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Atherosclerosis and Treatment for Coronary and Peripheral Artery Diseases

Your body can’t function without oxygen. Every organ needs it to survive. Your arteries are the roads that transport oxygen-rich blood throughout your body. But sometimes, these arteries can become hardened and narrowed by a buildup of plaque — cholesterol, fatty substances, cellular waste, calcium, and a clotting substance called fibrin.

This buildup is called atherosclerosis. When atherosclerosis develops in the arteries that bring blood to the heart muscle, it is called coronary artery disease (CAD). When the buildup is in the arteries that carry blood to the arms, legs, stomach, or head, it is called peripheral artery disease (PAD).

Coronary artery disease is the most common type of heart disease and the leading cause of death in the US. And people with PAD have a much higher risk of eventually developing CAD.

Both carry significant risks, especially because they can go undetected until they cause a major health event, like a heart attack or a limb amputation. Being aware of common causes and symptoms, as well as effective preventative measures, can help keep your arteries healthy.

There are many treatment options for both CAD and PAD. Choosing the one that’s right for you will depend mostly on the progression of the disease and how urgent intervention needs to be.

The Dangers of Coronary and Peripheral Artery Disease

Coronary Artery Disease

Plaque buildup that develops when you have coronary artery disease limits the blood supply to your heart. Whether this happens gradually or suddenly, limiting the blood supply to your heart is dangerous because it can lead to serious heart complications such as heart attack or heart failure.

If the plaque either ruptures (breaks open) or clots, this can cause a heart attack because of the disrupted blood supply to the heart. If the buildup progresses over time and slows the blood flow to the heart, this can damage your heart muscle. When the heart muscle is damaged, it can cause long-term problems, such as heart failure and an arrhythmia (irregular heartbeat).

Peripheral Artery Disease

With peripheral artery disease, plaque builds up on the walls of the arteries that bring oxygen and blood to your limbs. Your arteries narrow because of the plaque, which can cause pain and swelling in the limbs because of blocked blood flow. This can be heightened during activities like walking and climbing stairs. If it becomes severe enough, the blocked blood flow to the limbs can cause the tissue to die. This may lead to amputation of a limb.

The Facts About Plaque Build Up: Are You at Risk?

Plaque buildup can begin in childhood. Often times, it goes undetected. But there are many factors that put you at a higher risk of developing either coronary artery disease or peripheral artery disease, including:

  • High cholesterol
  • High blood pressure
  • Smoking/tobacco use
  • Insulin resistance
  • Diabetes
  • Obesity
  • Lack of physical activity
  • Unhealthy diet
  • Older age (45+ in men and 55+ in women)
  • Family history of heart disease

While some of these risk factors are out of your control, many of them can be managed by living a heart-healthy lifestyle, such as exercising and eating fruits and vegetables, in order to decrease your risk of plaque buildup that causes coronary and peripheral artery disease.

  1. Coronary Arteries: Blood vessels that bring blood to your heart
  2. Peripheral Arteries: Arteries that bring blood to your arms, legs, and feet
  3. Blood Clot: A blockage in a vein or artery that can restrict blood flow. Blood clots can also travel to other parts of the body
  4. Cardiothoracic Surgeon: A physician who specializes in heart procedures for conditions such as CAD and PAD
  5. Interventional Cardiologist: A physician who specializes in catheter-based procedures to manage and treat heart disease

Possible Risks: Conditions Caused by CAD and PAD

  • Heart Attack: When the flow of blood gets blocked to a portion of the heart, it can’t get oxygen. If this happens, parts of the heart muscle can die.
  • Heart Failure: When your heart is not functioning properly and cannot give the body the amount of blood it needs. Signs of this include trouble breathing, fatigue, and swelling in parts of the body, including your ankles, feet, legs, stomach, and veins in your neck.
  • Arrhythmia: An abnormal rhythm of the heart beat. It might feel too fast or like a flutter, and this can cause your heart to suddenly stop beating,
  • Sudden Cardiac Arrest: When your heart suddenly and unexpectedly stops beating, stopping the blood flow to the brain and other vital organs. This can cause death if not treated immediately.

Symptoms to Look out For

Knowing the signs of coronary artery disease and peripheral artery disease can help you to reduce your risk of complications. Symptoms of CAD include angina (chest pain or discomfort), pressure or tightness in your chest, and shortness of breath. Symptoms of PAD include pain, numbness, aching, or heaviness in the leg muscles, cramping of the affected legs and buttocks, and lessening of pain with rest.

If you experience any of these symptoms, it’s important to see your physician. There are many ways your physician will be able to determine if you have either condition.

To diagnose coronary artery disease, your physician may do one of the following:

  • EKG, or electrocardiogram: This simple, painless test can detect the electrical activity of your heart and help determine if you have heart damage.
  • Stress test: This test will record your heart activity while you exercise and make your heart beat fast. This will show if your heart if working at its full potential.
  • Echocardiography: Using sound waves to create a moving picture of your heart, this test can allow your physician to see blood flow and heart muscles to see if they are functioning normally.
  • Chest X-ray: This test uses an X-ray to take pictures of your heart. This will show the structures of your heart and determine if there is heart failure.
  • Coronary angiography: During this procedure, your physician will inject dye into your coronary arteries through a catheter in your arm or groin. This dye allows your physician to see your blood flow through the heart. This is usually done in a hospital while you are awake, and there is little to no pain.
  • Blood tests: These collected samples of your blood can specifically allow your physician to see if there are abnormal levels of certain fats, cholesterol, sugar, and proteins.

To diagnose peripheral artery disease, your physician may do one of the following:

  • Ankle-brachial test, a simple test that compares the blood pressure in your leg to the blood pressure in your arm. This will help determine if the blood flow in your legs is slower than normal.
  • Doppler ultrasound, a test that uses a handheld device over the affected area to detect sound waves. This will create a picture of the blood flow in your leg.
  • Treadmill test, which is simply walking on a treadmill while your physician is looking for any problems during walking.
  • Magnetic resonance angiogram, which uses magnetic and radio energy to take pictures of your blood vessels. This can show the location and severity of a potentially blocked blood vessel.
  • Arteriogram, where your physician will inject dye through a catheter into your artery. An X-ray is then taken to see where the blockage is.
  • Blood tests, specifically to see if you have diabetes or high cholesterol — both risk factors for PAD.

A Heart-Healthy Approach to Treatment

With peripheral artery disease, the purpose of treatment is to reduce the risk of heart attack or stroke and to ease symptoms like pain, numbness, achiness, and heaviness. The goal of treatment when it comes to coronary artery disease is to lower the risk of blood clots, heart attack, and stroke.

With both coronary artery disease and peripheral artery disease, treatment usually includes heart-healthy lifestyle changes. Changing your diet to lower your intake of saturated fat, trans fat, sodium, and alcohol can decrease your risk of complications. You may also be recommended to exercise more, quit smoking or using tobacco products, and manage stress levels — all in order to avoid complications.

When Diet and Exercise Are Not Enough: Treatments for CAD and PAD

If your coronary artery disease or peripheral artery disease is severe enough, your physician may recommend one of the following surgeries or procedures. These are used if the artery is nearly completely blocked.

  • Angioplasty: Percutaneous Coronary Intervention for CAD or PAD

    More commonly known as an angioplasty, this is a non-surgical procedure that opens blocked or narrowed coronary arteries.

    Steps of an angioplasty:

    1. You will be given medicine to relax you, but you will be awake during this procedure.
    2. Your physician will numb the injection site — usually at the groin or wrist — and insert a catheter (thin, flexible tube) into your blood vessel and to the affected area.
    3. Using that catheter, another catheter with a small balloon on the end will be threaded to the blockage. Once there, your physician will inflate the balloon to push the plaque against the walls of the artery, creating an opening and allows the blood to flow through.
    4. Your physician may also insert a stent — a small, mesh tube — into the artery to help prevent future blockages.

    You may have some soreness or bleeding at the injection site after the procedure. You will either be able to leave the same day, or you may be required to stay overnight. If stent was inserted, you will likely have to take anti-clotting medicine for 3 to 12 months afterward.

  • Cardiac Rehabilitation for CAD

    This medically supervised program is intended to help the heart health of participants through rehabilitation like education and exercise.

    The Components of Cardiac Rehabilitation:

    1. Education, counseling, and training, which will help you learn about your heart condition and how you can help reduce your future risk of complications. You will also work on stress and coping mechanisms regarding having coronary artery disease.
    2. Exercise training, which will help you understand how to safely and effectively strengthen your muscles to improve stamina and reduce your risk of heart problems in the future.
  • Coronary Artery Bypass Grafting for CAD

    This open-heart surgery uses other arteries to bypass — or go around — the narrowed or blocked arteries, helping to improve blood flow and prevent risk of chest pains and heart attack.

    Steps of a Coronary Artery Bypass Grafting:

    1. You will be given general anesthesia, so you will be completely asleep.
    2. Your physician will make an incision down the middle of your chest, cut your chest bone, and open your rib cage to access your heart.
    3. You will receive a medicine that stops your heart while it is being operated on, along with medicine that protects your heart’s functioning while it’s not beating.
    4. Your physician will take an artery or vein from somewhere else on your body — like your chest or leg — to use as a bypass graft, which creates an alternate route for blood to flow through.
    5. Your physician will use a wire to close your chest bone, which will stay in your body permanently. Staples or stitches will also be used to close the incision.

    You will spend at least 1 to 2 days in the Intensive Care Unit (ICU) and 3 to 5 days in a less intensive part of the hospital, where your heart rate, blood pressure, and oxygen levels will be closely monitored. Full recovery usually takes 6 to 12 weeks or more, and your doctor will determine when you can return to normal activities. Many people remain symptom free for 10 to 15 years following this procedure, though some need to have repeat surgeries if new blockages form.

  • Bypass Grafting For PAD

    This procedure uses a blood vessel from another part of your body or a synthetic tube to bypass (go around) the blockage to restore proper blood flow. This won’t completely cure PAD, but it will improve blood flow and relieve symptoms.

    Steps of a Bypass Grafting:

    1. You will be given anesthesia for the pain, but the level of anesthesia and your consciousness will depend on the artery that is being treated.
    2. Your physician will make an incision over the part of the artery that contains the blockage.
    3. Two clamps will be put at either end of the affected section of the artery, and the graft — the artery from another part of your body — will be sewn into place to allow proper blood flow.
    4. The incision will be closed, and you may have an X-ray called a arteriogram to ensure the graft is working as it should.

    You will likely remain in the hospital for 2 to 5 days afterward. It is likely that you will experience some pain at the incision site, along with some swelling and drainage. You will also be given pain medication. Most patients take a few weeks off from work because it will take time for you to return to your normal activities, depending on where the artery was transplanted.

  • Atherectomy for PAD

    This procedure removes the plaque buildup from the artery to restore blood flow.

    Steps of an Atherectomy:

    1. Your physician will insert a small cutting device through a catheter to reach the blocked artery.
    2. Using this, your physician will cut out the plaque causing the blockage. It will either be removed through the catheter or — if small enough — wash away in the bloodstream to be broken down later.
    3. Your physician will inject dye into your bloodstream and do an X-ray to ensure blood flow has been restored.
    4. The catheter will be removed and the procedure is complete.

    The procedure may take about 2 hours, and you will usually stay in the hospital for up to 2 days. Typically, you will be able to resume normal activities several days after the procedure.

Why Choose Stormont

Located in Topeka, Kansas, Stormont Vail Health is a community-driven organization. It offers close to home care and with limited travel requirements, it will be easier for you to get the care you need in a community you trust.

In 2009, Stormont Vail achieved Magnet designation, one of the highest awards in nursing excellence and high-quality patient care. Only 9% of US hospitals have earned this recognition.

The Joint Commission — with more than 50 years of accrediting hospitals in high quality standards — has accredited Stormont Vail Hospital. Stormont also achieved additional accreditations in many areas, including Advanced Primary Stroke Center and Chest Pain.

With over 200 employed physicians and 33 working specifically in Cardiology, Stormont Vail has an experienced and skilled physician to help you treat coronary and peripheral artery disease.


Next Steps

Make an Appointment

To make an appointment at the Cotton O’Neil Heart Center, call (785) 270-4000.

See a Primary Care Provider

  • Call (785) 270-4440 to schedule an appointment with your Stormont Vail primary care provider.
  • Not a Stormont Vail patient? Call (785) 270-4440 to set up your first appointment with one of our primary care providers.