Heart disease is the leading cause of death in the United States and Coronary Artery disease (CAD) is one of them. This disease in particular is scary because it has the ability to reduce one's lifespan by 16 years if gone unnoticed and untreated. CAD is known to be a silent killer because many people who have it don't show any symptoms and generally experience the negative effects of CAD later in life. Although there is no cure for this disease, there are many effective treatments that can help control CAD, and extra measures, such as lifestyle changes, can be made as a precaution to prevent further damage.
This disease dates back to over 4,000 years ago and studies show that pre-modern humans and mummies struggled with the same disease that we do today. It is thought that much of what we know about CAD was discovered by the Egyptians as they were very ahead of their time in the medical field. Since then, we have discovered much more about CAD such as how it spreads and who it targets. The fact that it is hereditary and can be influenced by lifestyle implies that both genetics and environmental factors play large roles in a person getting this disease. Some other risk factors include age because older arteries tend to narrow and the sex of a person, as men are generally at a greater risk. Smoking, obesity, lack of exercise, immense stress, and healthy diet, alcohol use, and amount of sleep are all environmental factors that greatly influence the chances of someone getting it in their lifetime. A good rule of thumb is if it is not a healthy habit, it is not good for the heart. Some pre-existing conditions that can greatly increase one's chances include high blood pressure, high cholesterol, diabetes, HIV, gum disease, chronic kidney disease, sleep apnea, high triglycerides, and certain autoimmune diseases. Those with a family history of CAD and who have any of these pre-existing conditions and/or lifestyle habits should check in with their cardiologist often because this kind of heart disease only becomes pronounced through fatalities such as heart attacks or strokes. Common diagnosis methods include an electrocardiogram/ EKG (which can be performed at home on an Apple watch), a stress test, a chest x-ray, a blood test, or cardiac catheterization.
So what is CAD? CAD occurs when plaque, fat, cholesterol, or other substances grow on the walls of the coronary arteries until it obstructs blood flow to the heart's muscles. It is because of this that the muscles in the heart lacks oxygen and the coronary artery gradually narrows over time which, in turn, reduces blood flow to the muscles even more. In some cases, the plaque can rupture and platelets will try to repair the torn artery, forming a blood clot. This alternative scenario prevents the free flow of blood to the heart and places high amounts of pressure on the artery. Although the amount of time it takes for the plaque to build up in the arteries differs per individual, it can take decades till one starts to notice side effects of CAD. The most common version of CAD occurs during childhood and builds into adulthood where most of the harmful effects of CAD start to show. Acute CAD, the less common type of heart disease, occurs when there is a sudden rupture of plaque on the walls which forms into a blood clot. It is estimated that 20.5 million Americans or 1 in 20 adults have CAD, making it the leading cause of death in America.
This disease is so fatal because of its complications which are generally experienced at a later stage of life. Lack of blood or oxygen to the heart can cause heart attacks/ cardiac arrest, abnormal heart rhythms, and even heart failure. Heart attacks can occur if a blood clot is obstructing the blood's path from the muscles in the heart. Irregular heart rhythms occur when the heart doesn't receive the amount of blood it needs, thus changing the heart's signaling. Heart failure can occur when the heart becomes weak or stiff due to the narrowed arteries or high blood pressure that develops due to plaque. Almost always, an individual realizes that they have CAD after experiencing one of these life-changing complications, which is why it's a good idea to stay ahead of this disease instead of waiting for it to announce itself to you. Other less deadly symptoms include any of the following sensations in the chest, shoulders, arms, back, or jaw: tightness, discomfort, pressure, heaviness, squeezing, burning, aching, numbness, or fullness.
There is no known cure for CAD, but there are many treatments, surgeries, and medications that have proven efficient in controlling the symptoms of CAD. The medications prescribed are generally targeted to subside the pre-existing conditions that may be aggravating the CAD. For example, medication given to lower blood pressure and cholesterol greatly reduced the risk of blood clots and more effectively prevented fatal complications. Surgeries such as coronary angioplasty, a minimally invasive procedure that reopens blocked arteries/inserts stents to help the arteries stay open, and coronary artery bypass grafting, creating a new path so the blood can flow around the blockage, and are beneficial for mitigating the effects of CAD and keeping it under control. Although there are complications that may arise as a result of these surgeries (bleeding, diarrhea, dizziness, cough, blood clot, coronary artery puncture, and infection), they have been shown to substantially improve long-term outcomes.
Although there is no cure for CAD yet, regenerative medicine and stem cell therapy are potential ways under research to repair damaged tissue in patients. Innovative drugs are the latest advancements in secondary prevention and is expected to have a good shot at mitigating the effects of pre-existing conditions in patients. Hopefully, less invasive surgeries and more stem cell therapy treatments will shine a light on the improvement of muscle function in the heart and serve as preventative methods to finally take down the biggest killer in America.
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