Coronary Artery Bypass Graft - Causes

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How does coronary artery disease develop?

Coronary artery disease (CAD) occurs when atherosclerotic plaque (hardening of the arteries) builds up in the wall of the arteries that supply the heart. This plaque is primarily made of cholesterol. Plaque accumulation can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. Patients are also at higher risk for plaque development if they are older (greater than 45 years for men and 55 years for women), or if they have a positive family history for early heart artery disease.

The atherosclerotic process causes significant narrowing in one or more coronary arteries. When coronary arteries narrow more than 50 to 70%, the blood supply beyond the plaque becomes inadequate to meet the increased oxygen demand during exercise. The heart muscle in the territory of these arteries becomes starved of oxygen (ischemic). Patients often experience chest pain (angina) when the blood oxygen supply cannot keep up with demand. Up to 25% of patients experience no chest pain at all despite documented lack of adequate blood and oxygen supply. These patients have "silent" angina, and have the same risk of heart attack as those with angina.

When a blood clot (thrombus) forms on top of this plaque, the artery becomes completely blocked causing a heart attack.

Heart Attack illustration - Coronary Artery Bypass Graft Surgery
Heart Attack illustration - Coronary Artery Bypass Graft Surgery

When arteries are narrowed in excess of 90 to 99%, patients often have accelerated angina or angina at rest (unstable angina). Unstable angina can also occur due to intermittent blockage of an artery by a thrombus that eventually is dissolved by the body's own protective clot-dissolving system.

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Comment from: countgermaine, 55-64 Male (Patient) Published: October 21

Family history of heart disease, smoking tobacco and marijuana heavily for many years, prolonged emotional stress, and poor diet caused me to need a coronary artery bypass graft.

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Comment from: DotDotDot, 45-54 Male (Patient) Published: November 03

I am a female in my 20s who doesn't exercise at all but eats decently. I started to suffer from recurring hemorrhoids randomly a year ago and it was so painful I would wake up from my sleep. It was painful in any position, sitting down, standing up, and lying on bed (side way, face up, face down, etc.) Walking around did seem to help, however. In the beginning, I used Vaseline to seal minor bleeding and tear. For pain, I took Advil or acetaminophen. Then, I purchased witch hazel wipes, which were helpful to reduce swelling. I use both Tucks (smaller sheets but more moist) and Preparation H (larger sheet but kind of dry). I prefer Tucks. I also purchased suppositories but found it painful to insert it. I am now going on a 100 percent cold-pressed juice diet and drinking 3 L of water per day to clean and rest my gastrointestinal tract. Hopefully, hemorrhoid will be gone for good!

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