Atherosclerosis

Coronary artery disease (CAD) is caused by atherosclerosis in the coronary arteries of the heart. Atherosclerosis can also occur in other arteries (brain, upper and lower limbs, kidneys). However, when it concerns the coronary arteries of the heart, it coincides with coronary artery disease.

The coronary arteries of the heart are responsible for supplying the heart with blood and oxygen. When the coronary arteries become blocked or narrowed due to atherosclerosis, coronary artery disease is caused. This occurs due to the deposition of lipids (e.g., cholesterol), calcium, and other substances on their walls. They thus form atherosclerotic plaques which harden and narrow the arteries. Then the blood flow is restricted, and the heart cannot receive the blood and oxygen it needs. This condition causes problems with cardiovascular function and can lead to serious heart conditions such as angina, myocardial infarction, and heart failure.

Symptoms of Coronary Artery Disease

Depending on the amount of oxygen reaching the heart, various symptoms occur:

• Pain or a feeling of pressure in the chest, which may extend to the shoulder, neck, back, or arms. This usually occurs during physical activity or stress and may subside with rest.

• Shortness of breath, when the heart has difficulty pumping blood due to insufficient oxygenation.

• Dizziness or fainting because the heart is unable to supply enough blood to the brain.

• Continuous fatigue – exhaustion for no apparent reason.

• Nausea, sweating, discomfort.

Diagnosis of Coronary Artery Disease

Patients with the above symptoms should visit a Cardiologist without delay. It is important to seek help from a Cardiologist who has knowledge of all modern diagnostic techniques and innovative therapeutic methods. In addition to accurate diagnosis, they will also contribute to the management of this condition, as the treatment may vary depending on the extent of the disease and the specific needs of the patient.

The diagnosis of coronary artery disease combines:

Medical history:

• Heredity – family history of early coronary artery disease

Clinical examination:

• Blood pressure and heart rate

Biochemical indicators:

• Blood tests such as measuring cholesterol levels (total, LDL, HDL)

• Other biomarkers indicating whether there is damage to the heart muscle tissue

Diagnostic tests performed in the office:

• Electrocardiogram (ECG): Records the electrical activity of the heart and helps identify any abnormalities in rhythm or function related to CAD and ischemia.

• Stress Test: Conducted on a treadmill while monitoring cardiac activity via ECG.

• Echocardiogram: Checks the regional and overall mobility of heart walls, structure and functionality of heart valves, pumping ability, and identifies areas with reduced blood flow due to coronary artery narrowing.

Today, more invasive diagnostic techniques, such as coronary angiography, are used when further assessment of disease severity is required or when other methods are insufficient. Before coronary angiography, the following tests can be performed:

• CT Coronary Imaging

• Magnetic Cardiac Tomography (if other methods do not provide sufficient information)

Coronary angiography (Cardioangiography):
Remains the main diagnostic method for coronary disease. It involves fluoroscopy and injection of contrast fluid into the coronary arteries to capture stenosis or vessel damage. It is performed via catheterization in a Hemodynamic Laboratory of a Hospital/Clinic.

Treatment of Coronary Artery Disease

The treatment of coronary artery disease depends on the severity of the condition, the extent of arterial narrowing, and the patient’s general health history.

• The Cardiologist administers medications to improve the patient’s condition, provided they are not at risk due to CAD.

• Individualized recommendations are given regarding diet, daily routine, stress management, and smoking cessation.

• Whether without intervention or after intervention, the Cardiologist systematically and periodically monitors the patient with CAD and atherosclerosis.