Physicians estimate the heart will beat three billion times in an average lifetime. It relies on major blood vessels (coronary arteries) to supply the blood, oxygen and nutrients it needs. Hearts react poorly to damage in their arteries. Lifestyle changes and other medical treatments can significantly improve heart health, even for patients diagnosed with multi-vessel disease.
Coronary Artery Disease
The average heart beats 100,000 times per day. It moves about 2,000 gallons of blood daily—equivalent to one million barrels in a 70-year lifespan. Atherosclerosis, narrowing of an artery due to plaque buildup, can reduce blood flow in coronary arteries and leave the heart running at less than peak performance. In triple vessel coronary artery disease (CAD), three of the four arteries feeding the heart are affected.
Plaque and Artery Damage
Along with essential nutrients and oxygen, the blood flowing through arteries carries microscopic cholesterol plaques and other cellular waste. In a healthy artery, the inner walls are smooth and blood speeds along freely. A damaged artery wall can snag plaques as they rush by. As more plaques come along and clump with the others, the artery narrows. Smoking, hypertension, high cholesterol, and diabetes can damage arteries, making them prone to plaque buildup. Age, gender and family history are also factors to consider.
When the narrowing is slight, there may not be any symptoms. As the deposits continue to accumulate and deprive the heart of oxygen-enriched blood, shortness of breath, fatigue or chest pain may occur. Complete blockage of a coronary artery can cause a heart attack. Patients have also described heaviness, burning, tightness and pressure sensation in the upper body with CAD. Women are more likely to have nausea, heartburn or stomach pain than men.
Medical management through strict control of cholesterol, blood pressure, diabetes and other possible contributors is vital. More severe cases may require balloon angioplasty. This entails threading a tiny catheter through the artery until it meets the "clog." A balloon at the tip of the catheter then opens and breaks up the plaque. Sometimes a stent is necessary, essentially a small metal cage that keeps the artery open. Surgery with coronary artery bypass graft may be the best option for significant or multi-vessel disease. The damaged arteries are "bypassed" and new ones grafted. The grafts typically come from sections of leg arteries.
The extent of disease, number of arteries affected and overall health of the patient influences treatment outcomes. Willingness to stop smoking, eat a healthy diet and otherwise change negative habits improves chances for a good prognosis. A patient's ability to follow medical advice will also determine recovery time from procedures such as coronary artery bypass graft. A patient can sometimes start with medication but need other, more invasive treatment like angioplasty or bypass grafting later.