 Coronary artery disease (also called CAD) is the most common type of heart disease. It is also the leading cause of death for both men and women in the United States.  It occurs when fatty deposits called plaque build up inside the coronary arteries. The coronary arteries wrap around the heart and supply it with blood and oxygen. When plaque builds up, it narrows the arteries and reduces the amount of blood that gets to your heart.

Research has yet to find the exact etiology of CAD. However, numerous contributing risk factors have been identified. It starts when certain factors damage the inner layers of the coronary arteries. It is classified as modifiable & non-modifiable.  Age  Sex  Family Hx  Ethnicity  Smoking  Hyperlipidemia  Sedentary Lifestyle  Stress  Elevated blood sugar  High blood pressure Non-modifiable Modifiable

 Once the inner wall of an artery is damaged, fatty deposits (plaque) made of cholesterol and other cellular waste products tend to accumulate at the site of injury in a process called atherosclerosis.  If the surface of the plaque breaks or ruptures, blood cells called platelets will clump at the site to try to repair the artery.  This clump can block the artery, leading to a heart attack

 A Narrowing or obstruction of the coronary arteries resulting from atherosclerosis. An accumulation of fatty plaques made of lipids in the arteries  Causes a decrease perfusion of myocardial tissue and inadequate myocardial oxygen supply

 Angina is a symptom of coronary artery disease.  Angina feels like squeezing, pressure, heaviness, tightness, or pain in the chest. It can be sudden or recur over time.  Depending on severity, it can be treated by lifestyle changes, medication, angioplasty, or surgery.

People may experience:  Pain areas: in the area between shoulder blades, arm, chest, jaw, left arm, or upper abdomen  Pain types: can be burning in the chest or like a clenched fist in the chest  Pain circumstances: can occur during rest  Whole body: dizziness, fatigue, lightheadedness, clammy skin, cold sweat, or sweating  Gastrointestinal: indigestion, nausea, or vomiting  Neck: discomfort or tightness  Arm: discomfort or tightness  Chest: discomfort or tightness

EKG: Examples of early repolarization from 2 patients with CAD.  A: ECG of a case subject with CAD who had VTA. Arrows show prominent notching in both inferior and lateral precordial leads.  B: ECG of a control subject with CAD. Slurring is noted in leads I, II, and V6 by arrows.

Cardiac enzyme studies measure the levels of enzymes and proteins that are linked with injury of the heart muscle.  Enzyme Creatine Kinase (CK)  Proteins Troponin I (TnI) and Troponin T (TnT). Low levels of these enzymes and proteins are normally found in your blood, but if your heart muscle is injured, such as from a heart attack, the enzymes and proteins leak out of damaged heart muscle cells, and their levels in the bloodstream rise.

 A coronary angiogram is a special X-ray test. It's done to find out if your coronary arteries are blocked or narrowed, where and by how much.  An angiogram can help your doctor see if you need treatment such as angioplasty or stent, coronary artery bypass surgery (CABG) or medical therapy.

 Percutaneous Coronary Intervention (Angioplasty and Stent)

 To improve blood flow to the myocardial tissue that are at risk for ischemia or infarction as a result of the occluded artery.

 Statins – Crestor ®, Simvastatin,etc  Antiplatelet Aggregators - Plavix ®  Nitrates  Calcium Channel Blocker  Beta-blockers

 Heart-healthy eating  Maintaining a healthy weight  Managing stress  Physical activity  Quitting smoking