Choose the content to read
- What is complex coronary artery disease?
- What are the risk factors of coronary artery disease?
- How many types of coronary artery disease are there?
- What are the warning signs of coronary artery disease and heart disease?
- How are coronary artery disease and heart disease diagnosed?
- How is angiography performed?
- How many treatment modalities are there for coronary artery disease?
- Preventive measures against heart disease and complex coronary artery disease
- A note from MedPark's doctor
What is complex coronary artery disease?
Typically, the coronary arteries consist of the left and right coronary arteries that supply blood to the left and right sides of the heart muscle, respectively. Coronary artery disease occurs when the artery becomes blocked or narrowed. This condition can compromise blood supply to the heart muscles, leading to a lack of oxygen. Fatigue and chest tightness during physical exertion are common symptoms that occur as a result. An acute coronary artery blockage causes a sudden lack of blood and oxygen supply to the cardiac muscles (acute myocardial ischemia), which is potentially life-threatening.
What are the risk factors of coronary artery disease?
The risk factors for coronary artery include:
- Age
- Genetics
- Smoking
- Diabetes
- Hyperlipidemia
How many types of coronary artery disease are there?
Coronary artery diseases are categorized as simple and complex. Among diagnosed cases, 30% are complex coronary artery disease. The types of complex coronary artery diseases may include:
- Arterial complexity
- Blockage in the left main coronary artery
- Total occlusion of a coronary artery
- Severe coronary artery calcification
- Bifurcation blockage
- Patient factor complexity
- Older age
- Comorbidities or preexisting diseases, such as stroke or chronic cough.
These abovementioned conditions can hinder the success of coronary intervention and are considered components of complex coronary artery disease.
What are the warning signs of coronary artery disease and heart disease?
Signs of coronary artery disease and heart disease include symptoms such as chest pain during exertion and extreme fatigue. These are early warning signs of coronary ischemia. Further evaluation of the heart is recommended when these symptoms arise.
If chest pain is acute and persists for more than half an hour to one hour without relief, it may indicate acute coronary myocardial ischemia. It is advisable to seek medical attention at the nearest hospital promptly to prevent life-threatening situations.
How are coronary artery disease and heart disease diagnosed?
Various diagnostic methods exist for coronary artery disease. A doctor begins with history taking, followed by a physical examination. A blood test can identify risk factors such as diabetes and hyperlipidemia. Subsequently, electrocardiography, exercise stress test, or echocardiography are available to assess heart health. Additionally, CT coronary imaging and angiography can help pinpoint blockage sites in the coronary arteries.
How is angiography performed?
Coronary angiography is a diagnostic imaging procedure involving endovascular catheterization and injection of radioopaque dye to detect blockages in the coronary arteries. It provides precise results and enables an interventional cardiologist to conduct balloon angioplasty during the same procedure. Coronary angiography is usually the final step following other diagnostic exams like EKG, or treadmill stress tests that have identified irregularities.
How many treatment modalities are there for coronary artery disease?
Presently, there are three treatment modalities available for coronary artery disease, which include:
- Medications
- Balloon angioplasty or percutaneous coronary intervention
This therapy is a modern preferred choice. The method uses a balloon catheter to widen a blocked coronary artery, preserving its openness with a stent to enhance blood flow. This approach is ideal for individuals of all ages and genders because of its advantages, including low risk and post-op discomfort, rapid recovery, and avoidance of open-heart surgery. - Coronary artery bypass graft (CABG)
This method was previously the mainstay therapy for coronary artery disease. It is ideal for patients who are neither too old nor too young. Elderly patients are at higher risk due to their existing conditions, slower recovery, and susceptibility to postoperative issues. Since the lifespans of the bypass grafts are around ten years on average, having the surgery at a young age could lead to the need to replace the grafts, which is a challenging, complex, and risky surgical procedure.
Difficulty in treating complex coronary artery diseases
Difficulty in complex coronary disease treatments depends on the type of complexity, either complex characteristics of the blood vessels or patient factor complexities. For example,
- Blockage in the left main coronary artery: Treatment for this coronary lesion is challenging due to an elevated risk of death during intervention because this is the area where nearly all the left ventricle blood supply passes through. The procedure, therefore, should be performed rapidly and precisely.
- Severe coronary artery calcification: Calcification can harden a coronary artery, potentially hindering the effectiveness of basic balloon angioplasty and increasing the risk of artery or balloon rupture during the procedure. Addressing this issue may necessitate a specialized tool known as a rotational atherectomy or rotablator. This device grinds away the calcified plaque within a coronary artery, making it more pliable for subsequent balloon angioplasty and stent insertion.
- Total occlusion: The challenge in treating total occlusion is a lack of a roadmap of the course of the occluded artery. Doctors must marshal their mastery in locating the proximal and distal ends of the arterial occlusion.
Preventive measures against heart disease and complex coronary artery disease
Heart disease and complex coronary artery disease are potentially life-threatening conditions. To prevent them, you should:
- Control your nutritional intake: Be mindful of your food choices. Avoid fried or fatty foods, decrease daily sugar calorie intake to less than 10% of total caloric intake, and opt for nutritious, high-fiber meals with whole grains.
- Exercise for at least 150 minutes per week: Incorporate cardiovascular exercises into your routine five days a week. Additionally, engage in light weightlifting twice a week to work your muscles and prevent muscle loss.
- Refrain from smoking and limit alcohol consumption to 100 grams a week.
- Have regular health checkups to monitor your blood cholesterol and blood sugar levels and to assess other potential risk factors.
- Regularly monitor your blood pressure to detect any abnormalities.
A note from MedPark's doctor
Although complex coronary artery disease is treatable, it heavily relies on the availability of specialized medical equipment and the expertise and experience of a team of physicians, medical staff, and nurses. Regular health checkups are recommended for everyone. If abnormalities or signs of coronary artery disease are detected, it is strongly advised to have your heart evaluated for early and proper treatment.
