About this disease
What it is about
Coronary artery disease is caused by deposits in the wall of the coronary vessels consisting of cholesterol, inflammatory cells and calcium salts. Such deposits develop slowly over a period of years and are called plaque. In early stages, there are no symptoms. However, when the narrowing of the vessel exceeds a certain level or the vessel closes completely, symptoms occur. The development of the deposits is favored by risk factors such as smoking, hypertension, lack of exercise, nutritional factors, diabetes and high blood lipid levels.
Types
A high-grade narrowing of a coronary vessel leads to exertion- or stress-related chest discomfort called angina pectoris. Physical exertion or stress causes an increase in blood pressure and heart rate. The resulting increased oxygen and energy demand of the muscle cells can no longer be met by the narrowed vessel. In the event of a heart attack, a blood clot forms in the area of the plaque, the vessel closes completely and the muscle area, which is no longer supplied with blood, is damaged.
Symptoms and consequences
Angina pectoris indicates a narrowing of a coronary vessel. During physical exertion, such as climbing stairs, running uphill, or sports activities, but also during psychological stress, there is a strong feeling of tightness in the chest, which disappears completely again within a few minutes at rest. In the case of a heart attack, the vessel closes completely. Here, too, a strong feeling of tightness occurs, often combined with nausea and sweating. A heart attack can occur regardless of physical exertion.
What we do for you
Examination and diagnosis
A heart attack is an emergency because the heart muscle tissue can be irreversibly damaged if treatment is delayed. Rapid diagnosis in the emergency department is aided by ECG, laboratory tests, and occasionally cardiac ultrasound. In the evaluation of chest pain, the aforementioned characteristics such as exercise dependence and duration and type of pain play an essential role and decide on further investigations (exercise test or imaging procedures such as coronary CT, scintigraphy or cardiac catheterization).
Treatment
A heart attack requires rapid further clarification by means of cardiac catheterization (coronary angiography). Occlusions or narrowings can be repaired by this method (coronary angioplasty, stenting). The examination is performed by the nearby center hospitals in Zurich. For the further course of the disease, influencing the risk factors is crucial. In addition to outpatient cardiological care in the consultation hours, Männedorf Hospital offers a 12-week outpatient rehabilitation program after heart surgery or catheter interventions.