CORONARY ARTERY DISEASE
The major blood vessels supply the heart with blood, oxygen and nutrients. When these vessels become damaged or diseased, cholesterol-containing deposits (plaque) and inflammation build up in the arteries causing restricted blood flow. This is known as coronary artery disease and left untreated; the lack of blood flow to the heart can lead to a heart attack.
Coronary artery disease often develops over time, meaning many won't notice the problem until there is a blockage in the arteries or heart attack. However, when the arteries are narrowed by plaque or inflammation, it can cause a range of symptoms. It may be time to see a cardiologist if you have experienced symptoms such as:
- chest pain or tightness or discomfort
- pain that radiates to the jaw or to the arms
- shortness of breath
- effort intolerance
- associated sweating
- rapid heartbeatt
- heart palpitations
Diagnosis & Treatment
In order to make a diagnosis, Dr Ho may do a physical exam followed by a range of tests including an electrocardiogram (ECG) or exercise stress test which can evaluate the electrical activity generated by the heart when it is at rest and when exercising. In some cases, he may also utilise coronary angiography to make a diagnosis. This involves a special dye being injected into the bloodstream. This dye will then outline narrow spots and blockages so that the blood supply to the heart can be visualised using x-ray images.
Because coronary artery disease is caused by cholesterol plaque buildup in the arteries (which is called atherosclerosis), treatment will be focused on decreasing the build-up of plaque and allowing for better blood flow through the arteries. To decrease cholesterol, various lifestyle changes would need to be made. Dr Ho will suggest that you eat healthier foods, exercise more regularly and lose excess weight. Some drugs may also help decrease plaque build-up such as cholesterol-modifying medications, beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) as well as aspirin type drugs.
In severe cases where a blockage or severely narrowed spot is found on the x-ray, during the diagnostic test, coronary angiogram, treatment known as cardiac catheterisation and coronary artery stenting can be done at the same time. During this procedure, if narrow spots and blockages are found on the x-rays, Dr Ho will thread a long, thin, flexible tube called a catheter through the artery in the leg up to the arteries in the heart. A balloon can then be pushed through the catheter and inflated where there is a narrowed area or blockage in the artery. Once inflated, a mesh tube (stent) can be placed to keep the now dilated artery open.