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If your father or a brother was diagnosed with heart disease before age 55, or if your mother or a sister was diagnosed before age 65, you have a greater risk of being diagnosed with heart disease.

Symptoms of Coronary Artery Disease

If your coronary arteries narrow, they can’t supply enough blood to your heart, especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause symptoms, but as plaque continues to build in your coronary arteries, your heart muscle doesn’t get the blood it needs and symptoms may develop. Symptoms may develop gradually (chronic) or suddenly (unstable angina or heart attack).

The most common symptoms of coronary artery disease include chest pain (angina) and shortness of breath with some kind of exercise or exertion. Though you may not have symptoms at rest, more strenuous activity increases the amount of oxygen that the heart needs, and brings on symptoms.Chest pain can also be described as discomfort, heaviness, tightness, pressure, aching, burning, numbness, fullness, or squeezing. It can be mistaken for indigestion or heartburn and can occur anywhere in the chest, and sometimes even the abdomen. The severity of these symptoms varies, and they may get more severe as plaque continues to build up and narrow your coronary arteries.Lack of energy and inordinate fatigue with the same level of activity may also be a sign of heart disease.

Common symptoms of heart attack include chest pain or discomfort that lasts more than a few minutes and doesn’t go away with rest. There may be upper body discomfort, and shortness of breath.Other possible symptoms of a heart attack include breaking out in a cold sweat, feeling unusually tired for no reason, nausea (sick to your stomach) and vomiting, and light-headedness or sudden dizziness.Associated symptoms such as pain the arms, neck, jaw, or upper stomach can also be surrogates for chest pain.

If you experience any of these symptoms, seek immediate treatment. Do not wait to schedule an appointment with your doctor; call 9-1-1 or have someone drive you to the emergency room to get checked out immediately.

If left untreated, coronary artery disease can lead to a heart attack.

Diagnosis and Treatment Options

Your doctor usually can diagnose coronary artery disease based on your medical history, risk factors, a physical exam, and the results from tests and procedures.

There is no one test that can diagnose coronary artery disease, so your doctor may recommend one or more of the following: electrocardiogram (EKG), stress test, echocardiogram (echo), chest x-ray, blood tests,and cardiac catheterization (angiogram).For more information on these tests, visit the common diagnostic tests page .

Many patients with coronary artery disease can be treated with medications alone. The most common procedures to treat coronary artery disease include coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI). Both treatment options will restore blood flow to your heart, but there is no one treatment guaranteed to be effective for all cases of coronary artery disease. In general, both CABG and PCI are designed to make patients with coronary artery disease live longer by decreasing the likelihood of dying from a heart attack (myocardial infarction).These procedures are also very effective at improving the symptoms of coronary artery disease, including chest pain and shortness of breath.

Who gets Coronary Bypass Surgery (CABG) vs. Catheter Based Therapy (PCI) vs. Medications only?

Extensive research and over 50 years of experience with CABG and 30 years of experience with PCI have helped to determine which patients do better with CABG and which are better candidates for PCI.The decision can be complicated and depends on the number and location of blockages in the coronary arteries, the condition of the patient, the function of the heart, and the presence of contributing diseases such as diabetes. Your cardiologist and cardiac surgeon will work together to decide which procedure is the best for you.Though CABG is more invasive than PCI, most patients with blockage of the left main coronary artery, blockages in all three of the major coronary arteries, those with weaker ventricles, and diabetics with severe coronary artery disease do better long term with CABG. Some patients do not need either CABG or PCI, and can be treated with medications alone.

Talk with your doctor or cardiothoracic surgeon to get more information on these treatment options and choose the one that is best for you. You can print these sample questions to use as a basis for discussion with your doctor.

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CABG (often pronounced “cabbage”) is the most commonly performed heart operation in the United States. The operation is designed to bypass the blockages in your coronary arteries in order to...

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Percutaneous Coronary Intervention (PCI)

PCI, sometimes referred to as angioplasty, is a nonsurgical procedure that can open blocked or narrowed coronary arteries.A thin, flexible tube with a balloon or other device attached to the...

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Recovery

As part of your recovery and to reduce the risk of developing further blockages, you should strive to maintain a healthy lifestyle. This includes regular exercise, eating healthy foods, weight loss, reducing stress, and quitting smoking. Even if you do not require surgery or PCI, incorporating healthy behaviors will help prevent further damage to your heart.

CABG surgery is a major operation, and you should expect to be in the hospital for about a week after surgery. Your hospital stay will likely include a day or two in the intensive care unit (ICU) where hospital staff can monitor your blood pressure, breathing, and other vital signs. You also will have a breathing tube for a few hours or possibly overnight, so communication will be difficult. The breathing tube will be removed as soon as you are awake and able to breathe on your own.

If your in-hospital recovery goes as expected, you should be discharged within a week. This is just the start of your recovery though. Even after going home, you likely will find it difficult to perform everyday tasks or even walk a short distance. You should expect a full recovery period of about 12 to 15 weeks. In most cases, you can return to work, begin exercising, and resume sexual activity after 4 to 6 weeks, but your doctor will discuss a personalized recovery plan with you following surgery.

The STS mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.

Venous samples for glucose, were drawn after an overnight 12-hour fast. Participants with fasting glucose values ≥5.8 mmol/L were requested to return for a second sample; the average of the two samples was used in analysis. Diabetes was defined as a fasting blood glucose ≥7.0 mmol/L. Impaired fasting glucose was defined as fasting blood glucose of 6.1-6.9 mmol/L, as per the Canadian Diabetes Association [ Patricia Green Splash Thong Slipper Womens SXb6L
]. Samples were analyzed at the Clinical Chemistry Lab at the Health Sciences Centre, Winnipeg, Manitoba.

Blood pressure was measured on site by a registered nurse or a trained research assistant, working under the supervision of the registered nurse. The average of two readings was used. Hypertension was defined as a blood pressure >140/90 mm Hg for those without diabetes, ≥130/80 mm Hg for those with diabetes and/or albuminuria, according to the American Diabetes Association [ RUSH by Gordon RushHaniger ZVFi0lsag
, 28 ], or a previous diagnosis treated with medication. Anthropometric measures including height, weight, and waist and hip circumferences were completed using standard techniques [ 29 ]. Current and past smoking status and number of cigarettes smoked per day were determined using a standardized questionnaire. Pack years was calculated as number of packs per day (1 pack = 20 cigarettes) multiplied by number of years smoked. Standard demographic information and diabetes history were derived via questionnaire. Awareness of disease states by participant, such as diabetes, hypertension and kidney disease, was asked by a simple direct question in similar fashion to the NHANES III study cohort [ 30 ].

Data are presented as mean (standard deviation) for continuous variables, median (range) for continuous variables that do not follow a normal distribution, and as n (percent) for categorical variables. Demographic, anthropometric and health characteristics were compared using -tests for normally distributed continuous variables, χ tests for categorical variables and Mann–Whitney U non-parametric tests for non-normally distributed continuous variables. Univariate and multiple logistic regression (backwards stepwise) were used to determine associations with albuminuria. Continuous variables were also explored as categorical variables to determine appropriateness of assumptions of linearity. Those variables that were found to be significant in univariate analysis, as well as independent of age, were included as potential variables in the backwards stepwise logistic regression model. Tests were two-tailed with p < 0.05 considered significant. Statistical analyses were performed using SPSS (version 16).

The study sample was representative of the larger community for age, sex, education and employment status [ 23 ]. That is, the sample had similar proportions of the previously listed characteristics as the study population. Nine subjects were ineligible due to incomplete data and 6 were excluded from the albuminuria analysis due to persistent hematuria, leaving 468 subjects for albuminuria analysis. Participants with persistent hematuria were excluded due to the inability to obtain an ACR and we could not determine the cause of the hematuria. These individuals were referred for clinical evaluation. However, most individuals whose first test was positive for hematuria were found not to be hematuric on subsequent tests and were included in analysis. The majority of these participants were women who were tested close to their menstrual period.

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