Procedure Description:

Coronary Artery Surgery:

Coronary artery surgery is undertaken because coronary artery disease is a leading source of morbidity and mortality. Variations in approach are conceivable, including the use of cardiopulmonary bypass and conduit selection. In a diabetic patient, the main indications for repair are left main disease, left main equivalent disease, and multivessel disease. This exercise discusses the evaluation and surgical treatment of coronary artery disease, emphasizing the importance of the interprofessional team in assessing and treating this condition.

Disease Overview:

Coronary arteries are the blood channels that provide oxygen-rich blood to your heart muscle, allowing it to continue to beat. The coronary arteries run parallel to the heart muscle. Coronary artery disease is a narrowing or blockage of your coronary arteries caused by plaque accumulation. Coronary artery disease, also known as coronary heart disease, ischemic heart disease, and heart disease, is a kind of coronary artery disease.

Disease Signs and Symptoms:

You may not experience symptoms at first, hence, you may not realize you have coronary artery disease. Plaque builds up in your arteries over time, from years to decades. However, when your arteries constrict, you may have moderate symptoms, indicating that your heart is working harder to transport oxygen-rich blood to your body. The most typical symptoms are chest discomfort or shortness of breath, which can occur even when doing nothing but going up stairs.

Disease Causes:

Atherosclerosis is the cause of coronary artery disease. The accumulation of plaque inside your arteries is known as atherosclerosis. Cholesterol, fatty compounds, waste materials, calcium, and the clotting ingredient fibrin make up plaque. As plaque builds up on the insides of your arteries, they constrict and harden. Plaque can block or damage your arteries, causing blood flow to your heart muscle to be restricted or stopped. Your heart can't obtain the oxygen and nutrients it needs to function correctly if it doesn't get enough blood. Ischemia is the medical term for this illness. Chest discomfort or pain might result from a lack of blood flow to your heart muscle (called angina). It also raises your chances of having a heart attack.

You're more likely to get coronary artery disease if you:

- Have a high level of cholesterol (particularly high LDL "bad" cholesterol and low HDL "good" cholesterol).

- Have a high blood pressure condition.

- Heart disease runs in the family.

- diabetes.

- Smoking

- post-menopausal lady or a male over 45 years old

- obesity

- Physically Inactive

Disease Diagnosis:

Your cardiologist will first question you about your symptoms, assess your medical history, evaluate your risk factors, and do a physical exam, unless your condition is an emergency (you're experiencing a heart attack or stroke).

A variety of diagnostic tests are available, including:

- EKGs (electrocardiograms) are tests that record the electrical activity of the heart. Can detect heart attacks, ischemia, and irregular heartbeats.

- Exercise stress tests: A treadmill test to see how well your heart works while it's working the hardest. Angina and coronary occlusions can be detected.

- Pharmacologic stress test: Rather than employing exercise to evaluate your heart when it is at its most active, medication is given to raise your heart rate and simulate activity. Angina and coronary occlusions can be detected using this test.

- Coronary calcium scan: This test determines how much calcium is present in the walls of your coronary arteries, which might indicate atherosclerosis.

- Echocardiogram is a test that uses sound waves to determine how well your heart's architecture and general function are operating.

- Blood test: Triglycerides, cholesterol, lipoprotein, C-reactive protein, glucose, HbA1c (a marker of diabetes management), and other blood tests are ordered for variables that impact arteries.

- Nuclear imaging is a test that uses a radioactive tracer to create pictures of the heart.

- Cardiac catheterization is a procedure in which tiny tubes are inserted into the heart's blood arteries to assess heart function, including the existence of coronary artery disease.

Disease Treatment:

Reducing your risk factors is the first step in treating coronary artery disease. This entails making lifestyle adjustments.

- Quit smoking or using tobacco products.

- Manage High cholesterol, high blood pressure, and diabetes

- Eat a diet that is good for your heart.The Mediterranean and DASH diets are two excellent dietary options.

- Consume alcohol in moderation. Drink no more than one drink per day for ladies and two drinks per day for males on a daily basis.

- Increase your degree of physical exercise. Exercising can help you lose weight, get in better shape, and alleviate stress.

Your doctor will prescribe drugs to help you control your heart disease risk factors. The following are examples of heart-related drugs that you may be prescribed:

- Cholesterol-lowering medications

- Blood pressure medications

- Angina-relieving medications

- Medications to lessen the risk of blood clots.

- Medication to reduce your blood sugar level if you have diabetes and coronary artery disease.

Surgery:

Nonsurgical therapies to remove plaque accumulation in the arteries and prevent blockages are known as interventional procedures. Balloon angioplasty and stenting are two common techniques.

When there is a blockage in the coronary arteries, coronary artery bypass graft (CABG) surgery entails constructing a new conduit for blood to circulate. The surgeon, in most cases, takes blood veins from your chest, arm, or leg and replaces them with a new pathway to supply oxygen-rich blood to the heart.

Enhanced external counterpulsation (EECP): Inflatable cuffs (similar to blood pressure cuffs) are used to compress the blood vessels in your lower body. This aids in the improvement of blood flow to the heart and the formation of natural bypasses (collateral circulation) around blocked coronary arteries.

Coronary angiography is a test that employs X-ray imaging to examine the blood arteries in your heart. The test is usually performed to determine if there is a blockage in blood flow to the heart.

Country wise cost comparison for Coronary Artery Surgery: