Understanding coronary artery disease

MANILA, Philippines – The heart, a muscle the size of your fist, is one of the most vital organs of the human body. It distributes a constant supply of blood, which contains nutrients and oxygen, throughout the body.

Like any other pump, the heart suffers whenever its vessels are blocked with a fatty substance cardiologists call “plaque” – particularly in the arteries. A blocked artery leads to Coronary Artery Disease (CAD), the most common type of heart disease and cause of heart attack.

A question of lifestyle

In the past decade, heart disease has been the number one cause of death among Filipinos. Worldwide, it takes the lives of 17 million people per year.

Leading causes of coronary heart disease:

• Old age 
• Family history of heart disease
• Smoking – decreases oxygen being delivered to the heart
• Hypertension – strains the heart and damages blood vessels
• High cholesterol – causes buildup of fatty plaque that will clog arteries
• Obesity or excess fat – causes increased blood pressure and cholesterol
• Lack of physical activity or inactive lifestyle – can contribute to acquiring coronary heart disease
• Diabetes – causes excess sugar buildup in blood vessels

Though the first two causes are out of our control, cardiologist Erwin Dizon says we can still help prevent CAD by avoiding an unhealthy lifestyle.

His fellow cardiologist Timothy Dy says that, sometimes, it’s not just avoiding certain types of food but its preparation as well.

“Certain types of food can increase cholesterol,” he says. “Salt can cause increase in high-blood pressure. If you cook adobo and you put sugar in it and someone has diabetes, that can also contribute to it. In general, it’s not just the types of food but how they are prepared.”

Angioplasty treatment

To avoid heart disease, cardiologists say that people should:

• Quit smoking
• Eat a healthy diet with lots of fruits and vegetables – avoid eating canned goods and in fastfood chains. 
• Eat food in its natural flavor – avoid adding salt or dipping it in soy or fish sauce
• Maintain proper weight – Not sure what your proper weight is? Click here.
• Excercise regularly – Dr. Dizon recommends an hour of brisk walking at least 3 times a week
• Avoid alcohol

Those who have already developed CAD are constantly in danger of getting a heart attack, but as with all other diseases, early detection and action can help a lot. Though some cases can still be helped by oral cholesterol-modifying medicine, others may need surgical treatment like a coronary bypass or angioplasty.

Both are very costly and risky. However, recent developments in the medical world have once again improved treatments. Dr. Enrique Posas, a cardiologist from St. Luke’s Medical Center, swears by the latest development in coronary angioplasty treatments.

An angioplasty is a technique wherein cardiologists mechanically widen blocked arteries.

They insert a guide wire with a balloon catheter and scaffold into the blocked artery. The balloon is inflated to put the scaffold in place, collapsed then carefully dragged out of the artery, leaving the scaffold to keep the artery open wide enough for the right amount of blood flow.

Until recently, scaffolds or stents used in agioplasty treatments were metal, but now, a scaffold made of polylactide is already available in the market and can be used in angioplasty treatments. 

The Bioresorbable Vascular Scaffold dissolves about 6 months after the angioplasty treatment.

Dr. Dy says some patients with CAD are often reluctant to get an angioplasty due to having a permanent metal scaffold installed in their artery. This new medical development, he says, will ease their fears.

Posas adds that having a scaffold that will eventually dissolve will prevent scarring in the arteries, as an agioplasty procedure entails widening the vessels and pushing the plaque to its sides. It will injure the artery and may trigger the body’s natural reaction to protect the artery and develop scars.

An injured artery with a permanent metal scaffold may also trigger spasms. “The dream was to crack the plaque and eventually restore the artery to its normal state after the procedure,” Posas said. “And now, we have it.”

However, the experts agree that one should not wait to get heart disease before starting a healthy lifestyle. Starting it early on helps prevent CAD and other life-threatening diseases. – Rappler.com

Image of heart with stethoscope from Shutterstock