Coronary Artery Disease: An Interview with Dr. Nazzaro
Coronary artery disease, or CAD, is the most common form of heart disease and can significantly reduce the supply of oxygen to the heart, thus increasing the risk of severe events. If not properly managed, CAD is the leading cause of clinical conditions such as silent ischemia, angina pectoris, acute coronary syndrome (unstable angina and myocardial infarction), and sudden cardiac death.
We asked Dr. Marco Stefano Nazzaro, a medical doctor and specialist in cardiology and interventional cardiology at UPMC Salvator Mundi International Hospital, to explain what coronary artery disease is, its causes, symptoms, the available treatments and, most importantly, how to prevent it.
Dr. Nazzaro, What is a Coronary Artery Disease?
Coronary artery disease is one of the leading causes of mortality worldwide, both in industrialized and emerging countries. In order to give you a sense of the seriousness of this issue: in 2021, around 64,000 deaths due to Covid-19 were recorded in Italy, but in the same year over 217,000 people died from cardiovascular causes.
CAD involves the narrowing of the coronary arteries, the vessels that carry blood and oxygen to the heart. When this blood flow is reduced, the heart muscle suffers, risking irreversible damage (necrosis).
What Causes It? What Are the Main Symptoms?
The causes of coronary artery disease include both non-modifiable risk factors (age, sex, genetics, family history) and modifiable ones such as:
- Poor diet.
- High cholesterol.
- Smoking.
- High blood sugar.
- Obesity.
- Sedentary lifestyle.
Symptoms are not always obvious: the classic chest pain, or discomfort in the neck and jaw, may not necessarily occur. Some patients discover the disease only after an acute event.
Early diagnosis is essential and it is based on basic tests (EKG, blood tests) and advanced investigations such as coronary CT scan or coronarography.
What Treatments Are Available for Coronary Artery Disease?
Treatment may be:
- Pharmacological: with medications that improve circulation and reduce the heart’s workload.
- Mechanical: with coronary angioplasty(revascularization using a stent) or coronary bypass surgery.
These two options can be combined for a personalized therapy.
Coronary angioplasty is a minimally invasive procedure that lasts about30-50 minutes, typically requires just one night of hospitalization, and allows for a quick recovery. However, not all patients are suitable candidates: evaluation by an interventional cardiologist is essential.
Can Coronary Artery Disease Be Prevented?
Cardiovascular prevention is our most effective ally. Regular check-ups with a general practitioner or cardiologist can help to:
- Adopt a healthy lifestyle habits (balanced diet, physical activity, quit smoking).
- Intervene early with targeted treatments.
- Monitor risk factors (cholesterol, blood sugar, blood pressure).
This approach can drastically reduce the incidence of heart attacks, cardiac arrests and sudden deaths.
To Summarize, What Is the Key Message You'd Like to Convey?
Don't wait for symptoms. Coronary artery disease may be silent but deadly. Today we have effective tools to diagnose and treat it promptly. The key is prevention, with regular check-ups and proper management of risk factors.