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Coronary Artery Disease
A Description
Coronary artery disease is the leading cause of death in the nation. It is also
preventable. Coronary artery disease is also called arteriosclerotic coronary artery
disease and ischemic heart disease. (The coronary arteries are the small blood vessels
that provide oxygen and nutrients to the muscles of the heart.)
In arteriosclerotic coronary artery disease, plaque builds up on the walls of the
arteries. This plaque build up is called arteriosclerosis. Plaque may be made up of
cholesterol, scar tissue, calcium and other substances.
Another name often used for arteriosclerosis is atherosclerosis. Atherosclerosis, however,
refers to plaque build up in blood vessels in other parts of the body. Because plaque
causes a decreased flow of blood (ischemia) to the muscles and nerves of the heart,
ischemic heart disease also describes the medical condition.
The build up of plaque over many years sets the stage for the problems encountered with
coronary heart disease. It narrows the size of the artery's opening and decreases the flow
of blood and oxygen to the heart.
When this happens, the muscles and nerves malfunction and pain occurs. This pain is called
angina. The pain is usually located below the breastbone and often is felt in the left
jaw, left shoulder and down the left arm. Although often brought on by exercise and
sometimes emotional stress, it may occur at any time including during sleep.
Anginal pain is usually an ache. Sometimes, it may feel like pressure. Angina pain is
often confused with other chest pains including pain caused by heartburn, pleurisy and
chest wall injuries which tend to be much sharper and often burning in nature.
Angina can also occur when there is no arteriosclerosis of the coronary arteries. This is
sometimes due to the abnormal contraction and narrowing of the walls of an artery
(vasoconstriction).
Although this may occur spontaneously, it is often brought on by exposure to cold, drugs
such as ergotamine and cocaine, and sometimes by emotional stress.
Prinzmetal's variant angina is a condition which also causes angina due to
vasoconstriction. This most commonly occurs in women under the age of 50.
In addition to angina, the decreased blood flow in the coronary arteries can cause fatigue
and abnormal beating patterns of the heart (arrhythmias).
The simple narrowing of the coronary arteries is enough to cause angina, but breakdown of
the plaques, tearing of the artery walls and blood clots are usually the cause of a heart
attack (infarction). The first sign of coronary artery disease may be a
heart attack.
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