Coronary artery disease

The coronary arteries are the arteries that supply the heart and provide it with the oxygen it needs to function. They run along the surface of the heart. Two coronary arteries bring oxygen-rich blood to the heart: the left and right coronary arteries.

These arteries divide into arterioles that end in capillaries within the heart muscle. Blood from the capillaries is collected in venules, which return the blood to the right side of the heart. Complete or partial blockage of a coronary artery deprives the heart of the oxygen it needs. This causes intense chest pain (a band-like pain) that radiates to the left arm or towards the jaw.

Myocardial infarction refers to the sudden blockage of a coronary artery. The area of heart muscle that is no longer supplied with blood dies within a few hours.
Angina pectoris is a painful episode resulting from an insufficient supply of oxygen to the heart muscle (myocardial ischaemia). This lack of oxygen is itself caused by narrowing of a coronary artery.
An episode of angina pectoris occurs during exertion: this is when the heart no longer receives enough oxygen. It should be stressed that not all chest pain is due to angina pectoris. Angioplasty (dilation of the coronary arteries) or surgery may be necessary.

Through two different mechanisms:

1. Atheromatosis, resulting from the formation of cholesterol plaques on the arterial walls.
2. Spasm or contraction of the muscles in the coronary arteries.

Atheromatosis results from several different causes:

• Excess cholesterol in the blood.
• High blood pressure.
• Smoking are the main risk factors.

Other factors also play a role:

• Stress.
• Diabetes.
• Glucose intolerance.
• Obesity.
• A sedentary lifestyle.
• Factors beyond our control: age, sex and heredity.

Addressing risk factors is essential. Medical treatment can slow down or reverse atherosclerotic lesions.

In many cases, however, angioplasty (dilation of the coronary arteries) or surgery is necessary.