Coronary Artery Disease - Symptoms and Causes

Coronary artery disease is the disease in which the major blood vessels (coronary arteries) that supply blood, nutrients and oxygen to your heart get damaged or disease stricken. It is mostly caused due to the coronary artery getting plagued or inflamed. The consequent reduction in blood flow to the heart causes the various symptoms of coronary artery disease like angina (chest pain), short breath etc.

Symptoms:

Here is a list of a few symptoms that help in identification of the coronary artery disease.

1. Angina

Pressure or tightness may be felt in or near the area of the chest that results in pain. It is mostly felt in the middle or left side of the chest.

2. Shortness of breath

Another symptom of coronary artery disease is short breath, fatigue and a feeling of exertion.

3. Heart attack

Complete blockage of the coronary artery results in a heart attack that is a prominent symptom of coronary artery disease. A person may feel heavy pressure in the chest, pain in the shoulder or arm, sweating etc. prior to getting a heart attack.

Causes:

Coronary artery disease occurs when damage or injury is done to the inner layer of the coronary artery. This damage causes plaque, which are deposits made of fat, cholesterol and other cellular waste materials to accumulate near the damaged area of the artery. This process is known as atherosclerosis.

The various causes that result in coronary artery damage are listed below.

- Smoking
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- High stress
- Physical inactivity

Knowing Coronary Artery Disease - Symptoms and Causes

Varicose veins are large veins that appear on the legs of some patients. Usually, blood travels to the legs from the heart through the arteries, and the veins take it back to the heart. The valves in the veins allow the blood to travel from the legs to the heart against gravity. During this process, the valves may leak and blood may collect in the veins, making them appear enlarged.
EVLT (Endovenous laser therapy) is the latest method for curing varicose veins without surgery. It heats the affected veins them through a laser instead of removing them.
Process
In this process, at first, an ultrasound scan is carried out to locate the veins that have to be treated. After marking them, the doctor applies local anaesthetic on the skin and a needle is inserted into it. A wire is then passed through the needle up to the target vein. Over this wire, a catheter is passed after removing the needle. After that, the wire is removed.
Through the catheter, a laser fibre is placed whose tip usually reaches up to the groin crease. Using tiny needles, a large amount of local anaesthetic solution is applied in the region surrounding the vein. The laser is then applied for 5 minutes on the veins. You might hear a buzz or feel a burning sensation but won t feel any pain. The catheter and the laser are then removed and the incision is covered.
The process takes about 30 minutes to complete. After the treatment, you will be advised to wear compressions stockings and can go back to your normal routine immediately.
Benefits
The different benefits of the surgery are:
The skin does not have to be stitched 
There is no pain in the process and patients can go back to work right after the treatment
The process is free from complications 
No scars are left after the treatment

Common uses of the process
EVLT is also used for treating the following:
Swelling of the veins 
Discolouration of the skin
The heaviness of the leg
Skin ulcers and irritation
Precautions
These are the precautions that you must take:
A week before the process, avoid taking arthritis medications, aspirin, and Ibuprofen as they can increase the chances of bruising 
Avoid alcohol and tobacco 2 days before the procedure
After the treatment, ask someone to drive you back home and do not use public transport
Avoid activities like swimming, running, jogging and weightlifting for at least 2 weeks after the procedure

The varicosities fade away after the process but rarely disappear completely. You might require further treatment for improving the appearance of the veins. 


EVLT Varicose Veins Treatment!

In our bodies, the vascular system is composed of vessels. This system is comprised of a complex network of veins and arteries. The arteries transport oxygenated blood away from the heart and spread it throughout our bodies and veins brings the deoxygenated blood (oxygen-poor) back to the heart for purification. Whenever this complicated process gets disturbed, pain, dysfunction of the system, and other complications may occur.

Most common complications among all are:
1. Abdominal Aortic Aneurysm: This condition is when there is a  bulge  formed in the weak area of the largest artery in the abdomen and keeps on increasing with each pressure flow of blood from that artery. This condition weakens the artery further and massive internal bleeding may occur.

2. Carotid Artery Disease - Stroke: This condition arises when the main blood vessels flowing blood to the brain develops a plague caused due to hardening of the arteries (atherosclerosis). The continuous increase of plague can cause a stroke.

3. Peripheral Arterial Disease: This condition occurs when the flow of oxygen-rich blood is insufficient to the lower limbs of the body due to hardening of the arteries in that area. This can cause difficulty in walking, foot ulcers, infections and can even lead to amputation.

The complication of these types are corrected by the vascular surgeon with the process is commonly known as vascular surgery. However, this condition is sometimes medically managed by an innovative, less invasive procedure called Endovascular surgery. 

Vascular Surgery-
Vascular surgery is generally the traditional surgery that corrects the diseases outside of the heart and the brain. This procedure is more invasive as it involves incisions that are surgical in nature. Vascular surgery comprises of the surgery of the aorta, carotid arteries, and other small diametric arteries. This surgery also involves surgery of veins for treating various conditions such as varicose veins and May-Thurner syndrome.

Endovascular Surgery:
However, this type of surgery is an innovative way to treat medical conditions related to the vascular system. For instance, during the procedure of treating the Abdominal Aortic Aneurysm, it involves making a small cut near the hip area and inserting the endovascular graft through the arteries and is positioned inside the aorta, in a catheter, which is a flexible, long, and narrow tube. The endovascular graft is a tube device made up of special fiber and is framed within stainless steel self-expanding stents. The grafts expand and seal off the aneurysm. This stops the internal bleeding the system and the graft remain in the aorta permanently.

This method has a short recovery time, smaller incisions, less discomfort, less stress on the heart and has fewer risks. This surgery is appropriate for the patient who is at high
risk of complications. 

Take Away-
Diseases related to artery and veins are now being treated with various methods such as angiography, stenting, sclerotherapy in various countries. These days vascular surgeons have become proficient with the endovascular surgical methods. Endovascular surgery is durable and less painful and stressful when viewed with the context of vascular surgery. However, the cost of staying longer at the hospitals is somewhat got balanced by the high cost of imaging equipment and other high financial expenses in the endovascular surgery.

Endovascular VS Vascular Surgery - Know The Difference!

Angioplasty is the procedure of opening a coronary artery blockage with the help of wire balloon and stent. This procedure is done to open the blocked coronary arteries if they are causing symptoms or acute heart attacks.

HOW IT IS DONE?

The procedure is usually done in local anaesthesia. A wrist artery (radial) or a groin artery (femoral) is used to gain access to the coronary artery as is done in angiography. A hollow tube called a catheter is passed upto heart artery and through this, a guidewire is passed across the blockage and over this wire balloon is passed and blockage dilated.

After this balloon is removed and the metallic stent is passed over this wire. The stent is then inflated and it takes its shape of the hollow tube so that the flow in the coronary artery is restored.

WHAT ARE INDICATIONS OF ANGIOPLASTY AND STENTING:

An acute Heart attack is the most definite indication of angioplasty and stenting. At the time of the heart attack, there is an urgent need to restore the blood flow of block coronary artery which is usually not possible with medicines alone. Angioplasty is the most effective and definite way of opening the artery urgently in such situation.

SHOULD ALL BLOCKAGES BE OPENED UP BY ANGIOPLASTY AND STENTING?

NO, all blockages do not warrant this procedure. There is some amount of risk involved in the angioplasty procedure itself. When the risk of blockage is considered more than the risk of opening the artery then the procedure is indicated. Patients who are doing good on medicines may be followed up without angioplasty.

All About Angioplasty!

Peripheral vascular disease (PVD) is a circulation issue that affects the veins and blood vessels outside of the brain and heart. PVD commonly strikes the veins that supply blood to the arms, legs, and organs situated beneath the stomach. These are the veins that are located away from the heart. They are known as peripheral vessels.

In PVD, the width of the veins get limited. Narrowing is normally created by arteriosclerosis. Arteriosclerosis is a condition where plaque develops inside a vessel. It is additionally called 'solidifying of the arteries'. Plaque acts towards reducing the amount of blood and oxygen that is supplied to the arms and legs. As the plaque development advances, clumps may develop, which may further affect the vessel.

There are two main types of PVDs:

    Functional PVD: This doesn't include physical issues in the veins. It causes accidental side effects. Typically,these fits happen suddenly.
    Organic PVD: This includes changes in the vein structure. This sort of PVD causes irritation, tissue harm, and blockages.

The most well-known reasons for functional PVDs are as follows:

    Emotional stress
    Smoking
    Cold temperatures
    Operating Vibrating machinery

The common causes of such natural PVDs are given below:

    Smoking
    High circulatory strain
    Diabetes
    High cholesterol

The symptoms include the following:

    Cramps
    Achiness
    Fatigue
    Burning

Diagnosis:

PVD can be diagnosed using interventional radiology (IR).

IRis a sub-claim of radiology that gives an image-guided diagnosis, and if required, includes treatment of the organs as well.It has developed as a first-line treatment in the administration of PVD.

Advantages:

IR medications are for the most part less demanding for patients than surgery, since they include no surgical cut.They are less painful and have shorter stays at the hospital. By and large, the patients are discharged on the same day the procedure is done. This mainly includes angioplasty and stenting. The procedure is as follows:

    Utilising imaging for direction, the interventional radiologist puts a catheter through the femoral artery in the crotch to the blocked vein in the legs.
    At that point, the interventional radiologist expands a balloon to open the vein that is blocked.
    Sometimes it is opened with a tiny metallic cylinder called astent.
    This is a treatment that does not require surgery; only a scratch in the skin the extent of a pencil tip.

Alternative measure:

Angioplasty and stenting have totally replaced invasive surgical methods. Early trials have proven IR to be as successful as surgery for some blood vessel and artery impairments. Earlier, extensive clinical experience demonstrated that stenting and angioplasty are favoured as first-line treatments for more procedures all through the body .

Doctors as well as patients who have been through the same, believe that IR is much better for PVD than invasive surgery, since it reduces the risk of infection.

Diagnosing Peripheral Vascular Diseases With Interventional Radiology

The coronary arteries supply the heart with oxygen-enriched blood and nutrients. If these arteries become damaged or diseased; they could cause Coronary artery disease or CAD. Plaque deposits on the walls of the arteries are the most common cause of this disease. This plaque is usually the result of high cholesterol levels. As the plaque builds up, the passage of blood flow is reduced. This reduces the amount of blood that reaches the heart. In cases of a complete blockage, CAD can even cause a heart attack. Because of its slow progression, this disease is often not diagnosed until it reaches a dangerous stage. However, it can be prevented and treated if diagnosed in time.

In the early stages of CAD, symptoms are not very noticeable. Symptoms become visible only when blood flow to the heart reduces and the heart has to pump harder than normal. The most common symptoms experienced include:

Chest Pain: This is also referred to as angina. It may feel like a tightening of the chest or pressure on the chest as though someone is pressing against it. This type of chest pain may be triggered by emotional or physical stress. It is usually relieved within a few minutes of stopping the activity. Women may experience this pain as a sharp, fleeting pain in the back, arm or neck.
Breathlessness: When the heart does not receive enough blood, it has to work harder to pump blood through the body. This may be translated to breathlessness of shortness of breath when performing any type of physical activity. It can also cause extreme fatigue.
Heart Attack: A heart attack is the most severe symptom of coronary artery disease. This is caused by the complete blockage of a coronary artery. A heart attack can occur without any symptoms or be preceded by slight symptoms. The signs of an impending heart attack include pain in the chest and shoulder, shortness of breath and extreme sweating. The chest pain may also travel to the lower jaw. These symptoms are more pronounced in men as compared to women. Women have a higher tendency of experiencing atypical signs such as extreme fatigue.
Other symptoms that might indicate coronary artery disease are dizziness, nausea and an irregular heartbeat. The good news is that this disease can be prevented. Staying physically active, maintaining a healthy weight, reducing stress and eating a low fat and low salt diet can help reduce the risk of CAD.

Coronary Artery Disease (CAD) - What Are The Symptoms?

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