Coronary artery disease is caused due to the formation of atherosclerotic plaque within the walls of the heart. The coronary arteries supply oxygen-rich blood to the heart muscle for it to function appropriately. Atherosclerotic plaque in arteries is made up of fat, cholesterol, calcium and other elements present in the blood. The plaque hardens slowly and narrows the coronary arteries. Rupture of plaque and formation of a clot can completely block the coronary artery.
The build-up of plaque in the arteries occurs over many years and it is practically an irreversible process. Plaque that is already present in the coronary arteries does not go away with treatment or lifestyle changes, but you can prevent further build-up of plaque- the cause of artery blockage- with treatment and lifestyle changes. New small blood channels form over time and increase the blood flow to the heart muscle.
Narrowing of the coronary arteries decreases the blood supply to heart muscle. Depending on the severity of decrease of blood flow to the heart muscle, you may or may not have symptoms of angina or a heart attack. When the blood flow is decreased, you may have chest pain during exertion. Angina or chest pain may not cause any other problem in some people, but over time, the reduced blood flow to the heart can weaken the heart muscle and lead to heart failure and arrhythmias (even though you may not have an overt heart attack).
If the blood flow to the heart muscle is blocked, it causes a heart attack. If blood flow isn’t restored promptly, the heart muscle in the region begins to die.Depending on the size of the injury to heart muscle during a heart attack, you may recover completely or it may cause serious problems and even death if it is not treated promptly and appropriately. You may recover after the first heart attack, but a repeated injury to heart muscle can weaken the heart muscle and lead to heart failure and arrhythmias.
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