Coronary artery disease or CAD is the name given to the heart condition in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased.

Blockages usually happen when cholesterol-containing deposits called plaque deposit in your arteries. Plaque narrows the lumen of your coronary artery which means your heart gets lesser and lesser oxygen and nutrients to function properly.
Inflammation is also to blame for coronary artery disease.
Common symptoms of CAD include

Angina or pain in the chest
Shortness of breath
If the blockage is complete, you can get a heart attack.
Common Diagnostic tests
When you go to a heart specialist, she will ask questions about your medical history and follow it up with a physical exam and order routine blood and diagnostic tests to confirm CAD like:

Electrocardiogram (ECG): An ECG records electrical signals as they travel through your heart revealing evidence of a previous heart attack or one that s happening. Holter monitoring is a type of ECG where you wear a portable monitor for 24 hours as you go about your normal daily activities. Abnormalities in the results suggest reduced blood flow to the heart signaling CAD.
Echocardiogram: This test uses sound waves to produce images of your heart. It helps your doctor determine whether all parts of your heart wall are contributing to your heart's pumping activity. If certain parts are moving weakly it can mean damage to muscle due to a heart attack or because of receiving too little oxygen- again signaling CAD.
Exercise Stress test: This test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an ECG. Sometimes, medication to stimulate your heart may be used instead of exercise.
This again detects areas in your heart that receive less blood flow.

Cardiac catheterization or angiogram. A special dye is injected into your coronary arteries to observe blood flow through your heart in a test known as an angiogram.
The dye is sometimes also injected into the arteries through a long, thin, flexible tube called catheter that is threaded through an artery in your leg to the arteries in your heart. This procedure is called cardiac catheterization. This test is very good in diagnosing CAD as the dye outlines narrow spots and blockages on the X-ray images of your heart.
Heart scans. Computerized tomography or CT can help your doctor actually see calcium deposits in your arteries that can be narrowing your arteries. If a substantial amount of calcium deposits are found, coronary artery disease could be the reason.
MRI scans are also done to diagnose CAD.

Common Tests For Coronary Artery Disease!

Blood flows through the tubes called as blood vessels. There are two networks of blood vessels   the arteries and the veins. The arteries carry pure or oxygenated blood from the heart to the various parts of the body. The veins, on the other hand, collect impure blood from all over the body and reach it to the heart. Blood flow in the veins is controlled via valves, which ensure blood does not flow in the reverse direction (against its desired direction of flow). The veins in the legs, which are farther from the heart, are quite thick and exert extra pressure to pump blood into the heart. They need to transport blood against gravity and so in people who are prone to stand for long hours, they can become thicker, swollen, twisted, and engorged. In severe cases, there could even lead to bleeding.

Some common causes for varicose veins are:

Damaged valves which are not able to control the flow of blood in the required direction.
Veins with a thin wall that are unable to control blood flow.
Risk factors: Though these are the suspected causes, there are specific risk factors which aggravate the condition of varicose veins.

Family history
Smoking
Occupations which require prolonged standing (construction jobs, painters, etc.)
Pregnancy
Obesity
Age, which reduces the elasticity of the veins
Surgery in the leg, which could have hampered the values or veins
There are quite a few symptoms of varicose veins. These are quite distinct and present as:

Swollen, ropy leg veins which can be blue
Pain, especially with prolonged standing
Tenderness on touching the veins
Itching and heaviness along the veins
Skin changes like scaling and dryness
Night cramps around the area
Susceptibility to bleed from these veins
While varicose veins are easy to diagnose given their distinct clinical presentation, some additional testing can involve the following:

Doppler ultrasound
Scanning
MRI
As said, prevention is better than cure; here are some preventive measures that can be really helpful:

Elevate legs as much as possible. When working, take short breaks to reduce stagnation and promote blood circulation
Quit smoking
Avoiding alcohol, as it causes venous dilation
Weight management
Avoid tight clothing and sitting with cross-legs for prolonged periods as they put a lot of pressure on the veins and valves
Follow a regular exercise regimen to improve blood flow in the legs, like walking or running
Starting from the least invasive to the most, this condition can be treated by:

Compression stocking (Ted hose or Jobst stocking) which improves circulation and reducing pain
Surgical options include sclerotherapy, laser treatment, and stripping off the vein. These are done in very severe cases, but quite rare.

Varicose Veins - How Best It Can Diagnosed?

The heart pumps pure blood to all parts of the body through a network of arteries. These are thicker in the beginning and become finer and thinner as they reach the various organs. These arteries are lined by a layer of epithelial tissues and as blood flows through them, the heavier cholesterol / fat molecules settle down along the walls. 


This attracts more and more fat molecules to settle down.  This is known as atherosclerosis (hardening of the arteries). Over a period of time, the vessels circumference reduces and the blood supply to the target organ reduces. This impacts proper functioning of these organs and when this happens to the major organs like the heart, kidney or the brain, conditions like stroke or thrombosis or heart attack can occur.


This condition, known as coronary artery disease, is becoming a major cause of deaths.  While that is the bad news, the good news is that it is largely lifestyle dependent, and if steps are taken, it can be prevented, and in the early stages, the damage completely reversed.


Preventive measures: 
1. Diet: A low-fat, high-fiber, heart-healthy diet consisting of Omega-3 fatty acids is recommended by doctors, especially to people who are prone to develop heart disease.  This also requires reduced salt, increased unsaturated fats, reduced triglycerides and reduced sugar.  Include loads of fresh fruits and vegetables, whole grains, nuts and seeds and fish oils. Include multivitamins or other supplements after checking with your doctor.


2. Exercise:  Regular exercise in any form increases the efficiency of the circulatory system, keeps the cholesterol levels in check and helps in blood pressure management.  Exercise in any form is advisable, based on individual preference. A moderate physical activity of 30 to 45 minutes per day is advisable.


3. Smoking: This is one of the major risk factors for smoking, and quitting or controlling smoking is one of the best methods to prevent coronary artery disease.


4. Alcohol consumption:  While moderate alcohol consumption is believed to be healthy for the heart, excessive alcohol consumption is a strict no-no.  Binge drinking especially is shown to cause heart attacks.


5. Weight management: Check with your doctor on what is ideal BMI for you and work out a plan to keep your weight under check.


6. Regular medications: If you are on blood pressure or diabetes medications, ensure you do not miss them.  Keep a constant check to ensure your readings are managed well. 


7. Watch out:  Ask your doctor if there are specific symptoms that you need to watch out and seek medical support if you see any of them.


Coronary disease is not treatable fully, but can be prevented and managed effectively to improve the overall quality of life.

Coronary Artery Disease - 7 Ways You Can Prevent it 

Varicose veins are superficial, swollen, enlarged and twisting veins, often appearing dark purple or blue on the feet and legs. The condition occurs when blood through the veins flow in the wrong direction and starts accumulating.

Although varicose veins is not a serious condition, you should seek treatment if it causes symptoms like swelling and pain in the extremities. In severe cases, where a varicose vein ruptures or develops to form skin ulcers, your doctor may recommend laser treatment.

Can laser treatment cure varicose veins?

Laser surgery can effectively treat varicose veins. The procedure involves using a high-intensity beam of light to reduce enlarged, bulging veins that are observed usually on the calves or thighs.

How does the procedure work?

The heat emitted from the laser damages a vein, which causes scar tissues to form. This scar tissue shrinks and closes the vein. A closed vein gradually loses its source of blood and dies. After some time, usually in a year or two, the vein disappears on its own.

Two types of laser surgery are performed, namely  

  Simple Laser Treatment   This is done on the outer layers of your skin. It can cure small varicose veins and spider veins under the skin surface. Normally, more than one session, scheduled every 6-12 weeks is needed.
  Endovenous Laser Treatment   This particular procedure is used to cure large varicose veins that appear on the legs.
The steps of the procedure are as follows  
  Your healthcare provider will administer local anaesthesia to numb the area. You may be provided with an eyeglass to protect your eyes
  The surgeon will make a small incision on the skin and pass a laser fibre through a catheter into the veins while closely monitoring the vein on a screen
  As he/she pulls out the catheter, the length of the vein will heat up and shrink, and eventually close

This outpatient procedure is less painful than stripping and litigation. It has a shorter recovery period and can be performed under local anaesthesia or mild sedatives.

What to Expect

After the laser treatment, you can walk around without much complication. The recovery period is typically brief. You can expect to return to your daily activities following simple laser surgery. However, you might need to wear a compression stocking for a week or so after the endovenous laser procedure.
You may notice redness, bruising or burns on the skin after the treatment. That is only normal, so you need not worry. Do follow up with your doctor to see if the vein has closed.


Laser Treatment For Varicose Veins!

What are varicose veins? 
Varicose veins are enlarged veins that typically develop in the legs and the feet. This condition is triggered when there is something wrong with the valves of the veins. When the valves do not function properly, blood flow to all parts of the body is disrupted. Since the legs are the farthest part of the body from the heart, gravity makes it difficult for blood to flow up to the heart. It is a common affliction and affects nearly 25% of the adult population all across the world and 10 million people in India are diagnosed with it every year. The raised veins just under the top layer of the skin appear to be purplish-blue.

Varicose veins are common in people who are -
  Above 50 years of age
  Long stretch sitting
  Pregnant
  Menopausal
  Obese
If someone in your family has a history of varicose veins, you are quite likely to get it too.

What are the symptoms of varicose veins?
Varicose veins are characterized by the following symptoms -
  The most obvious symptom is the large twisty veins
  Pain all down the length of your legs
  Discoloration of the skin of the legs and feet

Diagnosis of varicose veins -
The doctor usually diagnoses varicose veins by a physical examination. An ultrasound may determine if your flow of blood is affected. It is a non-invasive procedure and is done with the help of high-frequency sound waves.
You may even have to undergo a venogram. The doctor injects a colored dye into your veins and X-rays them. The dye gives an indication of how well your blood is flowing through the veins.

Treatment of varicose veins -
There are several treatment options for varicose veins-

Vascular surgery - When the other methods do not work, doctors prescribe vascular surgery.
Ligation and stripping - through this surgery, the surgeon ties up the vein to prevent pooling of blood in the veins and sometimes the vein itself is removed.
Sclerotherapy - the doctor injects a chemical right into the varicose vein which closes it.
Radiofrequency ablation - the doctor uses radiofrequency to heat the varicose vein up, which makes the walls collapse
Varicose veins are a painful condition that can be avoided if you implemented a few changes to how you live your life and even if you do get them, there are ways to cure them.

In Detail About Varicose Vein & Its Treatment!

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!

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