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Coronary artery disease on the rise
Kuldip Bhatia

Ludhiana, July 29
Coronary Artery Disease (CAD), one of the rapidly spreading diseases worldwide, is assuming grave proportions, particularly in India, cutting across age group, class and strata of society.

Its prevalence in India has gone up from 1.05 pe rcent in the sixties to about 10 per cent in the late nineties, particularly among the urban population.

Dr Rajeev Gupta, a renowned cardiothoracic surgeon, who recently joined Christian Medical College and Hospital (CMCH) here, said the increasing incidence of CAD was a part of epidemiological transition, characterised by changing lifestyles and a probable genetic predisposition.

Broadly speaking, CAD is caused when the heart, like other muscles, needing oxygen and other nutrients to provide energy , is deprived of enough blood and oxygen due to the coronary arteries getting blocked with fatty deposits or plaque

Whereas blockade in coronary arteries leads to discomfort and chest pain (angina), formation of blood clot, which could suddenly cut off blood flow in the arteries, can often cause a heart attack.

One of the major causes of plaque formation and blockade of the arteries is presence of cholesterol in the blood. As plaque builds up, the artery opening gradually narrows and becomes partially or completely clogged. The artery can also lose elasticity, commonly known as "hardening of the arteries". Dr Gupta says one may not know have CAD until the symptoms from clogged arteries begin to surface. Chest pain (angina) and shortness of breath are often the first signs of coronary artery disease. Women with CAD may experience breast pain or a feeling of indigestion. However 25 to 30 per cent of the patients have no symptoms despite the presence of CAD.

In 'Silent Ischemia', as the condition is called, the victims are unaware of potentially dangerous abnormal heart rhythms (arhythmia) while the absence of chest pain or other common symptoms can also set the stage for a heart attack that occurs without warning.

The two main risk factors are ageing and gender. Women tend to get heart diseases later than men do. It is thought that female hormones help protect women from heart diseases before menopause.

But after menopause, women have heart diseases as often as men .Other factors that raise the chances of cardiac disease include high cholesterol levels, high blood pressure, diabetes, high fat diet, lack of exercise or physical activity, chronic stress or depression, smoking, obesity and family history of heart diseases. The CAD can be treated and managed with the help of medicines, surgical procedures like angioplasty that open blocked arteries, and bypass surgery. In cases of massive blockage, Coronary Artery Bypass Surgery (CABG) is the most common and effective procedure.

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