Coronary artery disease is the result of the hardening of the coronary arteries (atherosclerosis), which gradually develops over the years.
Exposure to (cardiovascular) risk factors increases your chances of developing coronary artery disease.
A few risk factors:
– Smoking
– Increased cholesterol
– High blood pressure
– Diabetes mellitus
– Overweight
– Insufficient physical activity
– Family history
– Chronic negative stress
– Age and gender
Symptoms
The classic symptom of coronary artery disease is angina. Angina symptoms are often described as a painful, pressing, or constricting sensation in the chest, which can occur during exertion or at rest.
Additional symptoms include:
- Radiating pain to the (left) arm, shoulder, neck, and jaw
- Shortness of breath
- Palpitations
- Nausea, vomiting
- Excessive sweating
- Dizziness or fainting
Short-lasting, stabbing chest pain can also originate from the muscles, ribs, or nerves. If in doubt, always consult your doctor.
Treatment
Treating coronary artery disease is vital for survival. If left untreated, it can lead to arrhythmias, heart attacks, or even heart failure.
Depending on the extent of the condition, various treatments are possible. After diagnosis, the cardiologist, together with you and the multidisciplinary heart team, will decide which treatment is most suitable for you.
- Healthy lifestyle: A healthy diet and sufficient exercise are essential to slow down the progression of coronary disease. In some cases, a ban on exercise is recommended. Stress control and smoking cessation are also encouraged.
- Medication and Cardiac Follow-up: In the early stages, coronary artery disease can be treated with medication (including nitrates, beta-blockers, ACE inhibitors, antiplatelet agents, and cholesterol-lowering drugs), provided there is regular follow-up with a cardiologist. Today, medication can slow down the progression of coronary artery disease but cannot yet cure it.
- Balloon Dilation of the Coronary Artery: Percutaneous Transluminal Coronary Angioplasty (PTCA), also known as Balloon Angioplasty. A small balloon is guided via a catheter into the narrowed coronary artery to widen the blood vessel.
- PCI and Stent Implantation: Percutaneous Coronary Intervention (PCI). A metal spring or tube (stent) is inserted into the narrowed coronary artery using a catheter to keep the blood vessel open.
- Traditional Coronary Bypass Surgery: A healthy blood vessel is used to bypass the diseased section of the coronary artery, allowing blood to flow past the blockage.
- Coronary Bypass Surgery with the Help of a Surgical Robot (MIDCAB): A narrowed coronary artery is bypassed using a healthy blood vessel with the assistance of a surgical robot.
Some patients may be eligible for a combined approach, where a MIDCAB procedure is combined with balloon dilation or stent implantation.
Tests and Diagnosis
If coronary artery disease is suspected, one or more of the following tests may be performed:
- Clinical interpretation
- Blood tests
- Electrocardiogram (ECG)
- Exercise test
- Holter ECG
- Stress echocardiography
- MRI scan
- FDG-PET/CT scan
- Cardiac catheterization