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Atherosclerosis, CAD, and Diabetes

What is Atherosclerosis and Coronary Artery Disease?

Atherosclerosis is a narrowing of the arteries caused by a build up of fatty substance (cholesterol) that can eventually partially or completely block blood flow. Coronary artery disease (CAD) occurs when these blockages develop in the arteries that feed the heart.

CAD can cause chronic hypertension, chest pain, and heart attack. A heart attack, or myocardial infarction, occurs when a nearby blood vessel becomes blocked. Blood flow (and the oxygen the blood carries) is reduced and the affected area of heart muscle suffers damage or tissue death (i.e., infarction).

Symptoms

Individuals with CAD usually don’t experience any symptoms until the disease is far progressed and blood flow is significantly reduced. Symptoms of CAD include:

  • Chest pain (angina)
  • Pain in the arm, shoulder, neck or jaw
  • Tightness or pressure in the chest
  • Shortness of breath
  • Excessive perspiration
  • Nausea
  • Arrhythmia (irregular heartbeat)

    • Heart attack symptoms may include:

  • Chest pain (angina)
  • Pain in the arms, back, jaw, or neck
  • A feeling of indigestion
  • Shortness of breath
  • Excessive sweating
  • Nausea or vomiting
  • Light-headedness or dizziness

    • People with diabetes who also suffer from a form of nerve damage to the heart known as cardiac autonomic neuropathy (or CAN) may not experience the normal pain and other symptoms of a heart attack.

    Treatment and Prevention

    The American Diabetes Association recommends that most adults (i.e., over 21) with diabetes who have a history of risk factors for CAD, PVD, hypertension, or heart attack take a daily dose of coated aspirin. Statin drugs are often prescribed for diabetes patients who have significantly elevated cholesterol levels. Other essential strategies for lowering the risk of CAD and heart attack are maintaining good control of blood glucose levels, losing excess weight, quitting smoking, eating healthy, and exercising regularly.

    Surgical options for the treatment of CAD include angioplasty, bypass, and atherectomy. In angioplasty, a balloon-tipped catheter is inserted into the artery and threaded through the blockage; the balloon is inflated to open the block and in some cases, a tubular stent device is inserted to keep the artery from constricting again. Bypass involves grafting a healthy section of artery on to the diseased artery to bypass the blockage. Atherectomy is a surgical procedure in which fatty deposits are stripped from the arterial walls.

    Reviewed by Francine Kaufman, MD. 4/08

    Last Modified Date: March 24, 2009


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