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What is it about ?
Coronary artery disease is a disorder of the arteries of the heart (coronary arteries). These arteries are small blood vessels that cover the muscle of the heart (myocardium). They form a sort of crown all around the heart. They branch out into finer and finer vessels. All of these vessels carry blood to the heart muscle and provide it with oxygen.
In coronary artery disease, narrowing of the coronary arteries happens slowly. Inflammatory cells, cholesterol and other fats build up in the lining of the coronary arteries and form plaque (atherosclerotic plaque). This phenomenon is called arteriosclerosis, or atherosclerosis or atheromatosis. Usually you don’t even notice it. This is only realized when the narrowing of the arteries is already very advanced, which results in pain in the chest.
If a coronary artery becomes completely blocked, you have a heart attack (infarction). The part of the heart that was irrigated by this artery is no longer supplied with oxygen and is damaged.
The risk factors for coronary heart disease are:
- A high concentration of LDL cholesterol ;
- Smoking;
- THE’hypertension ;
- the diabetes ;
- Age.
What is its frequency?
Almost 5 in 1,000 people see a general practitioner for a feeling of tightness in the chest (angina pectoris) or heart attack.
How to recognize it?
The hallmark symptom is chest pain (angina pectoris), which may radiate to the neck, jaw, arms, stomach, or back.
Anginal pain begins gradually during exertion, is faster with sudden exertion, and worsens when exertion continues. The person feels a tightness or a tight feeling in the chest, causing it to slow down or stop. The pain goes away after a few minutes of rest or after taking nitroglycerin, a medicine that opens the heart’s vessels.
Other possible symptoms are: shortness of breath on exertion, fatigue on exertion, heart rhythm disturbances and heart failure.
How is the diagnosis made?
If the doctor thinks of coronary heart disease, he will perform a physical examination and order several technical examinations, such as an electrocardiogram (ECG), a blood test and possibly a test. stress test.
An ECG is often normal at rest. During the effort, as during a stress test on bicycle, the ECG may show reversible changes.
To view images of the heart, an echocardiogram is done and sometimes also a coronary angiogram or coronary angiography. THE’echocardiography allows you to see the structure of the heart. THE’coronary angiography or coronary angiography allows you to see the coronary arteries. For this test, a catheter is inserted into a blood vessel in the groin to send a contrast medium to the heart vessels, which can be seen on x-rays.
What can you do ?
Reduce the risk factors for coronary heart disease by adopting a healthy lifestyle : stop smoking, avoid excess weight, have regular physical activity and healthy eating habits.
What can your doctor do?
If the doctor sees a marked narrowing of the coronary arteries on the angiogram, he will try to unclog the blood vessel (revascularization). This can be done either by means of a balloon associated with the placement of a stent, or by bypassing the part of the blood vessel which is blocked. These procedures are performed by a specialized cardiac surgeon.
In addition to technical interventions, it is advisable to follow the advice on the lifestyle to be adopted in order to limit all the risk factors and to institute drug treatment (if necessary).
THE’hypertension and one too high cholesterol are treated with medicines to lower blood pressure (antihypertensive) and cholesterol (cholesterol lowering) (statin), respectively. In the event of angina pectoris, one should normally take aspirin which decreases coagulation and therefore decreases the risk of having an heart attack.
If the chest pain returns regularly, the doctor may prescribe drugs to further open the vessels of the heart when the pain returns.
Want to know more?
- The food pyramid – Eat Move – Health Question
- Eating and gaining years of life is possible! (video) – CSS – Superior Health Council
- Nutri-Score – SPF Public health, food chain safety and the environment
- Physical activity – Eat Move – Health question
- Move at any age… After 50 too! – Eat Move – Health Question
- Statins – CBIP – Belgian Center for Pharmacotherapeutic Information
- Lower your cholesterol with medication? The pros and cons – KCE – Federal Center of Expertise in Healthcare
- Coronary angiography and coronary dilation, here, Where to find on this page of Cliniques St Luc UCL
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
Source
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