The coronary arteries are blood vessels that carry blood and oxygen to the heart muscle. Coronary artery disease occurs when these arteries become clogged with fatty deposits (plaque). As a result, the blood flow and oxygen supply to the heart are decreased causing pain and heart muscle damage. If a blood vessel in the heart becomes completely or mostly blocked, then a heart attack or myocardial infarction may occur. If a blood vessel in the heart becomes only partly blocked, then chest pain (angina) may occur. Chest pain is the most common symptom of CAD. Coronary artery disease is the single leading cause of death in the U.S. It accounts for over 950,000 deaths a year, which is about 1 death every 33 seconds.
The non-surgical treatments for CAD include changes in lifestyle and use of medications. Invasive procedures (surgery), such as coronary artery graft bypass surgery (CABG) or balloon angioplasty with stent placement, may be used for advanced CAD.
The decision of how to treat CAD is based on a number of factors. These factors include the symptoms, the type of blockage, other diseases or conditions that may exist, and personal preference. For those who have stable CAD and find the risk of invasive procedures or surgery unacceptable, non-surgical treatment may be an option.
Two groups of risk factors are associated with CAD. One group of risk factors is called non-modifiable, which means you cannot control or change them. The non-modifiable factors includes a family history of CAD, being a male, being a female after menopause, and being over 45 years of age. The second group of factors is referred to as modifiable risk factors and includes things that can be changed. Modifiable risk factors include activities such as smoking cigarettes, eating a high fat diet, high blood pressure, uncontrolled diabetes, sedentary lifestyle, and obesity. All of the modifiable risk factors can be addressed through lifestyle changes.
Will I live longer if I have non-surgical treatment for CAD?
Appropriate changes in lifestyle and use of medications can stop and possibly reverse the affects of CAD. However, for some people with certain types of CAD, non-surgical treatment may have to be combined with more aggressive treatments, such as balloon angioplasty and CABG.
Will non-surgical treatment of CAD improve my quality of life?
Successful non-surgical treatment can improve your physical ability to exercise and your mental and emotional sense of well being. However, the best treatment for CAD is prevention. Prevention can be accomplished through the six lifestyle changes previously mentioned - stop smoking cigarettes, lower high blood pressure, reduce high blood cholesterol, lose extra weight, become physically active, and manage diabetes.
Does non-surgical treatment of CAD make my symptoms better?
For many, the changes in lifestyle and medications used to treat CAD can control the symptoms and also slow or stop the progression of the disease.
Non-surgical treatment avoids the possible complications associated with the aggressive, invasive alternatives of balloon angioplasty and CABG. Non-surgical treatment may be tried, and if not adequate, can be supplemented with the more aggressive, invasive treatments.
Your health care provider will need to closely monitor lifestyle changes and medication usage associated with non-surgical treatment. If prescribed, medications must be taken as directed. Medications can have side effects. If side effects occur, they should be reported to the doctor. Often, a change in the dose or type of medication, or the use of a combination of medications, can stop the side effects.
Many factors have to be considered to determine the best treatment for each individual. These factors include the number of blockages the individual has, where in the vessels the blockages occur, the general health of the individual, and personal preferences. It has been suggested that the invasive procedures be reserved for people with CAD that is not well controlled by the non-surgical treatment. All treatment options should be discussed with your physician.
Changes in lifestyle can help prevent or control CAD. These changes are:
Medications that are used to decrease symptoms of CAD and improve the heart's function include:
Invasive procedures or surgery may be required when lifestyle changes and medication use are not able to control CAD symptoms, or when the blood vessel narrowing progresses to a point that the heart muscle is in danger of damage. The two commonly used invasive procedures to treat CAD are balloon angioplasty and CABG. Both of these procedures have risks and may relieve the symptoms of CAD, but do not cure the disease. Following both of these invasive procedures, lifestyle changes are still necessary and medication is also frequently required.
While the cost for non-surgical treatment is usually less than an invasive surgical procedure, the exact cost will depend on the number and type of medications being taken.
The cost may or may not be covered by your health benefits plan.
The following are off-site links :
Circulation. AHA/ACCF secondary Prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update. Retrieved January 8, 2014 from http://circ.ahajournals.org/content/124/22/2458.full.pdf+html.
MayClinic.com. (2012, June). Coronary artery disease. Retrieved January 8, 2014 from http://www.mayoclinic.com/health/coronary-artery-disease/DS00064/METHOD=print&DSECTION=all.
National Heart, Lung, and Blood Institute. What is coronary heart disease. Retrieved January 8, 2014 from http://www.nhlbi.nih.gov/health/health-topics/topics/cad/.
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