Each of the four primary coronary arteries is named after one of the four major arteries in the body: the right coronary artery (RCA), the left coronary artery (LCA), the left anterior descending (LAD), and the left circumflex artery. Cardiovascular disease is a constriction or blocking of your coronary arteries that is typically caused by the deposition of fatty material known as plaque in your arteries. Coronary artery disease, also known as coronary heart disease, ischemic heart disease, and heart disease, is a type of cardiovascular illness. Cleveland Clinic is a not-for-profit academic medical centre located in Cleveland, Ohio. Advertising on our website contributes to the success of our mission. We do not recommend or promote any items or services that are not provided by the Cleveland Clinic. Policy
Working system
These are the blood veins that carry oxygen-rich blood to your heart muscle in order to keep it pumping continuously. It is precisely on top of your heart muscle that the coronary arteries are located. There are four major coronary arteries in your body:
- The right coronary artery is a branch of the coronary artery.
- The coronary artery on the left side.
- The left anterior descending artery is a branch of the left main trunk artery.
- The left circumflex artery is a branch of the coronary artery.
What exactly happens to the arteries when we have coronary artery disease
Atherosclerosis is the underlying cause of coronary artery disease. It is the buildup of plaque within your arteries that is known as atherosclerosis. Platelet-forming chemicals, such as cholesterol and fatty compounds, as well as waste products and calcium, contribute to the formation of plaque. Your arteries get narrower and stiffer as plaque builds up on the inside of the walls of your arteries. Plaque can clog or damage your arteries, causing blood flow to your heart muscle to be restricted or completely stopped. If your heart does not receive enough blood, it will not be able to receive the oxygen and nutrients that it need to function effectively. Ischemia is the medical term for this illness. Chest discomfort or soreness might occur if your heart muscle does not receive enough oxygen and nutrients to function properly (called angina). It also increases your risk of having a heart attack.
Causes
Coronary artery disease can affect anyone at any age. The rate at which it develops varies from one individual to another. The process normally begins while you are a child or adolescent. Before you reach your adolescence, fat streaks begin to appear on the blood vessel walls. During the process of plaque formation in your artery’s inner walls, your body fights back by dispatching white blood cells to assault the cholesterol, but this onslaught just serves to increase inflammation. This causes yet another group of cells in the artery wall to gather together and form a soft cap over the plaque.
This thin top above the plaque has the potential to break open (due to blood pressure or other causes). Platelets, which are fragments of blood cells, adhere to the location of “the injury,” causing a clot to develop there. The clot causes the arteries to become even more narrow. Occasionally, a blood clot will disintegrate on its own. Another scenario is that a blood clot restricts blood flow via an artery, depriving the heart of oxygen and ultimately leading to a heart attack.
The procedure for diagnosing coronary artery disease
Your cardiologist (heart doctor) will question you about your symptoms, take a medical history, examine your risk factors, and perform a physical exam unless your condition is an emergency (you’re experiencing a heart attack or stroke, for example).
Exercise stress tests: This is a treadmill test that determines how well your heart performs when it is functioning at its maximum capacity. Can be used to detect angina and coronary artery blockages.
An alternative to employing exercise to assess your heart’s performance while it is functioning at its most difficult is to administer medicine that causes it to increase in heart rate and simulate activity. Angina and coronary artery blockages can be detected using this test.
CTA (coronary calcium scan): This test assesses the quantity of calcium present in the walls of your coronary arteries, which may indicate the presence of atherosclerosis.
In this test, sound waves are used to evaluate the overall function of your heart as well as the functioning of the parts of your heart.
In addition to triglycerides, cholesterol, lipoproteins, C-reactive protein, glucose, HbA1c (a measure of diabetes management), and other tests, several blood tests are conducted to check for variables that damage arteries.
Heart catheterization: This procedure involves the insertion of tiny tubes into the blood vessels of the heart in order to assess cardiac function, including the existence of coronary artery disease, and to diagnose the condition.
Other types of diagnostic imaging examinations may be performed, such as:
Nuclear imaging is a technique that creates images of the heart after a radioactive tracer is administered to the patient.
Angiogram with computed tomography (CT) and contrast dye: This procedure uses CT and contrast dye to create 3D images of the moving heart and locate blockages in the coronary arteries.
Management and Treatment of Illness
Your healthcare professional will consult with you over the most appropriate treatment strategy for you. Make sure you follow your treatment plan to lower your chance of developing complications associated with coronary artery disease, such as heart attack or stroke.
Don’t take up smoking. If you smoke or use tobacco products, you should stop immediately. Inquire with your healthcare providers about options for quitting, such as programmes and drugs.
Health concerns such as excessive cholesterol, high blood pressure, and diabetes can be managed effectively.
Consume foods that are good for your heart. Consult with your healthcare physician or a certified dietitian about methods to make dietary changes to lower your risk of heart disease and other diseases. Diets such as the Mediterranean and DASH diets are both excellent alternatives.
Consumption of alcoholic beverages should be limited. Drinking should be limited to no more than one drink per day for women and two drinks per day for men on a daily basis.
Increase your degree of physical activity. Exercise aids in the loss of weight, the improvement of physical condition, and the reduction of stress. The majority of people can lower their risk of heart attack by walking for 30 minutes five times per week or by walking 10,000 steps each day on a treadmill. Before beginning any physical activity programme, consult with your healthcare physician.
Medications
Your healthcare practitioner will recommend medications that will help you manage your risk factors for heart disease to the greatest extent possible. The following are examples of heart-related drugs that may be prescribed for you:
Statins, bile acid sequestrants, niacin, and fibrates are examples of medications that can help you lower your cholesterol levels.
Beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers are examples of medications used to reduce blood pressure.
Angina-relieving medications such as nitrates/nitroglycerin or ranolazine are available.
Anticoagulants (including aspirin) and antiplatelet medications, among other things, are used to minimise the risk of blood clots.
It is likely that you may be administered drugs to lower your blood sugar level if you have diabetes and coronary artery disease together.
Conclusion
Maintaining a strict regimen of medication, particularly those for heart disease and other health concerns, is imperative. If you have any questions or concerns regarding which medications to take or how to take them, you should speak with your healthcare professional.