Diagnosis and Progression of CAD 

The heart is an organ that is protected very well by the body.  It is a mysterious organ that has fascinated humans since the dawn of time.  It has hid it's secrets from us, good or bad...so how does one find out if we have plaque buildup or if we are in danger of a heart attack?!  There are six methods that are very effective at diagnosing any malaise in the heart, especially for CAD. However, CAD is not diagnosed with just one of these tests.  If the doctor suspects any CAD, he will order more than one of the following tests (1).  These include: 

EKG(Electrocardiogram):

The EKG/ECG test is a test that measures your heart's electrical activity to find out how strong and fast the heart is beating (1).  Any anomalies in the beats will mean that there is something that is affecting how the heart is beating. From reading the charts, it is also possible to determine where in your heart the problem is stemming from! 

Stress testing: 

Stress testing is a very clever way for us to see how your heart is doing..... by making it work!  What better way to test your heart than by making it exercise?  While you exercise, your heart is monitored to find any abnormalities.  If you can't exercise, medications are given to raise your heart rate instead.  If you can't exercise as long as the normal range for your age, the heart may not be getting enough blood due to the arteries being blocked from plaque buildup (1).  Other symptoms to look out for are, abnormal changes in heart rate and/or blood pressure, shortness of breath or chest pain, and abnormal changes in your heart activity/rhythm (1). 

Echocardiography: 

This amazing technology is used to visualize your heart by using the sounds of your heart!  Think of it as a bat that uses echolocation to visualize everything around it.  Now that is what an echocardiogram does. 

Chest X-Ray:

How can the x-ray help see your heart?  The x-ray can see whether your heart is larger or smaller, which is indicative of heart failure.  The larger the heart is, the harder it has to work, which means the heart is facing a pathological resistance (1).  

Blood Tests: 

The blood test is a great way to measure whether or not somebody is at risk of CAD.  This test draws out a person's blood, then measures the level of fats, cholesterol, proteins, and sugar in your blood (1).  It also measures certain chemicals released by your heart called bio-markers that indicate whether the heart has been damaged (2).  All of these factors can cause damage/measure damage to the arteries, in which fat can accumulate and narrow the passage to blood flow. 

Coronary Angiography and Cardiac Catheterization:  

 

Coronary angiography and cardiac Catheterization is the use of special dyes and x-rays in order to show the arteries in the heart (2).  Cardiac catheterization is the insertion of a special tube into your bloodstream, then a special dye is released (2).  A special x-ray is then used.  It can show any occluded arteries or ones that are in danger of being occluded. 

Works Cited 

1) How Is Coronary Heart Disease Diagnosed? (2014, September 29). Retrieved January 26, 2015, from http://www.nhlbi.nih.gov/health/health-topics/topics/cad/diagnosis

2) Voss, J. (Director) (2015, January 26). Acute Coronary Syndrome. Lecture conducted from , Seattle.

Etiology/Pathophysiology of CAD

As we all know, from the incessant repetitions from our parents and teachers back in the days of yore, we must always exercise and eat healthy.  "But I'm not overweight and look perfectly healthy!"  Yes, yes you do, however, there are more reasons to exercise and eat right than you think!  There are also other factors that play into the development of CAD, such as smoking, eating foods with high fats/cholesterol/sugar, and high blood pressure (1) .  This video shows what happens and what causes CAD: 

Etiology/Signs and Symptoms of CAD:

Basically, not exercising, eating the wrong foods, smoking, etc, all have the ability to damage the heart and arterial wall.  Once the arterial wall is damaged, it causes lipids to accumulate, forming a plaque.  Once the plaque accumulates, it narrows the artery(s) over time, which can cause a plethora of problems over time, such as myocardial infarction! 

Pathophysiology of CAD: 

What may happen when your coronary arteries are totally blocked?  Well, for one, your heart tissue can die from the lack of oxygen.  A thrombus can develop when the plaque ruptures, which causes red blood cells to aggregate and block the already tight arterial space even further.  A piece of the thrombus can also break away, which is called an embolism and block oxygenation distal parts of the coronary artery (2).   This is what many would a heart attack or myocardial infarction.  This can easily cause death if not treated promptly, but would be even better if preventative measures were put in place years beyond the condition!  That is why education and putting that knowledge into action is so important.  Yes, I know it is the hardest thing to get up and go for a little exercise or avoid that ever so delicious cheese burger, but is that little bit of gratification worth the long term risks or death?  You may snicker and respond "YOLO".  In which case that is the truth, you only do live once, but would you prefer a shorter life or longer one? 

Works Cited

(1) What Causes Coronary Heart Disease? (2014, September 29). Retrieved January 23, 2015 from http://www.nhlbi.nih.gov/health/health-topics/topics/cad/causes 

(2)Prizel KR, Hutchins GM, Bulkley BH. Coronary artery embolism and myocardial infarction. Ann Intern Med 1978; 88: 155-161

EPIDEMIOLOGY OF CAD

Coronary artery disease  is one of the most feared diseases and is a very popular topic of discussion today since it is so lethal and can affect many people, causing much death in its wake.  In order to understand how much of an impact CAD, has consider this: ischemic heart diseases are and continue to be the single largest cause of death in the world, according to Finegold, Asaria, and Francis.  Not even the U.S is spared.  "In the United States, coronary heart disease (CHD) is a leading cause of death for both men and women.  Each year, about 375,000 Americans die from CHD (2)."  This isn't even the whole story, as many people are afflicted with CAD in the US.  17.6 million to be exact, according to Wilson and Douglas.   

CAD Incidence By Race in US

As we can see from this chart, Non-Hispanic Whites males aged 18 and above have the highest chance of getting CAD. For persons aged 40 years old, the lifetime risk of obtaining CAD is 49% in men and 32% in women.  For those reaching the ripe age of 70, the risk decreases to 35% in men and 24% in women (4).  However, not everything is doom and gloom.  The deaths from CAD has actually been DECREASING since 1999 in the U.S! 

CAD Deaths per 100,000 in US Over 9 Years

This trend of decreasing deaths in develop countries is due to many factors.  One is improvements in therapy and the other half of this is due to change in risk factors (reduction in smoking, physical inactivity, cholesterol, systolic blood pressure, etc.) (4)  Other developing countries such as China, however, are projected to have an increase in CAD mortality from 9 million to 19 million from 1990 to 2020 (4).  

In order to keep this trend going, we must first decrease our own risk factors for this disease and that starts with education of the masses.  Although it is a far fetch, it is well within our grasp to lead the charge against CAD and eliminate it (as best as we can).  It all starts with us, so lets get up to the gym after this and eat a very well balanced meal after! 

Works Cited

(1) Finegold, J., Asaria, P., & Francis, D. (2013). Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations. International Journal of Cariology, 168(2), 934-945. Retrieved January 16, 2015, from http://www.sciencedirect.com/science/article/pii/S0167527312014210

(2)National Heart Lung and Blood Institute. Who Is at Risk for Coronary Heart Disease? (2014, September 29). Retrieved January 16, 2015, from http://www.nhlbi.nih.gov/health/health-topics/topics/cad/atrisk

(3)Health Resources and Services Administration. Heart Disease and Stroke. (n.d.). Retrieved January 16, 2015, from http://mchb.hrsa.gov/whusa11/hstat/hshi/pages/213hds.html

(4) Wilson, P., & Douglas, P. (2014, November 26). Epidemiology of coronary heart disease. Retrieved January 16, 2015, from http://www.uptodate.com/contents/epidemiology-of-coronary-heart-disease

George's Super Cool Blog On Coronary Artery Disease

Hello, and welcome to my blog, where we will be talking about everything CAD (Coronary artery/heart disease).  "What is coronary artery disease?" you may ask.  Well, it's actually very simple.  Your heart is a muscle that pumps blood.  It also needs blood for itself or it will stop working!  CAD is caused when the arteries that supply the heart narrows.  There are a few very notable symptoms that are indicative of CAD.  Those include angina (chest pain), shortness of breath, and a heart attack.  If you see somebody with those symptoms, better have your CPR skills in handy!

Here is a picture of the heart and some of the basic arteries that give the heart it's oxygen.

Coronary Arteries of the heart: 

As you can see, the heart is a very complex organ.  One of the most, if not the most important muscle in the body.  Even underneath the arteries, the heart is very complex and fascinating, with two ventricles and two aortas that help pump blood.  The process of pumping blood requires oxygen from the coronary arteries.  See?  Isn't the heart such a fascinating organ?!  

Here is what happens when the heart arteries narrow as compared to a normal (healthy) artery: 

Inside an artery: 

The most common cause of coronary artery disease is atherosclerosis, cause by plaque buildup in the arteries. This usually occurs over the course of  many years.  In fact, it is better to start leading a better lifestyle now so it will lower the chance of getting CAD later in life!  I know it's very tempting and exciting to read this very exciting blog while munching on potato chips or chocolate cookies, but later on in life, it can come back to haunt you (even though I need to follow my own advice sometimes)!  So lets drop the sugar cookies, get up, and head to the gym to muscle up and fight coronary artery disease!

Sources: 

1. Coronary artery disease. (n.d.). Retrieved January 8, 2015, from http://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/basics/definition/con-20032038

2. Coronary arter. (n.d.). Retrieved January 8, 2015, from http://www.daviddarling.info/encyclopedia/C/coronary_artery.html