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Coronary artery disease - InDepth

Hardening of the arteries - InDepth; Arteriosclerosis - InDepth; Plaque buildup - arteries - InDepth; Hyperlipidemia - atherosclerosis - InDepth; Cholesterol - atherosclerosis - InDepth; Angina - InDepth; Atherosclerosis - InDepth; Heart disease - InDepth

An in-depth report on the causes, diagnosis, treatment, and prevention of coronary artery disease (CAD).

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  • Coronary artery disease - Animation

    Coronary artery disease

    Animation

  • Coronary artery disease - Animation

    If we looked inside the chest cavity, we would see the lungs and pericardium, which is the fibrous covering of the heart. We could also see the heart beating. Here are the left and right coronary arteries. They supply blood to specific regions of the heart. If either is damaged or blocked, it could injure the heart wall. In a healthy artery, red blood cells flow through unimpeded. But if the inner wall is damaged, cholesterol plaque can build up. This progressively narrows the space through which blood flows. Eventually, the artery may become too narrow for clotted blood to pass through. If it does, the artery could become completely blocked. That would cause a lack of oxygen, or ischemia, in the part of the heart the artery supplies. The result is a heart attack, known as a myocardial infarction.

  • Stent - Animation

    Stent

    Animation

  • Stent - Animation

    If you have a blocked artery in your heart, legs, or neck, you may need a stent to keep your blood flowing to prevent serious problems. Let's talk today about stents. A stent is a tiny tube we place in an artery, blood vessel, or other duct (such as the one that carries urine) to hold the tubes open. A stent is left in permanently. Most stents are made of metal or plastic mesh-like material. Stent grafts made of fabric are often used in larger arteries. Stents are used to treat a variety of artery and other problems. Your doctor will make a small cut in a blood vessel in your groin and thread a thin, flexible tube called a catheter to the place in your body where you need a stent. In the heart, a fatty substance called plaque can build up inside the coronary arteries. Plaque narrows the arteries, reducing the flow of oxygen-rich blood to the heart. One stent, called an intraluminal coronary artery stent, is a small, self-expanding, metal mesh-like tube that is placed inside a coronary artery after balloon angiography. This stent prevents the artery from re-closing. Another stent is coated with medicine that helps further prevent an artery from re-closing. In the carotid arteries, which are on both sides of your neck, plaque can build up and slow the flow of blood to your brain. Stents can keep the carotid arteries open. Stents can also open up narrow arteries in your legs caused by peripheral arterial disease. They're also used to treat an abdominal aortic aneurysm, which is when the large blood vessel that supplies blood to your abdomen, pelvis, and legs becomes abnormally large and balloons. After a stent procedure, your doctor will probably recommend that you take aspirin and another anti-clotting medication to prevent blood clots from forming in the stent. Make sure that you talk to your doctor, before getting a stent, about the risks associated with placing a stent to treat your condition, such as tissue growing around the area where the stent was placed.

  • Nuclear stress test - Animation

    Nuclear stress test

    Animation

  • Nuclear stress test - Animation

    Your heart is the engine that keeps blood pumping throughout your body. When your heart doesn't work as well as it should, your body can't function normally. If you've had heart problems in the past, your doctor may recommend that you have a test to see how well your blood is flowing into your heart. Let's talk today about thallium and sestamibi stress test, also known as nuclear stress test. This is your heart. It's job is to receive oxygen-poor blood from your body, send it to your lungs to pick up fresh oxygen, then pump that oxygen-rich blood back out to your body. When your heart doesn't get enough blood, it can't work as well as it should. So, why would you need a thallium or sestamibi stress test?Well, your doctor may recommend that you have this test to find out why you're having chest pain, find out which treatment is best for your heart disease, check whether a treatment you've already had, such as medicine or surgery, is working, or see if you have coronary artery disease. So, what happens during the stress test?Well, you'll start to prepare for the stress test a day ahead of time. Don't eat anything the night before the test, and avoid any foods that contain caffeine for a full day beforehand. You'll have to skip your morning cup of coffee or tea, and avoid sodas and chocolate. Your doctor will let you know if you need to stop taking any of your medicines before the test. When you arrive at the doctor's office or medical center for the test, an intravenous, or IV line will be placed into your vein. Through this line, a weakly radioactive substance will be injected into one of your veins. You'll lie down and wait for 15 to 45 minutes, and a special camera will take pictures as the thallium or sestamibi substance moves into your heart during a period of rest. Then you'll walk on a treadmill with EKG electrodes monitoring your heart activity. Once you've reached your maximum level of exercise you'll get another injection of the radioactive substance and your heart will be scanned to see how well the blood is flowing during a period of "stress. " If you can't exercise, you'll get a drug that will simulate the effects of exercise by making your heart beat faster. During the test, some people feel chest pain, shortness of breath, dizziness, or a fast heartbeat. Let the person who is doing the test know right away if you don't feel well. So, what do the test results mean?Well, your doctor will compare the first set of images to the second set, to see if you have heart disease or your heart disease is getting worse. If blood is flowing well through the arteries of your heart, then your test is normal. If blood isn't flowing well, you may have a blockage in one or more of the coronary arteries of your heart. In that case, you may need to have another test, or an angiography, stent or heart bypass surgery to open up a blocked artery. A stress test can help your doctor see how well your heart is working. Then, you can find out together which treatments you'll need to get your blood pumping smoothly again.

  • Electrocardiogram - Animation

    Electrocardiogram

    Animation

  • Electrocardiogram - Animation

    If your heart has been beating too fast, or you've been having chest pain, both you and your doctor will want to find out what's causing the problem so you can get it treated. One way to diagnose heart problems is with a test of the heart's electrical activity, called an electrocardiogram or ECG, or EKG for short. Your heart is controlled by an electrical system, much like the electricity that powers the lights and appliances in your home. Electrical signals make your heart contract so that it can pump blood out to your body. Heart disease, abnormal heart rhythms, and other heart problems can affect those signals. Using an ECG, your doctor can identify problems in your heart's electrical system and diagnose heart disease. So, how is an ECG done?First you'll lie down on a table. You'll have to lie very still while the test is done. Small patches, called electrodes, will be attached to several places on your arms, legs, and chest. The patches won't hurt, but some of the hair in those areas may be shaved so the patches will stick to your skin. The patches are then attached to a machine. You'll notice that when the machine is turned on, it produces wavy lines on a piece of paper. Those lines represent the electrical signals coming from your heart. If the test is normal, it should show that your heart is beating at an even rate of 60 to 100 beats per minute. Many different heart conditions can show up on an ECG, including a fast, slow, or abnormal heart rhythm, a heart defect, coronary artery disease, heart valve disease, or an enlarged heart. An abnormal ECG may also be a sign that you've had a heart attack in the past, or that you're at risk for one in the near future. If you're healthy and you don't have any family or personal history of heart disease, you don't need to have an ECG on a regular basis. But if you are having heart problems, your doctor may recommend getting this test. An ECG is pretty accurate at diagnosing many types of heart disease, although it doesn't always pick up every heart problem. You may have a perfectly normal ECG, yet still have a heart condition. If your test is normal but your doctor suspects that you have a heart problem, he may recommend that you have another ECG, or a different type of test to find out for sure.

  • Coronary artery disease

    Coronary artery disease

    The coronary arteries supply blood to the heart muscle itself. Blood supply through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the coronary arteries narrow, the flow of blood to the heart can slow or stop, causing chest pain (stable angina), shortness of breath, heart attack, or other symptoms.

    Coronary artery disease

    illustration

  • Coronary artery disease

    Coronary artery disease

    The right coronary artery supplies blood from the aorta to the right side of the heart.

    Coronary artery disease

    illustration

  • Tobacco and vascular disease

    Tobacco and vascular disease

    Tobacco use and exposure may cause an acceleration of coronary artery disease and peptic ulcer disease. It is also linked to cancer, stroke, COPD, fetal illness, and delayed wound healing.

    Tobacco and vascular disease

    illustration

  • Heart transplant  - series

    Heart transplant - series

    Presentation

  • Coronary artery disease - Animation

    Coronary artery disease

    Animation

  • Coronary artery disease - Animation

    If we looked inside the chest cavity, we would see the lungs and pericardium, which is the fibrous covering of the heart. We could also see the heart beating. Here are the left and right coronary arteries. They supply blood to specific regions of the heart. If either is damaged or blocked, it could injure the heart wall. In a healthy artery, red blood cells flow through unimpeded. But if the inner wall is damaged, cholesterol plaque can build up. This progressively narrows the space through which blood flows. Eventually, the artery may become too narrow for clotted blood to pass through. If it does, the artery could become completely blocked. That would cause a lack of oxygen, or ischemia, in the part of the heart the artery supplies. The result is a heart attack, known as a myocardial infarction.

  • Stent - Animation

    Stent

    Animation

  • Stent - Animation

    If you have a blocked artery in your heart, legs, or neck, you may need a stent to keep your blood flowing to prevent serious problems. Let's talk today about stents. A stent is a tiny tube we place in an artery, blood vessel, or other duct (such as the one that carries urine) to hold the tubes open. A stent is left in permanently. Most stents are made of metal or plastic mesh-like material. Stent grafts made of fabric are often used in larger arteries. Stents are used to treat a variety of artery and other problems. Your doctor will make a small cut in a blood vessel in your groin and thread a thin, flexible tube called a catheter to the place in your body where you need a stent. In the heart, a fatty substance called plaque can build up inside the coronary arteries. Plaque narrows the arteries, reducing the flow of oxygen-rich blood to the heart. One stent, called an intraluminal coronary artery stent, is a small, self-expanding, metal mesh-like tube that is placed inside a coronary artery after balloon angiography. This stent prevents the artery from re-closing. Another stent is coated with medicine that helps further prevent an artery from re-closing. In the carotid arteries, which are on both sides of your neck, plaque can build up and slow the flow of blood to your brain. Stents can keep the carotid arteries open. Stents can also open up narrow arteries in your legs caused by peripheral arterial disease. They're also used to treat an abdominal aortic aneurysm, which is when the large blood vessel that supplies blood to your abdomen, pelvis, and legs becomes abnormally large and balloons. After a stent procedure, your doctor will probably recommend that you take aspirin and another anti-clotting medication to prevent blood clots from forming in the stent. Make sure that you talk to your doctor, before getting a stent, about the risks associated with placing a stent to treat your condition, such as tissue growing around the area where the stent was placed.

  • Nuclear stress test - Animation

    Nuclear stress test

    Animation

  • Nuclear stress test - Animation

    Your heart is the engine that keeps blood pumping throughout your body. When your heart doesn't work as well as it should, your body can't function normally. If you've had heart problems in the past, your doctor may recommend that you have a test to see how well your blood is flowing into your heart. Let's talk today about thallium and sestamibi stress test, also known as nuclear stress test. This is your heart. It's job is to receive oxygen-poor blood from your body, send it to your lungs to pick up fresh oxygen, then pump that oxygen-rich blood back out to your body. When your heart doesn't get enough blood, it can't work as well as it should. So, why would you need a thallium or sestamibi stress test?Well, your doctor may recommend that you have this test to find out why you're having chest pain, find out which treatment is best for your heart disease, check whether a treatment you've already had, such as medicine or surgery, is working, or see if you have coronary artery disease. So, what happens during the stress test?Well, you'll start to prepare for the stress test a day ahead of time. Don't eat anything the night before the test, and avoid any foods that contain caffeine for a full day beforehand. You'll have to skip your morning cup of coffee or tea, and avoid sodas and chocolate. Your doctor will let you know if you need to stop taking any of your medicines before the test. When you arrive at the doctor's office or medical center for the test, an intravenous, or IV line will be placed into your vein. Through this line, a weakly radioactive substance will be injected into one of your veins. You'll lie down and wait for 15 to 45 minutes, and a special camera will take pictures as the thallium or sestamibi substance moves into your heart during a period of rest. Then you'll walk on a treadmill with EKG electrodes monitoring your heart activity. Once you've reached your maximum level of exercise you'll get another injection of the radioactive substance and your heart will be scanned to see how well the blood is flowing during a period of "stress. " If you can't exercise, you'll get a drug that will simulate the effects of exercise by making your heart beat faster. During the test, some people feel chest pain, shortness of breath, dizziness, or a fast heartbeat. Let the person who is doing the test know right away if you don't feel well. So, what do the test results mean?Well, your doctor will compare the first set of images to the second set, to see if you have heart disease or your heart disease is getting worse. If blood is flowing well through the arteries of your heart, then your test is normal. If blood isn't flowing well, you may have a blockage in one or more of the coronary arteries of your heart. In that case, you may need to have another test, or an angiography, stent or heart bypass surgery to open up a blocked artery. A stress test can help your doctor see how well your heart is working. Then, you can find out together which treatments you'll need to get your blood pumping smoothly again.

  • Electrocardiogram - Animation

    Electrocardiogram

    Animation

  • Electrocardiogram - Animation

    If your heart has been beating too fast, or you've been having chest pain, both you and your doctor will want to find out what's causing the problem so you can get it treated. One way to diagnose heart problems is with a test of the heart's electrical activity, called an electrocardiogram or ECG, or EKG for short. Your heart is controlled by an electrical system, much like the electricity that powers the lights and appliances in your home. Electrical signals make your heart contract so that it can pump blood out to your body. Heart disease, abnormal heart rhythms, and other heart problems can affect those signals. Using an ECG, your doctor can identify problems in your heart's electrical system and diagnose heart disease. So, how is an ECG done?First you'll lie down on a table. You'll have to lie very still while the test is done. Small patches, called electrodes, will be attached to several places on your arms, legs, and chest. The patches won't hurt, but some of the hair in those areas may be shaved so the patches will stick to your skin. The patches are then attached to a machine. You'll notice that when the machine is turned on, it produces wavy lines on a piece of paper. Those lines represent the electrical signals coming from your heart. If the test is normal, it should show that your heart is beating at an even rate of 60 to 100 beats per minute. Many different heart conditions can show up on an ECG, including a fast, slow, or abnormal heart rhythm, a heart defect, coronary artery disease, heart valve disease, or an enlarged heart. An abnormal ECG may also be a sign that you've had a heart attack in the past, or that you're at risk for one in the near future. If you're healthy and you don't have any family or personal history of heart disease, you don't need to have an ECG on a regular basis. But if you are having heart problems, your doctor may recommend getting this test. An ECG is pretty accurate at diagnosing many types of heart disease, although it doesn't always pick up every heart problem. You may have a perfectly normal ECG, yet still have a heart condition. If your test is normal but your doctor suspects that you have a heart problem, he may recommend that you have another ECG, or a different type of test to find out for sure.

  • Coronary artery disease

    Coronary artery disease

    The coronary arteries supply blood to the heart muscle itself. Blood supply through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the coronary arteries narrow, the flow of blood to the heart can slow or stop, causing chest pain (stable angina), shortness of breath, heart attack, or other symptoms.

    Coronary artery disease

    illustration

  • Coronary artery disease

    Coronary artery disease

    The right coronary artery supplies blood from the aorta to the right side of the heart.

    Coronary artery disease

    illustration

  • Tobacco and vascular disease

    Tobacco and vascular disease

    Tobacco use and exposure may cause an acceleration of coronary artery disease and peptic ulcer disease. It is also linked to cancer, stroke, COPD, fetal illness, and delayed wound healing.

    Tobacco and vascular disease

    illustration

  • Heart transplant  - series

    Heart transplant - series

    Presentation

Review Date: 1/16/2021

Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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