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Coronary artery disease means narrowing of
the coronary arteries (arteries that supply blood
to the heart). This narrowing is due to a buildup in the walls of the arteries
of plaque (deposits made up of cholesterol, other
fats, and calcium)—a process called atherosclerosis (hardening of the arteries). If a plaque becomes delicate and breaks,
a blood clot will quickly form that can block blood flow in the artery and
may lead to a myocardial infarction (death of the
heart muscle area supplied by the blocked artery), often referred to as a heart attack. The November 24, 2004, issue of JAMA includes an article about coronary artery disease.
Coronary artery disease can develop slowly without any symptoms.
Angina—chest pain that can radiate
to (or sometimes is limited to) the shoulders, arms, or jaw. Angina usually
lasts several minutes and may be related to activity, exercise, large meals,
cold, or stress. If angina lasts more than 15 minutes, there is a risk that
a heart attack may be occurring.
Heart attack symptoms include severe chest pain, shortness of
breath, sweating, and nausea. Symptoms can be different in men and women,
with women more likely to experience unusual fatigue after activity rather
than chest pain.
If you or anyone you know experiences heart attack symptoms, call immediately
for emergency medical evaluation.
Several tests can be performed in an emergency department to determine
if a heart attack is occurring. Blood tests can detect certain substances
in the blood that are released during a heart attack. An electrocardiogram (ECG, EKG) can reveal heart attacks and heart rhythm
Nitrate medication (such as nitroglycerin) can be taken to help
stop angina attacks.
Blood—thinning drugs, such as aspirin, can help reduce the
risk of blood clots.
Statins (a kind of cholesterol-lowering
drug) and beta-blockers (a kind of blood pressure—lowering
drug) can prevent heart attacks and premature deaths.
Percutaneous coronary intervention (PCI)—a
thin balloon is threaded into the blocked artery and inflated, pressing the
plaque and widening the artery to increase blood flow; a stent (a small flexible tube) is then placed in the artery to keep
Coronary artery bypass graft (CABG) surgery—uses
a vein from another part of the body to bypass a severely blocked coronary
American Heart Association 800/AHA-USA-1 (242-8721)http://www.americanheart.org
National Heart, Lung, and Blood Institute 301/592-8573 http://www.nhlbi.nih.gov
Exercise at least 30 minutes a day.
Keep high blood pressure, cholesterol, and diabetes under control
with diet, exercise, and, if necessary, medications.
Eat a diet rich in whole grains, fruits, and vegetables and low
in saturated fat.
A daily aspirin can reduce the risk of heart attack, especially
among men older than 50 years.
To find this and other JAMA Patient Pages, go to the Patient Page link
on JAMA's Web site at http://www.jama.com.
Many are available in English and Spanish. A Patient Page on coronary artery
bypass grafting was published in the April 21, 2004, issue; one on percutaneous
coronary intervention was published in the February 11, 2004, issue; and one
on electrocardiograms was published in the August 23/30, 2003, issue.
Sources: American Heart Association; National Heart, Lung, and Blood
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TOPIC: HEART DISEASE
Parmet S, Glass TJ, Glass RM. Coronary Artery Disease. JAMA. 2004;292(20):2540. doi:10.1001/jama.292.20.2540