COVID 19 pandemics remains a deadly disease the world generally is battling with considering the numbers of lives lost, patients on sick bed receiving treatment, people more cautious than ever on taking preventive measures and amount being spent by countries to provide vaccination to further safe lives.
It will interest you to know that before the advent of the deadly virus, the world has been battling a number of chronic ailments which have claimed millions of lives. They include cardiovascular (Ischemic heart disease, stroke), respiratory (chronic obstructive pulmonary disease, lower respiratory infections) and neonatal conditions – which include birth asphyxia and birth trauma, neonatal sepsis and infections, and preterm birth complications.
Topping the list of biggest killer diseases is Ischemic Heart Disease. According to the WHO records released in 2019, Ischemic Heart Disease is responsible for 16% of the world’s total deaths. Since 2000, the largest increase in deaths has been for this disease, rising by more than 2 million to 8.9 million deaths in 2019.
Many know little or nothing about this life-threatening ailments. It is important to know why people die to improve how people live. For this reason, City people had a chat with Dr Taiwo Alatishe, Citypeople had a chat with a physician in LAUTECH Teaching Hospital, Ogbomoso. The medical expert went extensively to explain the Coronary Artery Disease, its causes, symptoms, preventive measures, treatments, and possible chances of surviving the disease among other things you need to know about the disease.
What is Coronary Artery Disease all about?
Coronary Artery Disease or Schematic Heart Disease is basically a severe condition related to the heart. It’s a heart disease that affects the blood vessels of the heart thereby reducing blood supply to the heart. The heart itself has arteries that supply blood for it to function normally. When that blood supply is reduced due to some conditions inside the arteries of the heart that is when it is called the Coronary Artery Disease.
The Arteries are Coronary Arteries and that’s why they call it Coronary Artery Disease. So it’s a severe a condition that affects the blood supply of the heart due to the reduction in the movement of the Arteries by plagues that form there, thereby affecting the movement of blood from the heart.
When was Coronary Artery Disease First Diagnosed?
Well, I might not be able to give the exact time but it has been in existence for a long time. Now the issue is the name might come up maybe in the last hundred years or whatever number of years but it’s a condition that has been in existence for a long time and this can be shown by the fact that we have seen people that have an urgent condition, they hold on to their chest and go down. They have serious pains, holding up to their chest and go down.
That is a picture itself which has happened for a long time. That is a picture itself showing a person has what we call angina; sudden chest pain and going which is likely to be due to Coronary Artery Disease. It has been in existence for a long time and the only thing that changes over the years is the diagnosis and how to treat it. Maybe the name at times or the staging is more complex things generally in the medical world that improves over the years.
What are the causes of the Coronary Artery Disease?
Before I go to the causes, I would like to describe it a little bit again. What happens is the heart itself has its own blood supply that makes it; you see for the blood supply, it supplies the blood with nutrients, oxygen, and various things to make the heart function. The heart itself is a muscle for it to contract and relax.
That blood vessel has walls. So on the wall, because blood passes through it, there’s what we call fats. In our blood, there is water, red cells, white blood cells, plasma, and some other things like fats. Now those fats over the years depending on the level of the cholesterol of the fat get attached to the wall to form plagues. As it gets attached, it causes a reaction on the wall, other things also glue to the wall along the line.
So as that goes on for some time, the diameter of the arteries reduces it size. So the level of the blood that goes to the heart will reduce over time. And by the time it now reduces to the critical point where the heart is not getting enough oxygen or enough nutrients, the heart would not the ability to function well and it can now present the symptoms. So having this background will now lead us to what are things that are the causes.
Now there are no direct causes for Coronary Artery Disease and this falls to the line of most non-communicable diseases. Communicable diseases have direct causes. For example, we can say COVID 19 is caused by the COVID 19 virus, it’s a communicable disease. We can say Malaria is caused by this organism, it’s a communicable disease.
But Hypertension is a non-communicable disease it does not have a direct cause. It only has risk factors. Same for Coronary Artery Disease, It has risk factors. One of the risk factors is Age. As people age, the wall of the vessels becomes less elastic and the lumen reduces over time. And they have a high risk of having Coronary Artery Disease. The Other thing is Obesity.
That one stands to reason for people that are of the big size. The chances of having Heart Disease of Coronary Artery Diseases is higher because they have more fats in their system and definitely that also can lead to acumination of fats in the vessels gradually over time which can lead to Coronary Artery Disease. Also, other risk factors are those with Hypertension and that stands to reason.
The Coronary Artery Disease is something like Hypertension because for those who have hypertension, the major problem is the wall of their Arteries generally over the body is not as elastic as it should be making the blood pressure go high and what causes it is also related to fats.
For people that have Hypertension, the chances of having Coronary Artery Disease is also higher because the same thing that affects the general arteries can affect the arteries of the heart too which can make the person have Coronary Artery Disease. Family history, for somebody that his father has it or the mother has it, the person is at the risk of having it. But when we talk about family history one must be careful. It’s not an automatic cause.
That’s why for all these things, we call them to risk factors. Somebody might have Hypertension and not have Coronary Artery Disease. Somebody might have Diabetes and not have Coronary Artery Disease. So basically it’s just a risk factor, same for family history. If a parent or somebody in the family has it does not mean the person will automatically have it, but the person is vulnerable or is at high risk of having it.
This is essential that we should know. Other risk factors include High Cholesterol levels, smoking also because it affects Nicotine. The content of the smoke also affects the wall s of the blood vessels. Whether active or passive smoking, it can also affect it. Then the last one I will mention briefly because I can’t mention all the risk factors is Lack of Physical Activities or Reduced Physical Activities. That itself has been shown to be a risk factor for Coronary Artery Disease.
Is Coronary Artery Disease the same as Heart Attack?
No, Coronary Artery Disease can lead to Heart Attack. Heart Attack is like the Symptom or complication of Coronary Artery Disease. At times when you say people have Heart Attack, you see them holding on to their chest and go down. So most likely the person might have Angina pain or chest pain. A heart attack is just a complication or symptom generally which might be due to Coronary Artery Disease,
What are the symptoms of Coronary Artery Disease?
One of the commonest symptoms is Chest Pain or what we call Angina. In Medical parlance, we call it Angina but in the general term, we call it chest pain. It’s a form of Chest Pain; can be aching, burning, it can be squeezing pains at times, it can radiate as the person is having the pain. It can radiate to the arm, the back or jaw, or shoulder depending.
But it would be a sudden pain in the chest and it would be in form of severe pain. That is the commonest symptom. Another symptom for such people like women at times is the feeling of vomiting, some would be sweating and some might experience tiredness. The other one is some people might have what we call Palpitations. What I mean by Palpitation is like what happens when one hears one heartbeat.
You know when one is afraid and suddenly you started hearing your heart beating that is a form of Palpitation. Some might have Palpitation, some might have restlessness like shortness of breath; not being able to breathe very well or gasping for breath. Briefly, those are just the symptoms. There are related to the heart specifically.
What are the chances of surviving Coronary Artery Disease?
Like I mentioned earlier, it depends on one, the heart has various arteries, so it depends on the arteries affected. If it’s the major one that affects the major part of the heart, it might cause a major problem. Two, how serious, at times it may not be total occlusion. The severity of the disease itself, some people who have it and with the treatment they get better. They have an Angina on notice; they go for a test and have treatment. They survive it.
And some people have severe form and they don’t survive it because it can lead to some part of the heart failure which can complicate other aspects generally. Yes there’s still probability of survival depending on various factors and depending on the severity but also some might not survive it. And we know generally, we see people with heart attack like you said with no survival. But actually, some survive it.
Can Coronary Artery Disease be cured?
Cured! Now when we talk about non-communicable diseases, generally we don’t talk about a cure. We talk about treatment or management. The reason is this, cure generally used for communicable diseases because you can eliminate the organism or the direct cause. And that’s why Hypertension we don’t talk about a cure, Diabetes we don’t talk about the cure. It’s treatments, it’s management. Same for Coronary Artery Disease, It’s about management. After appropriate evaluation and tests, then it can be treated adequately.
What are the preventive measures from having the disease?
The first thing is Regular Check-Ups Prevention. Regular Check-Ups in the sense that age is a risk factor, anybody above 40 should do Regular Check-Ups of their blood pressure because Hypertension is also a major risk factor. Checking blood pressure at least twice a year so that if the person has Hypertension, it can be treated and it will not complicate other systems.
Two, Obesity once you do regular exercise. For those on the big side, they should try to reduce the weight and do exercise regularly. Like we said early also, lack of physical activities is a risk factor. So if you do exercise regularly it improves the functions of the heart itself. It would make the heart to be stronger to withstand any major issue.
Exercise also would help as a form of prevention. It does not necessarily mean one has to go and run or jog; you can something to make one fine. It might be brisk-walking for some minutes on a daily basis. That will also help. Then for those with medical conditions like Hypertension, Diabetes prompt treatment is key. Early treatment is very important to prevent complications. And for those people who use medication regularly and go for check-ups so that they can be followed ups that these medications you are using for it are working for it.
Because the medication might not be enough or might be too much, a regular clinic visit would adjust that as much as possible. That’s also for prevention. Then from time to time annually one can check the level of the lipid or fats in the system. We call Lipid Profile. Checking will also let know the cholesterol level in the body. If the cholesterol level is high, it’s a risk factor also for Coronary Artery Disease.
So checking it from time to time so that if it’s high one can regulate it and if it’s not high, it reduces the risk. These are the things one can do to actually serve as a form of prevention for it. It’s just like basically regulating the factors as much as possible to serve as a form of prevention.
What is advice for people battling with Coronary Artery Disease?
Because it’s an emergency, most of the time they cannot diagnose the person and the person would be at home. That’s the truth. If it’s diagnosed, the person would be at the hospital and steps would be taken. So basically anybody that has maybe basic chest pains which is the commonest symptom, the person not just assume because at times the pain might start and is not severe yet and something might be able to be done.
So basically, people should not take it for granted. Sudden chest pain especially on the left side where the heart is located, the person should just as much as possible go for an evaluation. One of the things that will be done apart from physical examination like checking the blood pressure and another thing that may be done, also there are other tests that can be carried out.
One of them is the ECG. ECG would help to look at the electrical activities of the heart. Some electrodes would be connected to the heart. It records the patterns of the electrical activities of the heart. So if the person has Coronary Artery Disease, it would reflect in some of the electrical activities of the heart. And if it’s not clear there is also another one, Echo, it’s like a scan of the heart.
That one will look at the heart directly and it has facilities that can help look at the anterior supply and pick if there is an issue. Another form of test to do is the Exercise Stress Test because some people might have it and it might not show if the person is not performing activities. And that’s why the symptoms can come at the peak of activities.
So they might do Exercise Stress Test, the person does on a trek mail or something and the activities of the heart are recorded. These are forms of evaluations or test that can actually pick and say this is the problem. The essence of this is; not every chest pain is Angina. Some people might have Muscleclo-skeletal pain because you have muscles on the rib or chest wall. So people might have pain related to that muscle.
That does not mean the person has Angina is not related to Coronary Artery Disease. But as an individual you can’t detect until you visit a doctor that checks you and can really say that what you have is not Angina, it’s just Muscleclo-skeletal pain. So one should not assume for oneself and say that this chest pain is minor and take it for granted. It might just be the initial warning signs that one needs to be cautious and know what to do about it.
So these are just some of the things that can be done to evaluate whoever has it. And after the evaluation, the next thing is treatment. Your treatment is in phases. One is very severe and might need surgery at times and if it’s not serious it might just medication. Some of the medications involve the use of blood in such as Aspirin such that blood flowing would not be vicious enough to want to affect the walls of the blood vessels and to make the flow faster to be able to supply the heart. Also, some might use Anti-lipids.
There some medications that reduce the level of fats or lipids or cholesterol in the body. So if it’s noticed in that person that the level of fats is higher than normal they might use medication to also reduce it. The other thing is the lifestyle modification generally that the person would be advised on. If the person is smoking; stop smoking. If the person is drinking alcohol; stop or reduce it to a minimal level.
Then also if the person is for example hypertensive, make sure they treat hypertension and they achieve optimal control, and also if the person has Diabetes, this is also regulated. So they are regularly exercise would be advised that make sure you do exercise every now and then. All these would be a form of treatment but the severity would determine which of the steps would be started with and what other things would be done later.
What is the ray of hope someone already battling with Coronary Artery Disease?
Whoever that’s been diagnosed of it basically, the ray of hope I have for them is that it is treatable and it is an acute thing. If the person is still alive active talking, it shows the person can still get better. So that is just it. It is sudden. If it does not kill you immediately, the chances of survival are higher if the person gets adequate treatments.
The ray of hope is even if a person is diagnosed he has Coronary Artery Disease, it’s not a death sentence. No, it’s not a death sentence. It’s something that can be treated. It’s something that can be treated. It’s just that the blood vessels supplying the heart is being occluded gradually. So they can use the tinner to at least increase the diameter and if the person does not stress the heart in those critical periods, the heart will cope gradually.
And for some people, if it happens gradually over time, the heart itself can get blood supply from other sources again apart from those places where there’s a problem. There’s always a way the body adjusts pending the time the treatment takes effect. So getting treatments in centres with specialists that can handle such situations, there is a ray of hope. People can do very well on it and by that is just to be careful of having a repeat of it next time.
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