Coronary artery disease, CAD

Coronary artery disease (CAD) is the most common and leading cause of death in UK. Almost 100,000 people die of CAD every year in the UK. About 2.6 million people are suffering from coronary artery disease and 2.0 million people experience angina that is symptom of CAD. Coronary artery disease is more common in men and in the elderly. CAD, cerebrovascular disease and peripheral vascular disease are together called cardiovascular disease.

Heart pumping function

Normal heart is about the size of the fist. Heart beats 60-80 times per minute to pump the blood to the whole body and therefore act as an engine driving the circulation. The right side of the heart pumps the blood poor in oxygen towards the lungs to collect oxygen. The oxygenated blood then enters the left side of the heart from where it is pumped to the whole body via network of arteries. Oxygen is extracted from the blood and used up by body organs. The deoxygenated blood then returns via veins to the right side of the heart and is again pumped to the lungs.

Heart itself needs oxygen to function properly as any other organ. Blood rich in oxygen get to the heart muscle tissue via coronary arteries, a network of small vessels on the surface of the heart.

Mechanism and prevention of coronary artery disease

With the passage of time, fatty substances deposit in the walls of the coronary arteries. The fatty substance is called atheroma and the process of atheroma formation is called atherosclerosis. Atherosclerosis makes the coronary arteries narrow and stiff and the resulting reduced blood and oxygen supply to the heart leads chest pain called angina. Stable atheroma leads to stable angina on exertion or stress. Complete and sudden blockage of coronary arteries causes myocardial infarction (heart attack).

Healthy lifestyle is one of the most important ways to prevent coronary artery disease. There are several risk factors that you can’t influence (age, gender, genetic disposition) but many others that can be modified. A healthy diet and regular physical activity to keep normal weight, no smoking, alcohol consumption within recommended limits can prevent not only coronary artery disease but also reduce risk of stroke and peripheral vascular disease (atherosclerosis in arteries in the legs).

Treatment of coronary artery disease

CAD can be conrolled by combination of lifestyle measures, medication and if appropriate, invasive procedures. Correct treatment of CAD improves symptoms and prognosis, reduces risk of heart attack and heart failure and prolongs life.

Some of the medicines used in CAD are aspirin, beta-blockers, calcium channel blockers, ACE-I, nitrates, nicorandil and statins.

The main two invasive procedures for treatment of CAD are: