This condition, also referred to as coronary heart disease, affects more than 13 million men and women in the United States making it the number one killer in America. Before coronary artery disease pathophysiology can be understood it is important to understand what this disease is. This condition occurs when the coronary arteries become clogged and blocked. When this happens, the blood flow becomes restricted, resulting in the heart not working properly due to not getting adequate amounts of vital nutrients and oxygen.
What Causes and Risk Factors Coronary Artery Disease?
Four main things cause this disease. These include smoking, high blood pressure, high levels of cholesterol and certain fats in the blood, and high levels of sugar in the blood because of diabetes or insulin resistance. These four things can cause damage to the coronary arteries and as the body works to heal this damage, compounds that encourage this process are released by excess fatty tissues. As the healing continues, plaque begins to build up in the areas of the arteries where there is damage.
Certain risk factors can also contribute to this condition. These risk factors are having family members with this condition (specifically family members who have had premature coronary artery disease), obesity, and sedentary lifestyle.
Pathophysiology of Coronary Artery Disease
This condition is chronic and begins when a person is an adolescent and then it slowly progresses throughout their life. Coronary artery disease pathophysiology revolves around a few theories. One widely accepted theory is that this condition occurs when the body is trying to heal itself as a result of endothelial injury. Inflammation is also beginning to be accepted as a critical component of potential plaque instability and atherosclerosis activity. Patients who have been diagnosed with established coronary artery disease and have several of the causes and/or risk factors as well are at a much higher risk of experiencing a cerebrovascular accident, myocardial infarction, and other vascular events in the future.
Elevated C-reactive protein levels, and other elevated biochemical markers, indicate a higher risk of experiencing a vascular event in the future and it indicates an increased likelihood of vascular inflammation. This marker may also indicate the need for aggressive preventative measures due to the patient having a quickly advancing coronary artery disease.
Signs and Symptoms of This Condition
Some patients may not experience any symptoms, particularly when the plaques are not causing significant narrowing. When symptoms are present angina (chest discomfort or pain) is the most common symptom. The severity and frequency of angina varies from patient to patient. Other symptoms can include feeling like your heart is being squeezed, fatigue and shortness of breath when exerted, and pain that occurs during activity or emotional events.
The Cleveland Clinic. (2010). Coronary Artery Disease. Retrieved on March 5, 2010 from The Cleveland Clinic: https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/coronary-artery-disease/#cesec3
WebMD. (2009). Coronary Artery Disease. Retrieved on March 5, 2010 from WebMD: https://www.webmd.com/heart-disease/guide/heart-disease-coronary-artery-disease
Heart Coronary Artery Lesion: Patrick J. Lynch – Wikimedia Commons