CORONARY ARTERY DISEASE – RISK FACTORS AND EFFECTIVE DIAGNOSTIC METHODS

🔴 Before discussing the high-risk groups prone to coronary artery disease, let's first understand what coronary artery disease is and the role of the coronary arteries in the body. 

🔹 Coronary arteries are the blood vessels that supply blood to the heart, enabling it to beat and pump blood throughout the body. These arteries surround the entire heart. The two main branches are the right coronary artery (RCA) and the left coronary artery, which includes the left main coronary artery (LMCA), the left anterior descending artery (LAD), and the left circumflex artery (LCx). 

🔹 These arteries further divide into smaller branches that supply blood to the heart muscle, categorized based on the amount of myocardium they supply. These classifications include epicardial arteries (located on the outer surface of the heart) and microvascular arteries (situated near the endocardium or the inner layers of the heart). 

🔴 The Role of Coronary Arteries 

✅ The primary function of coronary arteries is to supply oxygen-rich blood and nutrients to the heart muscle. The myocardium requires a continuous oxygen supply to pump blood effectively throughout the body. The coronary arteries possess autoregulatory mechanisms that allow them to adjust blood flow according to the heart's needs. 

✅ When coronary artery function is impaired, oxygen and nutrient supply to the heart muscle is reduced. This can not only limit blood supply to the myocardium but also impair the heart’s ability to pump blood effectively. Consequently, any disorder or disease affecting the coronary arteries can severely impact health, leading to symptoms such as chest pain (angina), heart attacks, and even sudden death. 

🔴 High-Risk Factors for Coronary Artery Disease 

Uncontrollable Risk Factors: 

🔹 Age: The risk of arterial damage and narrowing increases with age. Coronary artery disease is more prevalent in the elderly. 

🔹 Gender: Men have a higher risk of developing coronary artery disease. However, postmenopausal women also face an increased risk. 

🔹 Family history: If close relatives (parents, siblings, or children) have early-onset heart disease, your risk of coronary artery disease is higher. 

Controllable Risk Factors: 

🔹 Smoking: Smoking significantly increases the risk of heart disease. Quitting smoking and avoiding secondhand smoke can reduce this risk. 

🔹 High blood pressure: Uncontrolled hypertension can lead to arterial stiffness and narrowing, contributing to atherosclerosis and coronary artery disease. 

🔹 Cholesterol levels: 

High levels of low-density lipoprotein (LDL-C), or "bad cholesterol," increase the risk of atherosclerosis. 

Low levels of high-density lipoprotein (HDL-C), or "good cholesterol," can also contribute to plaque buildup in the arteries. 

🔹 Chronic conditions such as diabetes, obesity, and chronic kidney disease increase the likelihood of coronary artery disease. 

🔹 Sedentary lifestyle, stress, and unhealthy diet: Consuming foods high in saturated fats, trans fats, salt, and sugar can elevate the risk of coronary artery disease. 

🔹 Alcohol consumption and sleep disorders can also contribute to cardiovascular issues. 

🔴 How Is Coronary Artery Disease Diagnosed? 

Several tests can help diagnose or monitor coronary artery disease, including: 

🔸 Blood tests: Assessing blood sugar levels, lipid profile, kidney function, and high-sensitivity C-reactive protein (CRP-hs). 

🔸 Electrocardiogram (ECG): Detects arrhythmias and ischemic heart disease. 

🔸 Echocardiography: Evaluates heart muscle contraction and detects regional wall motion abnormalities. 

🔸 Exercise stress test (stress ECG): Helps identify coronary artery disease by assessing changes in ECG readings and symptoms such as chest pain during physical exertion. 

🔸 Coronary computed tomography angiography (CCTA): A non-invasive imaging technique that assesses arterial blockages and calcifications. This method is highly accurate, sensitive, and specific. 

🔸 Cardiac catheterization and coronary angiography: Often performed when a stress test is positive or a CT scan indicates arterial narrowing. This is considered the gold standard for diagnosing coronary artery disease. However, since it is an invasive procedure, it is only performed when strictly indicated to minimize complications.