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Atherosclerosis / Coronary Artery Disease

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This condition happens when the inner walls of arteries become narrower due to a buildup of plaque. The plaque is a sticky substance often caused by a diet high in fat, cigarette smoking, diabetes or hypertension. This buildup makes it harder for blood to flow through arteries, resulting in the body working harder to get enough oxygen to critical organs. It can cause chest pain, shortness of breath and eventually, heart attack, stroke, or painful extremities. Luckily you came to the University of Miami Health System, where specialists are leading the way in prevention, diagnosis, and treatment.

At UHealth, you have the benefit of multidisciplinary clinics specifically set up to manage your atherosclerosis:

  • Center for Advanced Coronary Revascularization and Chronic Total Occlusion
  • Center for Heart Disease Prevention
  • Center for Diabetes and Heart Disease
  • Center for Women’s Heart Disease

Tests

Blood Tests
Tests such as lipid and metabolic panels check for abnormal levels of certain fats, cholesterol, sugar, and proteins in your blood that may indicate risk factors for atherosclerosis.

Electrocardiogram (EKG)
An EKG is a simple test that detects the electrical activity of the heart and shows how fast the heart is beating, its rhythm and the strength and timing of electrical signals as they pass through each part of the heart. Certain electrical patterns can suggest whether coronary artery disease is likely, as well as show signs of a previous or current heart attack.

Chest X-ray
A chest x ray takes a picture of the organs and structures inside the chest, including the heart, lungs, and blood vessels; and can also reveal signs of heart failure.

Ankle/Brachial Index
This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. Difference in pressures can help diagnose peripheral artery disease (PAD).

Echocardiography
Sound waves create a moving picture of your heart and provide information about the size and shape of your heart and how well your heart chambers and valves are working. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow.

Computed Tomography (CT) Scan
This imaging test creates computer-generated images of the heart, brain, or other areas of the body; and can often show hardening and narrowing of large arteries.

Stress Testing
When the heart is beating fast and working hard, it needs more blood and oxygen and arteries narrowed by plaque cannot supply enough oxygen-rich blood to meet the heart's needs. Stress tests can be done with echocardiography to observe the way the heart works immediately after exercise. It may also be done with nuclear imaging, which helps your doctor see how much blood is flowing to different parts of the heart.

Coronary CT Angiography
This is the most frequently used test to directly show blocked arteries supplying the heart muscle. A special injected dye shows arteries and any blockages on a monitor.


Treatments

Statins
A group of drugs called “statins” are commonly used to reduce risk of heart attack and stroke. They also lower blood cholesterol. This category of medicine has a long track record of safety and is usually the first medicine prescribed for patients who have high blood cholesterol that is inadequately lowered by diet and exercise.

Cholesterol Absorption Inhibitors
These drugs lower your cholesterol by limiting your body’s absorption of dietary cholesterol and making more "parking spots" available in the liver to remove cholesterol from the circulation. They are sometimes combined with statins for extra heart attack and stroke prevention.

Bile-Acid-Binding Resins
These medications trap bile from the intestines and prevent the cholesterol in bile from re-entering circulation. This process also opens up new "parking spots" in the liver to remove excessive cholesterol from your circulation.

PCSK9 Inhibitors
These drugs are injectable medicines that help to lower cholesterol in people with very high cholesterol levels that are too high for diet and oral medicines to adequately lower circulating cholesterol.

Fibrates
These medications lower high triglyceride levels in your blood. Triglycerides are fats that provide energy for muscle activity and are used by the body to store energy in case of starvation. Levels of triglycerides that are too high can increase heart attack and stroke risk.

Omega-3 Fatty Acids
Some of these are available over the counter and others by prescription. They are commonly used to lower very high triglycerides in the circulation.

Niacin
This B vitamin increases the level of HDL cholesterol, but there is very little evidence that it provides benefits in preventing heart attacks


Why Choose UHealth?

Advanced heart failure therapies. Leading edge treatments include ventricular assist devices and heart transplant. For advanced heart disease, options for treatment go beyond what is available in the community to prolong life and give you or your loved one a second chance.

Multidisciplinary care by recognized specialists in their field.  In complex cases, heart disease care may require the services of a cardiothoracic surgeon, an interventional cardiologist, a lung specialist, a diabetes specialist and a geneticist. Your doctors talk to each other and make sure all specialties involved in your care are on-board with a unified treatment plan.


HeartAware: Free on-line health risk assessments that may save your life

Female doctor talking to a femail patient

Over 80 million American adults (more than one in three) have cardiovascular disease (CVD). Nearly 2,300 Americans die of CVD every day — that’s one death every 38 seconds. This number can be significantly reduced through education and early detection.


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