What is Coronary Artery Disease?

Coronary artery disease (CAD) or coronary heart disease is a common type of heart disease that occurs when the arteries become hardened and narrowed. This is caused due to the cholesterol and calcium deposit or plaque in the arteries.

Coronary artery disease begins due to a condition called atherosclerosis which occurs when cholesterol and calcium collects on the inner walls of the arteries. This build-up is known as plaque which can block blood flow due to the narrowing of the arteries. If the plaque bursts it can lead to a blood clot.

Symptoms of CAD

A patient having coronary artery disease can have chest pain, breathlessness, fatigue, nausea and due to the reduced blood flow to the heart. Chest discomfort or angina is accompanied by symptoms like numbness, heaviness, aching, squeezing, etc.

Complete blockage of blood flow can also lead to heart attack.

Risk Factors

In addition to high cholesterol, other causes of damage to coronary arteries include high blood pressure, diabetes, smoking, sedentary lifestyle, etc.

Obesity, stress, unhealthy diet, irregular sleep and alcohol usage are other risk factors for coronary artery disease.

Diagnosis of CAD

The doctor reviews the patient’s symptoms, risk factors and medical history before performing a physical examination. Diagnostic tests include:

  • Electrocardiograph test: This test can detect heart attack and heart rhythm issues by recording the heart’s electrical activity.
  • Exercise stress test: This is a treadmill test that can help suspect  coronary blockages
  • Pharmacologic stress test: This test can also help detect coronary blockages through medication given to increase heart rate. This is done in patients who cannot walk on treadmill.
  • Coronary calcium scan: This can identify the amount of calcium on the walls of the coronary arteries which can give an indication of atherosclerosis.
  • Echocardiogram: This test utilizes sound waves to measure the overall functioning of the heart.
  • Blood tests: These tests are done for factors affecting arteries like cholesterol, triglycerides, lipoprotein, glucose, etc.
  • Cardiac catheterization: In this test small tubes are inserted into the blood vessels to detect the presence of coronary artery disease and also evaluate the heart function.

Prevention of CAD

According to Dr. Ramji Mehrotra who is one of India’s leading cardiologist, coronary artery disease can be prevented by adopting a healthy lifestyle to improve heart health. These include stopping smoking and limiting alcohol use, consuming a heart-healthy diet, exercising and increasing activity levels, etc.

Blood pressure, diabetes and cholesterol should be controlled. Stress management is also essential to prevent coronary artery disease.

Life after Bypass Surgery

Coronary artery disease occurs due to the hardening of arteries supplying blood to the heart muscle. Bypass surgery is performed to restore normal blood flow to the obstructed coronary artery.

Bypass surgery helps the patients by improving the quality of life and decreasing angina and other CAD symptoms. It improves the pumping action of the heart and lowers the risk of a heart attack. Additionally it enables patients to resume a more active lifestyle.

According to Dr. Ramji Mehrotra, who is one of the Best Cardiac Surgeon in India, patients generally exhibit excellent results after bypass surgery. 85% of people have significantly reduced symptoms, with lesser risk of heart attacks in future, and a lesser chance of dying even beyond 10 years.

Recuperating after bypass surgery

Dr. Mehrotra says that patients should definitely follow the doctor’s advice regarding diet, activity and lifestyle changes, to be adopted after surgery and during recovery. They should take medication as per directions and notify the doctor immediately of any concerns like fever, pain, bleeding or problems at the incision site.

It is essential to follow the guidelines below while recovering after the bypass surgery.

Healthy diet – The patient should consume a healthy diet that is low in cholesterol and saturated and trans-fats. This can stop the build-up of plaque on artery walls.

Medications – Doctors prescribe the medications for promoting comfortable healing from the surgery and reducing the risk of future heart attacks. The medications generally prescribed include:

  • medicines to reduce cholesterol,
  • aspirin and antiplatelets to prevent blood clots,
  • ACE inhibitors and beta-blockers to regulate blood pressure, heart rate and cardiac remodelling.

Physical Activity – Physical activity should be gradually resumed by the patient and the advice of the physiotherapist may help gradual increase in exercise tolerance. For the first six weeks after surgery, the patient should not lift anything that is over 5 kg as the sternum (chest bone) will need time to heal. Walking is a good option for gradually increasing the activity level.

Cardiac Rehabilitation – Through Cardiac rehabilitation or rehab the patient can take up exercise under the supervision of a medical professional. It also involves psychological counselling, nutritional counselling, etc.

Diabetes Management – Patients with diabetes need to carefully manage their recovery in coordination with their doctors as diabetes contributes to cardiovascular disease.

Stress Management – Chronic stress is a risk factor leading to heart disease and hence must be managed carefully with a healthy lifestyle.

Improvement in Life – Improvement in quality of life after bypass gives the patient positive reinforcement towards life and patients are more receptive towards life style changes. Many quit smoking, alcohol and sedentary life style and start exercises and healthy dietary habits. 

Conclusion

As a leading arterial bypass Surgeon based in Delhi, Dr. Ramji Mehrotra is of the opinion that long-term recovery from bypass surgery involves managing the risk factors contributing to the cardiovascular disease. Though some risk factors like family history cannot be changed, others like healthy diet, medications, physical activity, and other lifestyle changes must be adopted for faster recovery and maintenance of good health.