Coronary Artery Disease

Coronary artery disease (CAD) is most common type of heart disease & one of the leading cause of death in India now. CAD happens due to narrowing of blood vessels (coronary artery) that supply blood to heart muscles & disease process is known as atherosclerosis. As a result, heart muscle does not get enough blood supply which can lead to chest pain (angina). At times this blood supply can totally cutoff & causes muscle damage ( myocardial infarction or heart attack). If the condition is allowed to be prolonged, it can lead to failure of heart pump also (heart failure).

There are few health factors associated with this disease process i.e. age, family history, obesity, smoking, high blood pressure, high fat diet, low physical activity, genetic predisposition & diabetis mellitus . Non invasive test to detect CAD include , ECG, stress test( ECG stress or Metabolic stress) or CT coronary angiography and these are screening test only. For confirmation of coronary disease & treatment planning, coronary angiography is still a gold standerd test.

CAD treatment options are Medical , Percutaneous interventions or surgery which depends upon several factors such as severity & extend of disease, symptomatic status of patient, general cardiac condition & other co morbidity pattern. Treatment pattern is usually tailored around the disease pattern, patient lifestyle &heart functional status. Percutaneous intervention (PCI) includes balloon angioplasty & stent implantation.

If the block in coronary arteries are multiple or involves main artery, poor heart function or diabetis mellitus,then you may reguire Coronary artery bypass  grafting (CABG). This is very safe & effective procedure. It provides the best long term outcomes in term of relief of angina & also prolong the life span of the patient. Various innovations of CABG like Total arterial revascularization , Beating heart surgery & minimally invasive surgery help in improving the outcome further. So it always advisable for patient to take well informed decision about the choice of treatment modality.



Copyright by Dr Sanjay Kumar Agarwal 2019. All rights reserved.

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