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What is coronary artery disease?
Coronary
Artery Disease (CAD) refers to blocked arteries that provide blood to the heart
muscle. Risk factors include smoking, high blood pressure, high cholesterol,
diabetes, obesity and family history of early cardiac events. Other, as yet
unknown, factors exist.
Symptoms of CAD include chest pain (angina), shortness of breath, jaw and/or
arm pain and other vague feelings, usually with exertion. CAD can lead to heart
attack, and congestive heart failure. It is important that you see your doctor
if you have any new or worsening symptoms like those listed above.
Careful attention to the management of risk factors like those listed, and
proper diagnosis and treatment of CAD can prevent heart attacks, leading to a
longer and more productive life. Once CAD is present, it must be managed to help
prevent heart attack, congestive heart failure and possible death. This talk
will focus on some of the newer methods to treat CAD.
How is CAD diagnosed?
- Stress testing (various types)
- Catheterization
- Newer techniques (ultrafast CT)
How is CAD treated? (Traditional methods)
- Medical therapy
- Bypass surgery (CABG)
- Balloon (PTCA)
What are some new techniques?
- Stents
- Transmyocardial revascularization (TMR)
- Angiogenesis (VEGF)
How does my doctor decide which method to use in my case, and what input do I have?
This
is a complex decision which must come from careful evaluation of each person's
unique situation. Every patient has factors that will steer the health care
provider toward a particular treatment method. For example, the amount of
blockage, the number of diseased arteries, other medical problems, the amount of
heart muscle damage present, and the wishes of the patient and family all play a
part in the decision-making process.
What's next in new treatments?
Many of
these newer techniques are still experimental and are at least a few years away
from being a rational choice. Many may not pan out at all! Research is important
in evaluating new therapies, and you may wish to participate in clinical trials
if you meet the trial criteria. Please discuss your case with your doctor, since
the mass media tend to generalize and "jump the gun" with new
treatments, making each new method seem like it's the perfect answer for
everyone!
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