Unlocking Insights with Dr. Madhav Upadhyay: Navigating Coronary Artery Disease, the Silent Menace

Coronary Artery Disease (CAD) is the single most common cause of death in the developed world, accounting for 1 in every 5 deaths. The history of CAD can be traced back to ancient times, with the earliest documented case of coronary atherosclerosis found in an Egyptian princess who lived between 1580 and 1550 BC. The prevalence of CAD continues to rise, making it a major public health concern globally.

The global impact of cardiovascular diseases (CVD) in 2022 resulted in a staggering 19.8 million deaths. In India, the incidence of CAD among those with diabetes stands at 21.4%, while non-diabetic individuals face an 11% risk. The overall estimated number of CAD cases in India exceeds a staggering 54.5 million, with 7-13% of the urban population and 2-7% of the rural population suffering from this condition.

Diagnosing CAD requires a comprehensive medical approach. Laboratory testing, electrocardiography, and coronary angiography are key diagnostic tools used to identify the disease. Symptoms of CAD can vary but commonly include chest pain, a feeling of sinking, easy fatigability, and palpitations (an abnormal sensation of heartbeats). While CAD cannot be completely cured, proper management can significantly improve the quality of life for affected individuals. Treatment options include medical management, angioplasty, and bypass surgery. However, the cornerstone of CAD management lies in lifestyle modifications, controlling risk factors, and avoiding addictive behaviors.

“Lifestyle modifications play a crucial role in preventing and managing CAD. Adopting a healthy lifestyle by incorporating regular exercise, maintaining a balanced diet, and managing stress is essential in reducing the risk of CAD. Controlling risk factors such as hypertension, diabetes, high cholesterol, and obesity is vital in preventing the progression of the disease. Additionally, avoiding addictive behaviors such as smoking and excessive alcohol consumption can significantly reduce the risk of developing CAD.” shared Dr. Madhav Upadhyay, Consultant Cardiothoracic & Vascular Surgeon Synergy Superspecialty Hospital, Rajkot.

Early Detection is Key: Diagnosing CAD early is crucial for effective management. Doctors rely on a combination of methods, including:

• Medical Evaluation: Your doctor will discuss your medical history, family history, and lifestyle habits
• Lab Tests: Blood tests can reveal cholesterol levels, blood sugar levels, and other markers that might indicate an increased risk of CAD
• Electrocardiography (ECG): This non-invasive test measures the electrical activity of your heart, which can show signs of ischemia (reduced blood flow) or damage
• Coronary Angiography: This X-ray imaging technique uses a contrast dye to visualize the coronary arteries and identify blockages

Symptoms to Watch Out For: CAD can sometimes progress silently without any symptoms. However, here are some common warning signs to be aware of:

• Chest Pain: This is the most common symptom of CAD, often described as a squeezing, pressure, or discomfort in the chest
• Discomfort or Sinking Feeling: You might experience a feeling of heaviness or tightness in your chest
• Easy Fatigue: Unusual tiredness and difficulty performing daily activities can be signs of CAD
• Palpitations: Feeling irregular heartbeats or a fluttering sensation in your chest could be a cause for concern

Living with CAD: There is currently no cure for CAD. However, with proper treatment and lifestyle changes, you can effectively manage the condition and significantly improve your quality of life. Treatment focuses on two main aspects:

• Managing the Condition: This involves medications like blood thinners, cholesterol-lowering drugs (statins), beta-blockers, and vasodilators to improve blood flow and heart function
• Preventing Complications: Lifestyle modifications are essential. This includes adopting a heart-healthy diet, regular exercise, maintaining a healthy weight, and avoiding smoking and excessive alcohol consumption

Procedures for Advanced Cases:In some cases, minimally invasive procedures like angioplasty with stent placement might be necessary to open narrowed arteries. For severe blockages or multiple blocked arteries, coronary artery bypass grafting (CABG) surgery might be recommended. CABG creates a bypass using your own arteries or veins to detour blocked arteries and improve blood flow to the heart muscle.

Understanding CABG Surgery:

• Creating a Bypass: During CABG surgery, surgeons use healthy arteries or veins from your chest wall, legs, or arms to create a new passage for blood to flow around the blocked coronary arteries
• Improved Blood Flow: Bypassing the blockage ensures adequate oxygen-rich blood reaches the heart muscle, improving its function and preventing complications
• Optimal Material: The left or right internal mammary artery is preferred for bypass grafts due to its superior long-term benefits

Living a Long and Fulfilling Life with CAD:

CAD remains a significant health burden globally, with millions of lives affected by this silent killer. Early detection, proper medical diagnosis, and timely intervention are essential in managing CAD. While treatment options can alleviate symptoms and improve quality of life, lifestyle modifications remain the cornerstone of CAD management. By following a doctor-recommended treatment plan, prioritizing a healthy lifestyle, and attending regular checkups, one can manage CAD effectively.