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Artemis - Coronary Artery Disease (CAD)
WHAT IS CORONARY ARTERY DISEASE (CAD)?
Coronary Artery Disease (CAD) occurs when the arteries that supply blood to your heart muscle (the coronary arteries) become hardened and narrowed. The arteries harden and get narrow due to the build up of a material called 'plaque', which is deposition of cholesterol/fat on their inner walls. As the inside of your coronary arteries get narrower, less blood can flow through them. Eventually, blood flow to your heart muscle gets reduced, and because blood carries much - needed oxygen, your heart muscle is not able to receive the amount of oxygen it needs. Reduced or cut off blood flow and oxygen supply to your heart muscle may lead to problem like :
Angina : Angina is chest pain or discomfort that occurs when your heart does not get enough blood.
Heart attack : A heart attack happens when a blood clot develops at the site of narrowing in a coronary artery and suddenly cuts off most or all the blood supply to the part of the heart muscle. Cells in the heart muscle begin to die if they do not receive enough oxygen-rich blood. This can cause permanent damage to the heart muscle and even result in death.
Over time if untreated, CAD can weaken the heart muscle and contribute to :
SYMPTOMS OF CAD
The following are the symptoms a person with significant narrowing in coronary arteries may experience :
If these symptoms are precipitated by physical or mental stress then it is strongly suggestive of CAD. In some patients, the first sign of a CAD is a heart attack.
HOW IS CAD DIAGNOSED?
After taking your detailed medical history, your doctor will conduct a thorough physical check-up and will advise you the following tests.
ECG (Electrocardiogram) : This test will record your heart's electrical activity while you rest. A graph recorded on an ECG sheet can give clue to the reduction of blood supply to heart. It may show evidence of previous heart attacks. It will also show any abnormality of heart rhythm.
Echocardiography : It uses ultrasound waves to produce an image of your heart to see its functioning. It shows functioning of various chambers and valves of heart.
Exercise ECG / Treadmill Test (TMT) : During this test your ECG and BP is recorded while you walk on a treadmill. This test, if abnormal, suggests reduction of blood supply to your heart when you exert.
Exercise Thallium Test : During the advanced test, which is similar to TMT a radioactive substance will be injected into your bloodstream at the peak of exertion, that will enable your doctor to see the blood flow to various regions of your heart.
Coronary Angiography : This is the final / gold standard test for diagnosing CAD. During this test your doctor will inject a dye through a catheter into your coronary arteries. Then he will take an X-ray image to see the blood flow through your coronary arteries. This test will enable your doctor to choose the right treatment for you, depending on the number and extent of blockages.
WHAT IS THE TREATMENT OF CAD?
Depending on the severity of the blockages and your general health condition, there will broadly be four treatment options to choose from:
Lifestyle changes
Making lifestyle changes can help treat CAD. For some people, these changes may be the only treatment
needed.
Eat a healthy diet to prevent or reduce high blood pressure and high blood cholesterol and to maintain a
healthy weight.
Medicines
As per your requirement, your doctor will prescribe one or a combination of medicines. Some medicines, decrease the workload on the heart while others decrease the chances of having a heart attack.Because medicines cannot clear blocked arteries, therefore, you may have to resort to a percutaneous coronary intervention or a bypass surgery to restore the blood supply to your heart muscles if there is significant narrowing in the coronary arteries.
Percutaneous Coronary Interventions / Angioplasty
In this procedure, a long, thin tube called a catheter, which will have a small balloon on its tip, will be directed to your blocked artery. This balloon will then be inflated at the blockage site to flatten or compress the deposited cholestrol / fat against your artery wall. This will open the path of blood flow, through your narrowed artery. During this procedure, your doctor might decide to place a 'stent' at the site of your blockage. A stent is a metallic, mesh like device which is used to keep the heart vessels open and to prevent them from collapsing again.
Bypass Surgery
Coronary artery bypass surgery will involve "bypassing" blood flow around one or more narrowed vessels of yours by using a vein or artery from another part of your body as a graft.
FOLLOW UP CARE
At Artemis, follow up care is an essential element of the overall treatment plan. Regular check-ups are advised to detect any changes in health as early as possible. Facilities for diagnostic cardiac tests include Treadmill Test (TMT), Ecocardiography (colour Doppler) Stress Ecocardiography, 24 hours Holter monitoring, Ambulatory BP Monitoring, Stress Thallium test, 64 slice CT angiography, Coronory and Peripheral angiography and electrophysiological study. Artemis Health Institute also offers the best combination of equipment and doctors for world class treatment of all cardiac diseases in form of coronary angioplasty, bypass surgery, valvularplasty / valve replacement, radio frequency ablation and pace maker implantation.