Coronary Artery Disease

Symptoms of coronary heart disease depend on the severity of the disease. Some people have no symptoms. If too little oxygenated blood reaches the heart, a person will experience chest pain called angina. When the blood supply is completely cut off, the result is a heart attack, and the heart muscle begins to die. Symptoms of coronary artery disease include:

• Heaviness, tightness, pressure or pain in the chest behind the breastbone (angina).
• Pain spreading to the arms, shoulders, jaw, neck or back.
• Shortness of breath
• Weakness
• Fatigue

At INTEGRIS, we use the most advanced imaging methods and diagnostic tools to determine the cause, severity and prognosis of your coronary artery disease. Some of these diagnostic tests may include:

• Electrocardiogram (ECG or EKG): This test records the electrical activity of the heart, shows abnormal rhythms (arrhythmias) and detects heart muscle damage.
• Stress Test (also called treadmill or exercise ECG): This test is given while you walk on a treadmill to monitor your heart, breathing and blood pressure rates during exercise. A stress test may be used to detect coronary artery disease, or to determine safe levels of exercise after a heart attack or heart surgery. This can also be done while resting using special medicines that can synthetically place stress on the heart.
• Cardiac Catheterization: During this procedure, a wire is passed into the coronary arteries of the heart. X-rays are taken after a contrast agent is injected into an artery, which help locate the narrowing, blockages and other problems.
• Nuclear Scanning: Radioactive material is injected into a vein and then is observed using a camera as it is taken up by the heart muscle. This indicates the healthy and damaged areas of the heart.

Your multidisciplinary team will craft a specific treatment plan for your coronary artery disease based on your age, overall health, medical history, the extent of the disease and your tolerance for specific medications, procedures or therapies. Of course, your personal opinions and preferences will also be taken into consideration. Treatments may include:

• Modification of Risk Factors: Risk factors that you can change include smoking, high cholesterol levels, high blood glucose levels, lack of exercise, poor dietary habits, being overweight and high blood pressure.

Medicines

• Antiplatelets:These decrease blood clotting and include aspirin, clopidogrel, ticlopidine and prasugrel.
• Antihyperlipidemics: These lower lipids (fats) in the blood, particularly LDL (low density lipid) cholesterol. A group of cholesterol-lowering medicines called statins include simvastatin, atorvastatin and pravastatin, among others.
• Antihypertensives: These lower blood pressure. Several different groups of medicines work in different ways to lower blood pressure.

Surgical Procedures

• Coronary Angioplasty: During this procedure, a balloon creates a bigger opening in the vessel to increase blood flow. Percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. PCI procedures include:
  
  • Balloon Angioplasty: A small balloon is inflated inside the blocked artery to open the blocked area.
  • Coronary Artery Stent: A tiny mesh coil is expanded inside the artery to open the blocked area and is left in place to keep the artery open.
  • Atherectomy: The blocked area inside the artery is cut away by a tiny device on the end of a catheter.
  • Laser Angioplasty: A laser used to vaporize the blockage in the artery.

• Coronary Artery Bypass: Most commonly referred to as bypass surgery or CABG (pronounced cabbage), this surgery is often done in people who have chest pain (angina) and coronary artery disease. During the surgery, a bypass is created by grafting a piece of a vein above and below the blocked area of a coronary artery, enabling blood to flow around the blockage. Veins are usually taken from the leg, but arteries from the chest or arm may also be used to create a bypass graft. Sometimes multiple bypasses may be needed to restore blood flow fully to all regions of the heart.

Part of heart and vascular care includes managing heart disease and preventing further deterioration to help you live the fullest life possible. To accomplish that, we’ll provide you with education, continued care options and programs even after you are discharged including:

• Cardiac Rehabilitation
• Heart Education
• Anticoagulation Management Clinic
• Heart Care Program
• Integrative Medicine
• Palliative Care