Symptoms and Risk Factors of Coronary Artery Disease

As surprising as it may seem, coronary artery disease may begin during adolescence. That's one of the startling facts about coronary artery disease pathophysiology!

Beginning as such a young age, the disease continues through life according to pathophysiology of coronary artery disease.

You may be interested in viewing coronary artery disease images. They're easy to find on the internet. Just do an image search through Google.

How do I know if I have Coronary Artery Disease?

For many there are no signs and symptoms of Coronary Artery Disease until one day they have a heart attack. If you think you are at risk the best thing to do is see your doctor. The risk factors for Coronary Artery Disease are:

1) Overweight: those who carry their weight in their mid-section are at an even higher risk of heart disease.

2) Lack of Exercise

3) Smoking tobacco products

4) High levels of continuous stress

5) Diabetes

6) Hypertension

7) High lipid profile or high cholesterol levels

8) Age 65 or older

9) Male gender

10) Family history of heart disease

11) Menopause

Your doctor will ask you questions about any chest discomfort that you may be experiencing. They will want to know what you are doing when the chest pain starts and what it feels like. They will want words that describe the pain such as crushing, sharp, stabbing, dull, etc. They will also want to know where the pain is and if it radiates (travels) to other areas. Common areas of pain are the chest, the jaw, pain moving down the left arm or around to the back. Next tell your doctor how the pain is relieved. Do you take medications, does it go away with rest or do you feel the chest pain constantly.

Your doctor will also ask you about your past medical history and your close family history. This means mom, dad, your brothers and sisters, your grandparents and your parents’ brothers and sisters if you don’t have information on your grandparents. They especially want to know about close family members who were diagnosed with coronary artery disease before the age of 50.

The doctor will take your blood pressure, listen to your heart and lungs, check your extremities (arms and legs) for impaired circulation and take some basic blood tests that include cholesterol, triglyceride and lipid levels. The doctor should also get a 12-lead electrocardiogram (ECG). Your doctor will then determine how many risk factors you are positive for and proceed from there. If they believe you are a high risk or you have pain that is unrelieved they may do some more testing such as stress tests and echocardiograms. If these are positive they will move on to more invasive testing such as a coronary angiogram to determine the extent of the blockage to the arteries.

What are the risk factors for Coronary Artery Disease and how can I manage them?

RISK FACTORS FOR CORONARY ARTERY DISEASE - WHAT YOU CAN DO

The risk factors for Coronary Artery Disease fall into 3 categories: Modifiable, Controllable and Non-Modifiable. Before I get into what the risk factors are, let me explain the difference between these categories. A modifiable risk factor is something that you are actually able to change by changing your behaviors. A controllable risk factor is something that you can’t change but you can keep under control through medications and/or by changing your behaviors. A non-modifiable risk factor is something that you cannot change or control. Ok, now that I’m finished explaining that I bet you want to know what you can and can’t change.

MODIFIABLE RISK FACTORS:

Obesity: Most cardiologists now base your weight related risk factor on your Body-Mass Index (BMI), which is an indicator of total body fat. A BMI within 18.9 – 24.9 is considered normal and does not indicate an increased risk for Coronary Artery Disease. A good place to find a BMI calculator is at the CDC (Center for Disease Control) web site. http://www.cdc.gov/nccdphp/dnpa/bmi/index.htm they have a calculator for both adults and kids. (Note: Childhood obesity is currently a big issue in healthcare because it leads to so many future diseases).

Lack of Exercise: In a study on exercise at Duke University in Durham, North Carolina, they found that participating in an exercise program could actually help reverse the damaging effects already incured by a previous lack of exercise (Rheuters Health Information: June 5, 2006). Check with your doctor before you start your exercise program if you already have health concerns. Start slow and work up to a good cardiovascular exercise routine at least 3 times a week. It was hard for me at first because I just didn’t think I could find the time. But I found after I started exercising I didn’t want to quit, it feels really good to get out of the house every day and do something good for myself (and set a good example for my family). Now my 16 year old runs with me in the morning and my 7 year old goes for walks with me after dinner. Quality time and fitness all mixed into one ;-).

Smoking: Ok, do I really need to say anything? “SURGEON GENERAL’S WARNING: Quitting smoking now greatly reduces serious risks to your health.” Contact your local hospital or the American Heart Association for smoking cessation programs – often they are FREE.

CONTROLABLE RISK FACTORS:

High blood pressure/Hypertension: This is a silent killer, because this disease does not have many early signs or symptoms. Often you don’t even know you have high blood pressure until you are in a crisis situation. Get your blood pressure checked! Normal is considered less than 140 systolic (top number) and 90 diastolic (bottom number), for diabetics the numbers are 135/85. If you have two readings on separate occasions that are high or near high, you probably have hypertension. Your doctor will prescribe medications to keep your blood pressure under control. The cause of hypertension is not fully understood but your doctor will most likely encourage you to lose weight, stop smoking and exercise (sound familiar?). You may not be able to get rid of the hypertension but by keeping your blood pressure within normal ranges you can prevent the multiple complications of hypertension.

DIABETES:

There are three different types of diabetes:

Type 1 is usually diagnosed in childhood. This is when the body makes little or no insulin, and daily injections are required to sustain life.

Type 2 diabetesusually occurs in adulthood and makes up approximately 90% of the diabetic population. This is when the pancreas does not make enough insulin to keep blood glucose levels normal, or the cells in the body do not react properly to the insulin that is produced. The incidence of Type 2 diabetes is rising due to an increase in obesity, and failure to exercise (AGAIN!!! – I’m starting to see a pattern here!).

Gestational diabetesis high blood glucose that develops during pregnancy in someone who does not have diabetes, this is not considered a risk factor for Coronary Artery Disease.

Poor control of diabetes leads to coronary artery disease as well as many other neurological and vascular problems. If you are diabetic you should be under the medical advice of an endocrinologist to prevent wide fluctuations in blood glucose levels and the risk of a diabetic crisis. Unfortunately, there is no cure for diabetes though the American Diabetes Assoc. is constantly working on it as well as on improvements in anti-hyperglycemic medications.

Abnormal Cholesterol levels:

Specifically this means four different tests 1) Total Cholesterol level - high 2) LDL Cholesterol level-high, 3) Triglycerides-high and 4) HDL Cholesterol level- low. Unfortunately a lot of this is predetermined by your family history but it is also about what you eat. If you haven’t had your cholesterol levels checked, see your doctor or check the local hospital to see if they have free screening ‘with’ interpretations. Cholesterol levels are directly related to atherosclerosis with high LDL cholesterol levels being the best indicator of increased risk of heart disease. Cholesterol levels can be managed with diet and lipid lowering medications. Your doctor will work with you to find the right medication for you.

NON-MODIFIABLE RISK FACTORS:

Ok,I’m just going to list these because there isn’t anything you can do to change them, and no they are not in any particular order:

1. A family history of coronary artery disease in close family members – especially if they developed the disease before the age of 50.

2. Male

3. Age = 65+

4. Menopause or other factors causing loss of estrogen

Ok, I hope this helps you determine if you are at risk for Coronary Artery Disease. If you think you are, see a doctor, go to a clinic, do something to start to change your bad habits and get healthier before it’s too late.