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There is a genetic risk for the development of coronary artery disease,
but many factors are involved, including smoking, high blood pressure,
diabetes and cholesterol levels.
Some families, however, carry
gene
mutations
that make them likely to have a very high cholesterol levels. This is
known as
familial hypercholesterolemia
or
FH.
Families affected usually have members who have suffered from heart
attacks, sometimes at very young ages.
What are the symptoms?
A person with narrowed arteries may experience heavy or tight chest
pain - called angina - or breathlessness, most commonly during exertion,
as a warning. A person who has FH may develop fatty lumps in the skin
around the eyes or in the muscle tendons, but, usually, the only way of
telling is to have a blood test.
How is it diagnosed?
An
ECG
at rest will often be normal. An
exercise
ECG
may show signs that the heart is being starved of oxygen. Depending on
how high the doctor thinks the risk of having narrowed coronary
arteries is, a range of different tests may also be offered, such as an
ECHO during exercise, a special
MRI scan
or a
CT scan
of the coronary arteries. If the doctor thinks risk is high then a
coronary
angiography may be offered
to diagnose the condition.
Treatment and advice
Anyone
with coronary artery disease should receive advice on
lifestyle - including stopping smoking, a healthy diet and regular
exercise. If cholesterol levels are high they can be treated with
tablets, known as statins, to reduce the risk of further artery furring.
Tablets can also treat symptoms of chest pain and reduce the chance of a
heart attack.
If an angiogram suggests a very tight narrowing in one of the coronary
arteries then a catheter can be used to open up the narrowing by blowing
up a balloon at the narrowing (known as angioplasty) and inserting a
metal tube (stent) to keep the artery open. If an angiogram shows more
severe furring, especially if both the right and the left coronary
arteries are affected, then a bypass operation may be required to
improve the blood supply to the heart. |
