What is Coronary Artery Disease (CAD)? 

Coronary artery disease is the leading cause of morbidity and mortality in the world.  

It happens when the blood flow to a section of the heart suddenly stops and the muscle cells do not receive enough oxygen. The cardiac function is reduced or even fails completely. 

A heart attack is caused be a blockage of one or more coronary arteries. Plaque is a buildup of cholesterol, white blood cells, calcium and other substances in the wall of the artery. This phenomena is called coronary artery disease. 

If the heart is severely damaged, even minor stress may overstrain its capacity, causing a potentially fatal heart attack. It is therefore crucial to find and treat the blockage of the blood flow as quickly as possible. 


Blood clot in a coronary artery 

Symptoms of Coronary Disease: 

The symptoms of a heart attack could be very different. They are varying from person to person.

They may develop slowly with mild chest pain and discomfort. They can manifest while you're at rest or active. 

Most heart attacks show a severe and long - lasting retrosternal chest pain. The chest pain may spread to the arms, shoulders, jaw or upper abdomen. The patient may fall in a cold sweat and experience shortness of breath, nausea and fainting. 

Womans often explain a pain in the upper abdomen combined with nausea and vomiting.  

Risk Factors for Coronary Heart Disease:

- High cholesterol 

- Diabetes 

- Smoking 

- High blood pressure 

- Family history of heart disease are higher risk of developing CAD

- Being overweighted

- Climacteric (menopause) may also increase the risk of CAD in woman

How is Coronary Artery Disease diagnosed?

For quickly diagnosing a heart attack, your doctor would typically use an electrocardiogram (ECG). If the electrocardiogram findings confirm a heart attack, the heart's electrical activity will be observed during emergency treatment in order to detect any heart rhythm disorders early. As a second step, the medical team has to find out where the affected section of the heart is and which coronary artery is blocked. To do this, they will perform echocardiography. Coronary arteries are usually examined via minimal invasive catheter technique - called coronary angiography. 

How is Coronary Artery Disease treated? 

- With medications (statin, anticoagulation)

- With an PTCA (percutaneous transluminal coronary angioplasty) or bypass grafts  

What is a Coronary Angioplasty (PCI)? 

Coronary angioplasty is a medical procedure used to treat coronary heart disease. During coronary angioplasty, a small balloon is inserted into one or more of your coronary arteries to open up an area of your arteries that has become very narrow (by plaque including cholesterol, calcium, fatty deposits and other substances). This procedure will improve again the blood flow to your heart muscle cells. 



Coronary angioplasty (PTCA) 


Coronary angioplasty conceptually described by Dotter and Judkins in 1964. 

The first successful percutaneous coronary angioplasty on an awake patient was performed in Zurich by the German cardiologist Andreas Gruentzig on September 16th 1977, Switzerland. 

He expanded a short, about 3mm, non - branching section of the left anterior descending (LAD) artery which supplies the front wall and tip of the heart, which had a high grade stenosis, about 80% of the lumen.

Gruentzig presented the results of his first four angioplasty cases at the 199 American Heart Association (AHA) meeting, which led to widespread acknowledgment of his pioneering work. 

Gruentzig's success remains a major breakthrough and great contribution to the filed of medicine in demonstrating that doctors could work inside of the arteries safely without the need for open surgery.

The vast majority of PCI procedures performed currently involve balloon angioplasty and stent deployment.  

Andreas Gruentzig at USZ, Zurich on September 16th, 1977