can show which parts of the heart may receive less
blood flow than normal.Angiogram. This is an x ray of the heart taken when a
small tube, or catheter, is inserted into the arteries
through a blood vessel in the groin or arm. The tip of
the catheter can be guided to the coronary arteries
and contrast is released. The contrast will be visible
on x rays and will help show blood flow in the heart’s
chambers. Today, angiograms can be performed
through the use of contrast and imaging with com-
puted tomography or magnetic resonance imaging.
Computed tomography (CT) scan. A CT scan, which
is a cross-sectional x ray of the body or an organ of
the body, can show images of the arteries to deter-
mine atherosclerosis. Ultra-fast CT imaging also can
detect calcium within plaque.
Magnetic resonance imaging (MRI). This noninva-
sive method may be used to examine the tissues of the
heart. MRI uses no radiation. Magnetic resonance
angiography provides an alternative to the more
invasive method that involves introducing a catheter
into the body.
Other imaging methods may be used to detect coro-
nary heart disease, such as single photon emission
computed tomography (SPECT).
Treatment
There are many ways to treat coronary heart dis-
ease, and the choice of treatment depends on the cause
of the disease and its severity. Treatment ranges from
lifestyle changes and use of medication to surgical
procedures. People with less severe disease and fewer
risk factors may be able to manage their disease
through lifestyle changes and drug therapy. Changes
in diet and an increase in exercise, as well as quitting
smoking, can gain control of coronary heart disease.
Often all treament procedures are used. Lifestyle fac-
tors such as diet and exercise are first line prevention
and treatment methods. They are to be continued even
after beginning medications and following surgery.
Medications used to treat coronary heart disease
include:
cholesterol-lowering medicines such as statins and
fibrates
blood thinners, or anticoagulants, to prevent blood
clots from forming
aspirin, also to help prevent clotting
blood pressure medicines to lower blood pressure, such
as angiotensin-converting enzyme (ACE) inhibitors
calcium channel blockers, to relax blood vessels and
lower blood pressure
beta blockers to slow heart rate and lower blood
pressure
Surgery or other procedures also may be recom-
mended to treat coronary heart disease. A physician
may be able to use a catheter to guide a tiny balloon
into the artery. Once in place, the balloon is inflated
and used to widen the artery by pushing the plaque up
against the artery wall, Next, a stent, or mesh tube, is
placed in the widened area to help keep the artery
opened and clear for adequate blood flow.
Coronary artery bypass surgery reroutes, or
bypasses, blood flow around the arteries that have
clogged to improve blood flow to the heart. To per-
form the procedure, the surgeon takes a healthy blood
vessel from another part of the body and uses it to
create a detour around the clogged artery. This proce-
dure requires open heart surgery and is reserved for
people with multiple areas of artery blockage.
Heart attacks from coronary heart disease require
emergency medical treatment.Nutrition/Dietetic concernsNutrition is key to preventing and controlling
coronary heart disease. The American Heart Associa-
tion recommends that adults get no more than 300 mg
of cholesterol a day in their diet and that those with
heart disease get no more than 200 mg a day. It also is
important to limit cholesterol that comes from animal-
based foods and from saturatedfats. All animal foods
contain some cholesterol, so eating lean meats, fish,
and poultry in smaller servings helps to control the
amount eaten. Eating fat-free or low-fat dairy prod-
ucts also helps keep cholesterol and fats in check.
Controlling blood pressure helps prevent or man-
age coronary heart disease. A diet low in salts and high
in fruits, vegetables, and whole grains helps to control
blood pressure. TheDASH dietis a balanced approach
to controllinghypertension.
Eating lots of sugars and simplecarbohydrates
can lead to or complicate diabetes and affect triglycer-
ide levels, increasing risk of coronary heart disease. It
is important for people with diabetes to control their
intake of white bread, bagels, cakes, soft drinks, and
other carbohydrates. Studies show that whole-wheat
breads, brown rice, and legumes are healthier choices
to provide carbohydrates andproteinin the diet. Even
people with coronary heart disease who do not have
diabetes should try to eat the recommended daily
amounts of grains and fats and to get them from
whole grains when possible.Coronary heart disease