What is Coronary Artery Disease?
The coronary arteries are responsible for supplying oxygen-rich blood to the heart. Coronary Artery Disease (CAD) results from the build-up of fat and cholesterol deposits called plaques in those arteries (a process called atherosclerosis), which partially or completely blocks the flow of blood to the heart. The condition could cause areas of the heart muscle to become damaged or die, potentially resulting in a heart attack.
The most common form of heart disease and the leading cause of death worldwide, CAD is hereditary and is more common in the elderly. Men are more likely to develop the condition than women. Risk factors include obesity, high blood pressure, high cholesterol, diabetes, smoking, and physical inactivity. At Mount Sinai Heart, our widely recognized Interventional Cardiology/Catheterization Laboratory team is dedicated to fighting CAD through advanced diagnostics (i.e. CT angiogram, CMR, intravascular ultrasound, and diagnostic catheterization) and treatments.
Coronary Artery Disease Symptoms and Diagnosis
While CAD may develop without any obvious signs, the following symptoms could develop in serious cases that could progress to a heart attack:
- Angina, which is a sporadic, painful pressure in the chest that may radiate to the shoulder(s), arm(s), or jaw
- Shortness of breath
Women suffering a heart attack my experience additional symptoms, including:
- Excessive fatigue
- Pressure in the chest and middle of the back
- Cold sweats
If you go to the emergency room with chest pain, diagnostic tests to determine whether you're experiencing angina or a heart attack could include blood tests, electrocardiogram, echocardiogram, stress test, and coronary angiography (an X-ray of the arteries after they have been injected with dye).
Medications to Treat Coronary Artery Disease
When choosing a treatment plan for CAD, Mount Sinai physicians consider factors including a patient's age, overall health, and disease progression, as well as the patient's personal preferences. While lifestyle changes to address CAD's risk factors are effective (such as losing weight and quitting tobacco), your doctor may give you a prescription to help manage the disease. These could include blood-thinning medications (such as aspirin or Coumadin), cholesterol-lowering medications (such as statins), beta-blockers, ACE inhibitors, and calcium channel blockers. Nitroglycerin could be given either during a heart attack, or as a preventive measure against angina.
Procedures to Treat Coronary Artery Disease
Mount Sinai Heart offers non-surgical and surgical procedures to treat CAD and is a major referral center for complex cases. Our physicians are highly-skilled in performing the following:
- Percutaneous coronary intervention (PCI): This minimally-invasive procedure involves threading a catheter fitted with a device (such as a stent, balloon, or grinding instrument) from a small incision (in the groin or arm) to the problem site in the heart in order to open the blockage and restoring adequate blood flow.
- Coronary artery bypass graft (CABG): This surgery involves taking a segment of a vessel from another area of the body and sewing it into the coronary artery to detour blood flow around the blockage.
- Rotational atherectomy: For tough blockages, interventional cardiologists can apply this treatment, in which they use a tiny, fast-spinning blade to scrape away arterial plaques to improve blood flow. Rotational atherectomy is a complex procedure and Mount Sinai receives frequent referrals from other hospitals in the northeast due to its success rate with this technique.