Coronary artery disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing deposits (plaque) in your arteries and inflammation are usually to blame for coronary artery disease.
When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.
Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack. But there's plenty you can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.
If your coronary arteries narrow, they can't supply enough oxygen-rich blood to your heart — especially when it's beating hard, such as during exercise. At first, the decreased blood flow may not cause any coronary artery disease symptoms. As plaque continues to build up in your coronary arteries, however, you may develop coronary artery disease signs and symptoms, including:
Chest pain (angina). You may feel pressure or tightness in your chest, as if someone were standing on your chest. This pain, referred to as angina, usually occurs on the middle or left side of the chest. Angina is generally triggered by physical or emotional stress.
The pain usually goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be fleeting or sharp and felt in the neck, arm or back.
Shortness of breath. If your heart can't pump enough blood to meet your body's needs, you may develop shortness of breath or extreme fatigue with exertion.
Heart attack. A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating.
Women are somewhat more likely than men are to experience less typical signs and symptoms of a heart attack, such as neck or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.
When to see a doctor
If you suspect you're having a heart attack, immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort.
If you have risk factors for coronary artery disease — such as high blood pressure, high cholesterol, tobacco use, diabetes, a strong family history of heart disease or obesity — talk to your doctor. He or she may want to test you for the condition, especially if you have signs or symptoms of narrowed arteries.
Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including:
High blood pressure
Diabetes or insulin resistance
Once the inner wall of an artery is damaged, fatty deposits (plaque) made of cholesterol and other cellular waste products tend to accumulate at the site of injury in a process called atherosclerosis. If the surface of the plaque breaks or ruptures, blood cells called platelets will clump at the site to try to repair the artery. This clump can block the artery, leading to a heart attack.
Risk factors for coronary artery disease include:
Age. Simply getting older increases your risk of damaged and narrowed arteries.
Sex. Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.
Family history. A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55 or if your mother or a sister developed it before age 65.
Smoking. People who smoke have a significantly increased risk of heart disease. Exposing others to your secondhand smoke also increases their risk of coronary artery disease.
High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel through which blood can flow.
High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaque and atherosclerosis. High cholesterol can be caused by a high level of low-density lipoprotein (LDL) cholesterol, known as the "bad" cholesterol. A low level of high-density lipoprotein (HDL) cholesterol, known as the "good" cholesterol, can also contribute to the development of atherosclerosis.
Diabetes. Diabetes is associated with an increased risk of coronary artery disease. Type 2 diabetes and coronary artery disease share similar risk factors, such as obesity and high blood pressure.
Overweight or obesity. Excess weight typically worsens other risk factors.
Physical inactivity. Lack of exercise also is associated with coronary artery disease and some of its risk factors, as well.
High stress. Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for coronary artery disease.
Unhealthy diet. Eating too much food that has high amounts of saturated fat, trans fat, salt and sugar can increase your risk of coronary artery disease.
Risk factors often occur in clusters and may build on one another, such as obesity leading to type 2 diabetes and high blood pressure. When grouped together, certain risk factors put you at an even greater risk of coronary artery disease. For example, metabolic syndrome — a cluster of conditions that includes elevated blood pressure, high triglycerides, low HDL, or "good," cholesterol, elevated insulin levels and excess body fat around the waist — increases the risk of coronary artery disease.
Sometimes coronary artery disease develops without any classic risk factors. Researchers are studying other possible factors, including:
Sleep apnea. This disorder causes you to repeatedly stop and start breathing while you're sleeping. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system, possibly leading to coronary artery disease.
High sensitivity C-reactive protein. High sensitivity C-reactive protein (hs-CRP) is a normal protein that appears in higher amounts when there's inflammation somewhere in your body. High hs-CRP levels may be a risk factor for heart disease. It's thought that as coronary arteries narrow, you'll have more hs-CRP in your blood.
High triglycerides. This is a type of fat (lipid) in your blood. High levels may raise the risk of coronary artery disease, especially for women.
Homocysteine. Homocysteine is an amino acid your body uses to make protein and to build and maintain tissue. But high levels of homocysteine may increase your risk of coronary artery disease.
Preeclampsia. This condition that can develop in women during pregnancy causes high blood pressure and a higher amount of protein in urine. It can lead to a higher risk of heart disease later in life.
Alcohol use. Heavy alcohol use can lead to heart muscle damage. It can also worsen other risk factors of coronary artery disease.
Autoimmune diseases. Conditions such as rheumatoid arthritis and lupus (and other inflammatory rheumatologic conditions) have an increased risk of atherosclerosis.
Coronary artery disease can lead to:
Chest pain (angina). When your coronary arteries narrow, your heart may not receive enough blood when demand is greatest — particularly during physical activity. This can cause chest pain (angina) or shortness of breath.
Heart attack. If a cholesterol plaque ruptures and a blood clot forms, complete blockage of your heart artery may trigger a heart attack. The lack of blood flow to your heart may damage your heart muscle. The amount of damage depends in part on how quickly you receive treatment.
Heart failure. If some areas of your heart are chronically deprived of oxygen and nutrients because of reduced blood flow, or if your heart has been damaged by a heart attack, your heart may become too weak to pump enough blood to meet your body's needs. This condition is known as heart failure.
Abnormal heart rhythm (arrhythmia). Inadequate blood supply to the heart or damage to heart tissue can interfere with your heart's electrical impulses, causing abnormal heart rhythms.
The same lifestyle habits that can help treat coronary artery disease can also help prevent it from developing in the first place. Leading a healthy lifestyle can help keep your arteries strong and clear of plaque. To improve your heart health, you can:
Control conditions such as high blood pressure, high cholesterol and diabetes
Stay physically active
Eat a low-fat, low-salt diet that's rich in fruits, vegetables and whole grains
Maintain a healthy weight
Reduce and manage stress
अॅक्यूट कोरोनरी सिंड्रोम (Acute Coronary Syndrome ) म्हणजे एक अशी स्थिती ज्यामध्ये कोरोनरी आर्टरीमध्ये रक्तप्रवाह अचानक कमी होतो. यामुळे रक्त मुबलक प्रमाणात हृदयापर्यंत पोहोचत नाही. यामुळे व्यक्तीला स्ट्रोक, एंजाइना किंवा हार्ट अटॅकचा धोका होतो. साधारणतः ही समस्या कोरोनरी आर्टरीमध्ये फॅट्स जमा झाल्यामुळे होते. या आर्टरीमुळे हृदयापर्यंत आवश्यक पोषक तत्व आणि ऑक्सिजन पोहोचतो. जर हृदयापर्यंत आवश्यक तेवढ्या प्रमाणात ऑक्सिजन पोहोचला नाही तर हार्ट मसल्समधील हार्ट सेल्स नष्ट होऊ शकतात. परिणामी व्यक्तीला हार्ट अटॅकचा धोका वाढतो.
2. वेदना छातीमध्ये सुरू होऊन खांद्यांपर्यंत आणि मानेपर्यंत पोहोचतात.
3. उलट्या होणं आणि पचनक्रिया सुरळीत नसणं
4. श्वास घेण्यास त्रास होणं
5. अचानक खूप घाम येतो आणि थकवा जाणवू लागतो.
दरम्यान, अॅक्यूट कोरोनरी सिंड्रोमची लक्षणं व्यक्तीचं वय, लिंग आणि इतर मेडिकल कंडिशन्सनुसार वेगवेगळी असू शकतात.
ही समस्या होण्यामागील कारणं आणि त्यामुळे उद्भवणारा धोका
जेव्हा कोरोनरी आर्टरीमध्ये फॅट जमा होतं, त्यावेळी त्या ब्लॉक होतात. यामुळे हृदयापर्यंत रक्तप्रवाह सुरळीत होऊ शकत नाही. तसेच हृदयाचं कार्य सुरळीत चालवण्यासाठी आवश्यक असणारी पोषक तत्वही हृदयापर्यंत पोहोचू शकत नाहीत. अशा परिस्थितीमध्ये हार्ट मसल्सच्या पेशी नष्ट होतात. तसेच नष्ट नाही झाल्या तरिही या पेशी कमकुवत होतात आणि त्या योग्यप्रकारे काम करत नाहीत.
अॅक्यूट कोरोनरी सिंड्रोमवर उपचार करण्यासाठी सर्वात आधी याबाबत सविस्तर जाणून घेणं गरजेचं आहे. त्यासाठी ईसीजी करण्यात येतं. याला वैद्यकिय भाषेत इलेक्ट्रोकार्डियोग्राम असं म्हटलं जातं. याव्यतिरिक्त ब्लड टेस्ट आणि कार्डिएक परफ्यूजन स्कॅनमार्फत या सिंड्रोमबाबत सविस्तर जाणून घेणं शक्य होतं. या टेस्टच्या आधारावरच डॉक्टर्स निर्णय घेतात की, लक्षणं एंजाइनाची आहेत की, हार्ट अटॅकची.
नवभारत टाइम्सने दिलेल्या वृत्तानुसार, अॅक्यूट कोरोनरी सिंड्रोम एक मेडिकल एमर्जन्सी आहे. म्हणजेच, यासाठी लगेच उपचार घेणं आवश्यक आहे. जर कोणत्याही व्यक्तीमध्ये वरील लक्षणं दिसून आली तर त्वरित डॉक्टरांचा सल्ला घेणं आवश्यक असतं.
वैद्यकिय उपचारांसोबतच डाएटमध्ये काही बदल करून एक्यूट कोरोनरी सिंड्रोमपासून बचाव करणं शक्य होतं.
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