Peripheral Artery

Coronary Artery Disease (CAD) is the damage, deterioration or blockage of the coronary arteries that are located on the heart. The coronary arteries are the main arteries that supply oxygen and nutrients to the cardiac tissues. If these arteries are damaged or blocked, the cells of the heart lack enough oxygen or nutrients to carry out basic biological processes leading to cardiac muscle damage. CAD is a result of coronary arteriosclerosis (a gradual process of the inner lining of the artery wall getting damaged and subsequent buildup of plaque at the site). If not treated in time and diagnosed correctly, CAD can lead to several potentially fatal cardiovascular problems like myocardial infarction (or heart attack).

Coronary artery disease often progresses over a number of years, so one might not notice an issue until he/she has a significant blockage or a cardiac arrest. However, one can adopt several methods to prevent or reduce the risk of coronary artery disease. Switching to a healthy lifestyle could make a major impact.

• Family history of heart disease
• Diabetes
• High blood pressure
• Unhealthy lifestyle
• Obesity
• High blood cholesterol or triglyceride levels
• Tobacco use
• Stress
• Physical inactivity

• Chest pain or Angina – it is the most common sign of CAD. It could be felt as a pressure, tightness or discomfort in the chest area. This pain usually occurs in the middle or towards the left side of the chest. Angina is usually triggered by strenuous physical activity or emotional stress. The pain usually goes away within minutes after stopping the stressful activity. In some cases, the pain may be short or sharp and felt in the neck, arm or back region.
• Shortness of breath - When the heart is unable to pump enough oxygen carrying blood to meet the body's requirements, the person is likely to experience shortness of breath or severe fatigue.
• Weakness, nausea, light-headedness and cold sweat.

Following are a list of methods of diagnosis of CAD:

• Electrocardiogram (ECG) – non-invasive painless method by which electrical activity of the heart, as well as the rate and regularity of the heartbeat is measured.
• Echocardiogram – uses ultrasonic sound waves and traces an outline or picture of the heart’s movement.
• Chest X-ray – uses x-rays to trace out pictures of the heart, lungs, respiratory tract, blood vessels and the bones of the chest.
• Exercise stress test – measures heart rate when the heart is working under stress and is expected to pump more blood. It analyses how well the heart responds while a person is running on a treadmill.
• Coronary angiogram – A minimally invasive but reliable method that utilizes x-rays to view the heart’s blood vessels, measuring the blood flow through coronary arteries and detecting blockages.
• Cardiac catherization - Analyses the interiors of the arteries to detect blockages by introducing a thin, flexible tube called catheter through an artery in the arm, groin, or neck to reach the blood vessels of the heart.
• Cardiac CT scan – helps to visualize the calcium deposits in the arteries, measuring the calcium build-up and plaque formation leading to blockages.

Lifestyle modification:
Incorporating these simple lifestyle changes can greatly help in promoting healthier arteries and treating coronary artery disease.

• Quit smoking
• Regular exercising
• Maintaining a healthy body weight
• Reducing stress levels
• Controlling risk factors like blood sugar, blood cholesterol and blood pressure.
• Eating healthy, low-fat foods
• Invasive procedural or surgical approach:
   

Angioplasty- a unique inflatable balloon is mounted on a catheter which is inserted into the blood vessel having the blockage. When the catheter reaches the blockage or plaque build-up, it inflates the balloon to push the blockage radially outwards, clearing the blood vessel passage to secure proper blood flow. This is called balloon angioplasty. Angioplasty is a procedure to widen the coronary artery and restore the blood flow.
 

Meril’s Evermine50 is stent used in angioplasty and has the following features:

• Ultra-low strut thickness of 50μm for promoting early vascular healing
• Variable strut width and variable crown design to ensure adequate radial strength of 1.1bar*
• Hybrid cell stent design: Open cells in the middle of the stent for side-branch access and closed cell design on ends for optimal scaffolding and conformability
• Clinically established drug everolimus with biodegradable polymer for proven clinical safety & long-term efficacy

Our specialized Bioresorbable Scaffold – MeRes100 is classified under Sirolimus Eluting BioResorbable Vascular Scaffold System. It has the following features: -

• Next Generation BioResorbable Scaffold: World's first 100µm BVS
• Ideal strut thickness to minimize vascular injury & ensure early endothelialization
• Virtual Tubing: Couplets of tri-axial RO markers at either end of the scaffold
• Hybrid Stent Design: Strut width variability allows for adequate radial strength
• Future treatment possibilities: Restore the artery to natural state after resorption

Coronary artery bypass surgery- a graft is created to bypass the blocked coronary artery, using a blood vessel from another part of the body. It restores blood flow to the heart by diverting the flow of blood around a section of a blocked artery in the heart. Since this requires an open-heart surgery, it is most often reserved for cases where there are no other less invasive methods clinically advisable.

The risk of a cardio vascular disease is different for different people. The symptoms are easily mistaken for just fatigue. Do not ignore the warning signs. Get it diagnosed and be ahead to enjoy every moment of your life and add more to life.  It is never too late to adopt a healthier lifestyle.