Chambana Sun

There are over twelve million Americans living with coronary artery disease (CAD). With CAD, plaque forms in heart blood vessels over years, building up as fatty deposits that block blood flow.

“At every age, men develop CAD at higher rates than women.” said Muhammad Salman Akhtar, MD, FACC. “Patients with risk factors such as hypertension, elevated cholesterol, diabetes, history of smoking as well as aligning genetics and a family history of premature CAD, are at higher risk compared to other patients.”

This condition is the number one killer of adults in the United States. CAD starts as early as teenage and worsens due to lifestyle factors. This includes smoking, high cholesterol, a sedentary lifestyle or high blood pressure. A family history of CAD can also be a contributing factor.

A physical exam or blood test may reveal CAD, which is how 64-year-old Bruce Harris discovered his condition. Harris is an avid golfer and walker, but over the past four years, it became harder to do so. “I didn’t think it was a problem,” said Harris. “I thought I was just getting older. I thought I just needed to push myself harder.”“Atypical symptoms include shortness of breath, discomfort at sites other than left side of chest,” said Dr. Akhtar. “If there is any concern of symptoms being cardiac in nature, patients should seek attention. If they resolve quickly, a medical office is an appropriate place for evaluation. But if they are not, emergency room evaluation is more appropriate.”

Symptoms of CAD depends on the presentation of the disease in patients. “There is acute coronary syndrome CAD and non-acute CAD,” said Dr. Akhtar. “With acute syndrome, symptoms are constant and unstable. With non-acute symptoms, symptoms only appear when the patient exerts themselves, such as with exercise.”

If a patient is asymptomatic or symptoms are not addressed, CAD can lead to ischemia, reduced blood flow in the heart, and arrhythmias.

“A heart attack can be the first presentation of CAD in a significant number of patients,” said Dr. Akhtar. “Those patients may have ignored their symptoms, or they didn’t know. CAD can occur in patients with mild symptoms that they don’t recognize.”

In May of 2022, he received a CAD diagnosis, but at the time, he thought it was only acid reflux. “My son was dealing with acid reflux issues at the time, too. I was convinced we had the same thing,” said Harris. “I would get a gas pocket in my upper chest, but once I purged that, I felt fine. But it was getting harder to eat anything.”

This difficulty prompted a visit to the doctor where his physician recommended a stress test.

Harris began to struggle during the stress test while exercising until the gas pocket developed in his chest. His doctor told him that although it may feel like gas, the monitor was telling him a different story.

“He told me, ‘Bruce, most people don’t like to have their chest opened, but it’s the best course of action’,” said Harris. “He told me my artery was 98% blocked, and that’s when I was finally able to process what he was saying.”

“There’s treatment and fixing,” said Dr. Akhtar. “Everyone needs treatment like lifestyle modifications and medication.” Lifestyle changes address the modifiable factors that can help prevent CAD or treat the condition.“Cardio activities that involve sustained a heart rate response is what helps most,” said Dr. Akhtar.

Dietary changes also prevent or help treat CAD. Eating more fruits, vegetables, and white meats like fish and chicken.

“Fixing is required in the case of ischemia,” said Dr. Akhtar. “This could be putting in a stent or bypass surgery.”

In June, Harris underwent a quadruple bypass surgery. “Before the surgery, I was slowing down so gradually the only thing I was noticing was increasingly longer recovery times after exercise. After the surgery, I immediately felt the difference in the increased blood flow to my legs. They felt completely different, almost like I had new legs.”

Harris completed a rehabilitation course at Carle BroMenn Medical Center and continues to exercise paired with medication. “I feel much, much better,” said Harris.

“Early recognition and compliance are the most important thing,” said Dr. Akhtar. “Recognize the symptoms and take steps to address it. Don’t wait." 

Original source can be found here.