Your Virtual Pharmacist Guest Post: Coronary Artery Disease

[youtube] You are in a hospital room and overhear the physician say the word (or you think it's a word) "STEMI." What exactly does this mean? Coronary artery disease and it's consequences do not have to be a foreign language.

First of all coronary artery disease is just a fancy term for heart disease. Basically, when the choloesterol is high, plaque is able to be formed and gathers in the heart arteries (or coronary arteries). When this plaque is growing, it can form a clot due to attracting platelets that are gathering to try to heal or fix the plaque. This platelet rich clot grows to the point of stressing the heart whether completely or incompletely.

There are currently three different types of CAD (coronary artery disease) types. The least invasive is UA or unstable angina. Basically angina means heart pain. The second is called NSTEMI or non S-T wave elevation myocardial infarction. The third is called STEMI or S-T wave elevation myocardial infarction.

UA and NSTEMI present the same. Both with chest pain. The difference between the two is that NSTEMI has coronary markers or troponin involved. UA does not. NSTEMI is a clot that is not complete. STEMI, on the other hand, is a complete clot and more of an emergency because cell death is happening in the heart muscle. With no blood flow down a coronary artery, the heart muscle is dying. When the heart muscle cells begin to die due to lack of oxygen and blood, the heart cannot function properly and will go into erratic rhythms. Most of the time, this is what causes death.

The difference between NSTEMI and STEMI is the S-T elevation in the heart waves. S-T elevation signifies cardiac cell death and is a more serious event.

The reason why your doctor will always give you aspirin is due to aspirin's anti-platelet effects. Aspirin is a wonderful drug in that it targets that platelet rich clot that is forming in your coronary arteries and helps to prevent a heart attack. It is also the FIRST thing that you should take if you feel the symptoms of a heart attack coming on... aspirin 81 mg. Well, that and if you have a nitroglycerin sublingual tablet and get to the emergency room fast!

The goal is to prevent these events from happening in the first place. The statins are a class of drugs that help to reduce cholesterol, specifically LDL in the bloodstream to prevent these clots from forming (Lipitor, Pravachol, Zocor, etc... ). Diet and exercise are the best to try first.

I hoped this helped to clear up some of the more complex terms of coronary artery disease.

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