Diagnosis of Coronary Heart Disease

Coronary heart disease, also known as coronary artery disease, is a narrowing of blood vessels carrying blood and oxygen to the heart. The narrowing is caused by plaque buildup on the walls of arteries called atherosclerosis. When this blood flow to the heart is slowed or stopped, it can cause a heart attack. Coronary heart disease is the leading cause of death for both men and women according to the National Institutes of Health.

Causes

• There are many reasons for arteries to become narrowed and blocked. Genetics, diabetes and high blood pressure can increase your risk. High levels of low-density lipoprotein (LDL) cholesterol contribute to heart disease. Alcohol abuse, smoking and severe stress may also increase your risk.

Symptoms

• When arteries narrow and constrict blood flow, symptoms may include a shortness of breath and chest pain. When an artery becomes completely blocked, the result is a heart attack. Symptoms of a heart attack include a feeling of crushing pressure in your chest, excessive sweating and pain in your arm or shoulder. Women may also experience pain in the jaw or back and nausea.

Diagnosis

• Your doctor may perform several tests before confirming diagnosis of coronary heart disease. An electrocardiogram, or ECG, records electrical signals of the heart and reveals whether a heart attack has taken place or whether one is taking place at that time. An echocardiogram reveals whether all parts of your heart are functioning properly. Parts of your heart that are performing weakly may be damaged from coronary heart disease. A stress test is used to monitor how your heart performs under exertion. You walk on a treadmill with electrodes attached to your skin while a machine records heart activity. A computed tomographic (CT) scan or magnetic resonance imaging (MRI) shows images of blood vessels and reveals any narrowing or blocking of arteries.

Drug Treatment

• After being diagnosed with coronary heart disease, your doctor will start treatment with medication. Cholesterol-lowering drugs such as Lipitor decrease the amount of plaque buildup on your artery walls. Aspirin is a blood thinner your doctor may recommend to reduce any clots from forming in your bloodstream. Beta blockers slow heart rate and angiotensin-converting enzyme (ACE) inhibitors decrease blood pressure and may prevent coronary heart disease from progressing.

Surgical Procedures

• More aggressive treatment may be needed for coronary heart disease. Angioplasty and stent placement involves a thin tube inserted into the narrowed part of your artery. A deflated balloon attached to a wire is passed through the tube and is inflated in the narrowed part of the artery causing plaque to compress against the artery wall. A stent is placed into the artery to keep the artery wall open. In a coronary artery bypass surgery, your surgeon will create a graft from a vessel in another part of your body and replace the blocked vessel, allowing blood flow to go around the blocked artery. Bypass surgery is a major operation and reserved for when several arteries are blocked.