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January 26, 2022

What to know about coronary artery disease

Prime Healthcare offers the Pennsylvania region insights into the most common type of heart disease

Adult Health Cardiology

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Limited - Coronary Artery Disease Illustration 7activestudio/istock.com

Coronary artery disease (CAD) is the most common type of heart disease, affecting more than 18 million adults in the United States. The condition is caused by atherosclerosis, which occurs when the arteries that supply oxygen-rich blood to the heart become narrower or blocked by a buildup of plaque. Over time, this condition can cause chest pain and lead to a heart attack.

The Cardiac Care program at Lower Bucks Hospital provides specialized care for patients in the Philadelphia area who have been diagnosed with coronary artery disease or other heart conditions. The program’s cardiology team takes a diverse approach to care by emphasizing lifestyle changes combined with advanced treatments and management of contributing conditions, such as diabetes and hypertension.

Risk factors and symptoms of coronary artery disease

Individuals with the following heath conditions have a higher risk of developing CAD:

• High blood pressure
• Diabetes Mellites
• High Cholesterol
• Smoking
• Family history of CAD at young age
• Unhealthy lifestyle, like lack of exercise and poor eating habits
• Obesity

The symptoms of CAD vary from person to person. Some patients have no symptoms, while others have chest pain, chest pressure, heartburn, shortness of breath, dizziness, nausea, extreme sweating, and weakness. If you experience any of these symptoms, call 911 or go to the nearest emergency room for evaluation. You should not delay your care due to COVID-19 concerns.

Diagnosis

A doctor can diagnose CAD based on symptoms, medical history, blood test results, and diagnostic imaging tests.

• An EKG reviews the electrical activity of the heart muscle and can detect heart damage and assess heart structures and functions.
• A stress test involves exercise on a treadmill or stationary bike (or medicine) to evaluate blocked heart arteries.
• A computed tomography (CT) angiography scan of the heart shows pictures of the heart's arteries to determine if there is a buildup of plaque (even in the early stages, before the plaque hardens).
• A coronary angiogram is done in the cardiac catheterization laboratory. It involves threading a thin tube or catheter into an artery (usually in the wrist or leg) and into the heart. Dye is injected into the artery to evaluate it for any blockages. This test usually is recommended when a non-invasive one is abnormal, a patient's symptoms strongly suggest CAD, or after a heart attack.

Once a diagnosis is made based on the test results, the severity of the disease is determined by how much narrowing has occurred in the coronary arteries:

• Mild: Less than a 49 percent narrowing
• Moderate: A 50 to 69 percent narrowing
• Severe: A narrowing greater than 70 percent

Treatment

The treatment for CAD depends on the severity of the blockages and the number of arteries impacted. Most of the time, CAD is treated with medicine, which include antiplatelets like aspirin, beta blockers to decrease the workload of the heart, and management of cholesterol and blood pressure. You should also adopt a healthy lifestyle including heart healthy diet, regular exercise and no smoking.

In more severe cases, one of the following procedures may be required to unblock the arteries and improve blood flow:

• Angioplasty: placing a stent to keep the artery open, typically through a small tube placed in a blood vessel in the wrist (percutaneous coronary intervention).

• Open-heart surgery, or coronary artery bypass (CABG) surgery, to re-route blood around the blocked or narrowed area by using other arteries or veins in the body.

Your doctor may refer you for cardiac rehabilitation, which is a 12-week program that includes a mix of supervised exercise, nutritional counseling, and stress management. This program can also help you quit smoking. Cardiac rehabilitation is best for patients with angina, heart failure or those who have had a recent coronary procedure, such as angioplasty or bypass surgery.

Lower Bucks Hospital is a proud member of Prime Healthcare, an award-winning health system operating 45 acute care hospitals in 14 states. Prime Healthcare Pennsylvania Region includes Roxborough Memorial Hospital in Philadelphia, Lower Bucks Hospital in Bucks County, and Suburban Community Hospital in Montgomery County.


About Dr. Shahzad Ahmed MD, FACC, FSCAI, RPVI
Interventional Cardiologist, Director Cardiology

Limited - Dr. Shahzad Ahmed MD, FACC, FSCAI, RPVI
Dr. Ahmed is Board Certified in Interventional Cardiology, Cardiovascular Medicine, Echocardiography, Nuclear Cardiology, Vascular Ultrasound and Internal Medicine. He received the prestigious award of Fellow of American College of Cardiology (FACC) in 2019 and Fellow of Society of Cardiovascular Interventions in 2020 (FSCAI). He completed internal medicine, cardiovascular and interventional cardiology training at Drexel University College of Medicine. He was appointed Assistant Professor of Medicine at Drexel University College of Medicine. Under his leadership, Lower Bucks Hospital has started many new programs including same-day discharge after percutaneous coronary intervention, Venous and Pulmonary Thrombectomy, Carotid stenting and implementing the radial first approach (Cardiac Cath through arteries of hand).

Dr. Ahmed is currently accepting new patients at BMC Cardiology Practice, 501 Bath Road in Bristol. For more information or to schedule an appointment, please call 215-785-5100.

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