Coronary Artery Disease

The various blood supplies to the heart (coronary arteries) just like any other blood vessel in the body are susceptible to arteriosclerosis (blood vessel disease). An occlusion in these areas of arteriosclerosis either via a thrombus (embolic) or rupture results either in a catastrophic event or a debilitating condition. Risk factors associated with arteriosclerosis were enumerated on the home page under the heading "The A-B-C's of the heart."

Some disease processes such as Lupus and Kawasaki Syndrome can cause embolus to the coronary artery. Coronary artery events usually start with chest pains. Localized just superior and medial to the left breast, the pain and is usually characterized as squeezing, "like a ton of bricks on my chest", it radiate to the left shoulder or neck, down to the left arm, up to the elbows. Often the pain is accompanied by shortness of breath, diaphoresis, nausea, and sometimes vomiting and a sense of impending doom. Episodes usually last 20 to 30 minutes. Classically each episode is precipitated by exertion such as stressful work, running, lifting, power walking or lawn mowing and is received by rest. This is the classic stable angina.

There are however patients who may experience same symptom during periods of rest or with no exertion. These patients have the unstable type of angina. Diabetic patients mostly have unstable angina.
Complications of coronary artery disease are many, including:

Reduction of precipitation of coronary events can be achieved by:

Treatment
Medications The four groups of drugs extensively used in the treatment of patients with coronary artery disease are:

1. Nitrates:
• Nitroglycerine - immediate, opens up the blood vessel.
• Long acting nitrates.
2. Beta Blockers: Reduce precipitating symptoms and complications of a coronary event.
3. Calcium Blockers: Treats angina with hypertension.
4. Antiplatelet drugs: Prevents the formation of thrombus that is responsible for blocking coronary vessels.