Coronary artery disease is basically the obstruction of the blood flow through the coronary arteries. Due to this problem the oxygen supply to the cardiac muscle is interrupted. There are several risk factors that make possible the development of the disease. Among those we have: hypertension, diabetes, high levels of cholesterol, smoking, lack of exercise, obesity, stress and some others. They affect the internal wall of vessels (endothelium), beginning the formation of obstructive plaques, threatening the normal circulation.

When the blood flow is not enough for a certain activity (exercise), the patient feels angina, which is the typical chest pain when walking or climbing stairs; the more severe the obstruction, less effort is necessary to trigger the chest pain (angina).

At this stage, the disease can be easily detected by your cardiologist, who will prescribe you some tests after performing a history and physical examination, He will probably order an EKG, and Echocardiogram, a tread mill stress test and in some cases a nuclear myocardial perfusion study.

If those test are positive for myocardial ischemia (lack of coronary blood flow), it means that you might have severe obstructions (more than 70% of diameter of the artery). That shows that your quality of life is affected, and more important, you are at risk of heart infarction. Your cardiologist will order a cardiac catheterization in order to localized and measure the obstructions so he can define the best way to treat you.

The first possibility is the angioplasty, which is the reopening of the obstructed artery with a special balloon, and then implant of a stent, a metallic prosthesis that will prevent a new obstruction of the vessel. This procedure is done through a needle and under local anesthesia. It is very similar to cardiac catheterization, and if there are no complications, you will be at home the next day.

Inflation of the catheter balloon at the plaque level and delivering of the stent

If performing the angioplasty is not possible, your cardiologist will indicate you cardiac surgery. It consists in performing a by pass in the coronary arteries using grafts from the leg veins or other vessels, in order to allow the normal blood flow avoiding the coronary artery obstructions.

In some cases the coronary artery disease can be so severe that neither angioplasty nor surgery are possible. In those cases your cardiologist will probably prescribe you several medications at high doses. Normally, those patients are at high risk of infarction, and have several limitations in their lifes. If they are with angina despite the medication, they are ideal candidates for stem cell therapy. Those cells will create new vessels, so the symptoms and the quality of life are going to be improved, and the risk of myocardial infraction is going to be reduced.