Coronary Artery Disease: What Is It and What Treatments Are Available?

Coronary artery disease is a serious health problem. It is the most common type of heart disease and the leading cause of death in the United States for both men and women. In this report, Dr. Lee Surkin, a cardiologist and sleep medicine specialist, explains coronary artery disease, discusses risk factors, and describes preventive and reparative treatment.

“Coronary artery disease,” Dr. Surkin explains, “is a build-up of plaque in the heart arteries.” It develops after there has been damage to the inside lining of those arteries. The damage causes the body to undertake a repair process that leads to the plaque build-up and perhaps a blockage of the arteries.

The causes of the disease are related to risk factors. Those factors include high blood pressure, high cholesterol, smoking, family history, diabetes, obesity, high stress, and obstructive sleep apnea.

Screening for the disease is not always invasive, Dr. Surkin says. His office begins by getting a patient’s history and an electrocardiogram. Then comes the decision as to the kinds of non-invasive tests to be used. These include an ultrasound study of the heart, a stress test, and a CAT scan or MRI scan. If the tests suggest that an invasive test is needed, the next step is a cardiac catheterization in which a dye solution is injected into the cardiac arteries to get a direct image of plaque build-up in those arteries.

The good news, Dr. Surkin says, is that the condition can sometimes be reversed. “The treatment depends on an aggressive approach to modifying the risk factors.” All the risk factors previously listed need to be evaluated and treated. Some studies show that aggressive lowering of a patient’s cholesterol level—using exercise, improved diet, and drugs called statins—can reduce the extent of arterial blockage.

Prevention and treatment of coronary artery disease “involves a multifaceted approach.” The first step, called primary prevention, is to keep the disease from occurring. Secondary prevention involves dealing with a disease that is already established and keeping it from getting worse. Once again, treatment requires an aggressive look at all the risk factors and mitigating them.

If a patient has the disease and if it is serious enough, the physician may have to directly manipulate the coronary arteries. Using coronary angioplasty, the plaquing can be pushed off to the side, Dr. Surkin explains. The physician inflates a balloon inside the artery to push the plaque to the side, then inserts a metal stent to keep the artery open.

The other surgical treatment is coronary artery bypass. In this procedure, a blood vessel taken from under a patient’s breastbone or from the leg is plugged directly into the heart to bypass the damaged artery.

Dr. Lee Surkin, MD, FACC, FCCP, FASNC is a cardiologist in Greenville, North Carolina and is affiliated with multiple hospitals in the area, including Martin General Hospital and Vidant Medical Center. He received his medical degree from Drexel University College of Medicine and has been in practice for more than 20 years. He is board certified in Cardiology, Nuclear Cardiology and Sleep Medicine. He is the founder of the American Academy of Cardiovascular Sleep Medicine. The Health and Wellness Network is a featured network of Sequence Media Group.