ATHEROSCLEROSIS

Atherosclerosis is a common condition in which cholesterol, fatty deposits and other substances gradually build up within the walls of the arteries. Over time, these deposits can form plaques that narrow the artery and reduce blood flow.

When atherosclerosis affects the coronary arteries, it is known as coronary artery disease (CAD). Reduced blood flow to the heart muscle can cause chest pain, angina and, in some cases, a heart attack.

WHAT ARE THE SYMPTOMS OF CORONARY ATHEROSCLEROSIS?

Atherosclerosis may not cause symptoms during its early stages. As coronary artery narrowing becomes more significant, symptoms may include:

• Chest pain, pressure or tightness, particularly during physical activity.
• Shortness of breath.
• Fatigue or reduced exercise tolerance.
• Pain that may spread to the arm, shoulder, back, neck or jaw.
• In some cases, the first presentation may be a heart attack.

WHAT INCREASES THE RISK OF ATHEROSCLEROSIS?

Important risk factors include:

• High cholesterol.
• High blood pressure.
• Diabetes.
• Smoking.
• Overweight and physical inactivity.
• Family history of cardiovascular disease.
• Increasing age.
• Unhealthy diet and lifestyle factors.

HOW IS CORONARY ARTERY DISEASE DIAGNOSED?

Diagnosis depends on the patient's symptoms, medical history and cardiovascular risk factors. Depending on the clinical situation, the doctor may recommend:

• Electrocardiogram (ECG).
• Exercise stress test.
• Echocardiography (Echo).
• Coronary CT angiography (CCTA).
• Invasive coronary angiography and cardiac catheterization.

HOW IS ATHEROSCLEROSIS TREATED?

Treatment depends on the severity and location of the coronary artery disease, the patient's symptoms and overall cardiovascular risk.

Treatment may include:

• Lifestyle and dietary changes.
• Smoking cessation.
• Control of blood pressure, diabetes and cholesterol.
• Appropriate medications based on the patient's condition.
• Coronary angioplasty when indicated.
• Coronary stent implantation when appropriate.

WHEN IS CARDIAC CATHETERIZATION NEEDED?

In some patients, coronary artery narrowing may be severe, cause significant symptoms or result in reduced blood flow to the heart muscle.

In such cases, cardiac catheterization and coronary angiography may be required to accurately determine the location and severity of the blockage. When appropriate, treatment can sometimes be performed during the same procedure using balloon angioplasty and coronary stent placement.

ATHEROSCLEROSIS AND HEART ATTACK

Atherosclerotic plaques can sometimes rupture and trigger the formation of a blood clot inside the coronary artery. This can suddenly block blood flow and cause an acute heart attack.

Early evaluation of symptoms and proper management of cardiovascular risk factors are important in reducing the risk of serious complications.

INDIVIDUALIZED CARDIAC CARE

Every patient is different. The appropriate diagnostic test and treatment depend on the patient's symptoms, risk factors, coronary anatomy and overall medical condition.

Treatment may range from lifestyle modification and medications to advanced coronary interventions, including angioplasty and stent implantation when indicated.

If you experience recurrent chest pain, shortness of breath or symptoms that occur during physical activity, a timely medical evaluation is important to determine the cause and assess your cardiovascular risk.