol levels, beta blockers to lower blood pressure, ACE inhibitors to slow the progression of the disease, and nitroglycerin to manage symptoms like chest pain.

In cases where the arterial blockage has become severe, surgical treatments may be necessary. An angioplasty is a procedure in which a thin tube called a catheter is placed into the narrowed part of the artery to keep it open. Another option is coronary artery bypass surgery which involves creating a graft to bypass the blocked artery using a healthy vessel from another part of the body – this allows your blood to flow around the blocked artery and into the heart.

Left untreated, coronary artery disease can cause some serious complications including heart attack. Fortunately, it is very easy to prevent CAD in the first place. Just follow a healthy diet, get some exercise, and maintain a healthy body weight. If you have certain risk factors such as high cholesterol or hypertension, your doctor may also recommend medication or other therapies to manage these factors.

[1] “Heart Disease and Stroke Statistics 2017 At-a-Glance.” American Heart Association. <https://healthmetrics.heart.org/wp-content/uploads/2017/06/Heart-Disease-and-Stroke-Statistics-2017-ucm_491265.pdf>

[2] Whitlock, Jennifer. “Atherosclerosis, Arteriosclerosis, and Heart Surgery.” VeryWell Health. <https://www.verywell.com/atherosclerosis-arteriosclerosis-and-heart-surgery-3156967>

[3] “Coronary Artery Disease.” Mayo Clinic. <https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613>

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