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What Is Coronary Artery Disease?

In coronary artery disease, the coronary arteries become narrowed or blocked by a gradual buildup of fat (cholesterol) within the artery wall, which reduces the blood flow to the heart muscle. This buildup, called “plaque,” may begin in childhood and slowly progress. If the plaque narrows the channel of the artery, it may make it difficult for necessary quantities of blood to flow to the heart.

There are three main coronary arteries in your heart. These arteries are located in the front of the heart (LAD), in the back of the heart (CIRC), and on the right side of the heart (RCA). One, two, or all three of these coronary arteries or their branches may be involved in the process of narrowing or blockage. The blockage may be partial or complete (see figures below). When a coronary artery becomes partially or completely blocked, the part of the heart muscle supplied by the blood vessel does not get its required blood supply.

The first symptom of coronary artery disease usually is chest pain or chest discomfort which may be described as a pressure or heaviness beneath the breastbone (sternum) with associated neck, jaw or arm discomfort. The pattern varies from patient to patient and may have associated symptoms of sweating, shortness of breath, or nausea. This group of symptoms is referred to as angina. Angina is commonly brought on by physical work, mental work or stress, but may occur while at rest or even while sleeping at night. Angina may be improved with the use of NTG (nitroglycerine), which helps the heart cope with these partial blockages.

If the blood supply to the blockage is not corrected rapidly, you may develop a “heart attack” (myocardial infarction). The area of the heart muscle not receiving the blood supply will become scar tissue and will lose its ability to pump. You will be given a packet by your doctor who will mark the sites of your blockage on this illustration. After surgery, the doctor will usually mark the course of your bypass graphs. If he or she does not, ask your heart surgeon to mark the course of the proposed bypass grafts.

If your cardiologist or primary care physician has found coronary artery blockages during your catheterization, they should have recommended coronary artery bypass surgery to protect your heart muscle from these threatening blockages.

Texas Surgical Associates