Heart Disease (Coronary Artery Disease)

Introduction to heart disease
The heart is like any other muscle, requiring blood to supply oxygen and nutrients for it to function. The heart's needs are provided by the coronary arteries, which begin at the base of the aorta and spread across the surface of the heart, branching out to all areas of the heart muscle.
The coronary arteries are at risk for narrowing as cholesterol deposits, called plaques, build up inside the artery. If the arteries narrow enough, blood supply to the heart muscle may be compromised (slowed down), and this slowing of blood flow to the heart causes pain, or angina.
A heart attack or myocardial infarction occurs when a plaque ruptures, allowing a blood clot to form. This completely obstructs the artery, stopping blood flow to part of the heart muscle, and that portion of muscle dies.

What are the risk factors for heart disease

Risk factors for heart disease include:

• Smoking
  
• High blood pressure (hypertension)
  
• High cholesterol
  
• Diabetes
  
• Family history
  
• Peripheral artery disease
  
• Obesity

What are the symptoms of heart disease?

The typical symptoms of coronary artery disease are associated chest pain with shortness of breath. Classically, the pain of angina is described as a pressure or heaviness behind the breast bone with radiation to the jaw and down the arm accompanied by shortness of breath and sweating. Unfortunately, angina has a variety of presentations, and there may not even be specific chest pain. There may be shoulder or back ache, nausea, indigestion or upper abdominal pain.
Women, the elderly, and people with diabetes may have different perceptions of pain or have no discomfort at all. Instead, they may complain of malaise or fatigue.
Healthcare providers and patients may have difficulty understanding each other when symptoms of angina are described. Patients may experience pressure or tightness but may deny any complaints of pain.
People with coronary artery disease usually have gradual progression of their symptoms over time. As an artery narrows over time, the symptoms that it causes may increase in frequency and/or severity. Healthcare providers may inquire about changes in exercise tolerance (How far can you walk before getting symptoms? Is it to the mailbox? Up a flight of stairs?) and whether there has been an acute change in the symptoms.
Once again, patients may be asymptomatic until a heart attack occurs. Of course, some patients also may be in denial as to their symptoms and procrastinate in seeking care.