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Multivessel heart disease requires a multifaceted treatment approach.
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Coronary heart disease causes blockages in the blood vessels that bring blood to the heart. Without treatment, coronary heart disease can lead to a heart attack. Most people have three major coronary arteries that supply blood to the heart. When more than one artery is affected by blockages, a person is said to have multivessel heart disease. Multivessel heart disease puts more of the heart muscle at risk for a heart attack and typically has to be treated more aggressively than single-vessel disease.
Multivessel Coronary Disease
Coronary heart disease, also called coronary artery disease, develops due to a buildup of cholesterol and other fatty substances in the blood vessels that supply the heart. These blockages, known as plaques, promote the formation of blood clots that can further obstruct blood flow and cause a heart attack. While anyone can develop multivessel heart disease, people with diabetes are at particularly increased risk. Chronically elevated blood sugar leads to inflammatory changes in the blood vessels that contribute to coronary heart disease at an early age. Smoking, high blood pressure and high cholesterol are other leading risk factors for coronary disease.
Multivessel heart disease often comes to light first on an electrocardiogram, or EKG. An EKG displays the electrical activity of the heart and can indicate areas of the heart that have received inadequate blood flow. Likewise, an echocardiogram, or ultrasound of the heart, may reveal evidence of multivessel heart disease. During a cardiac catheterization, doctors take pictures of the coronary arteries using special x-rays. This procedure allows doctors to confirm the diagnosis of multivessel heart disease.
Without treatment, multivessel heart disease can eventually lead to a massive heart attack. People with multivessel heart disease are also at risk for a disorder known as ischemic cardiomyopathy. This condition is characterized by heart muscle weakness due to a chronic lack of blood flow. In some cases, ischemic cardiomyopathy does not cause obvious symptoms. In other cases, however, profound shortness of breath may develop as a result of heart failure. In severe instances, multivessel heart disease can cause the heart to become so weak that blood pressure drops abruptly and other organs begin to fail, a condition called cardiogenic shock.
Dietary changes and medications to address risk factors, including high blood pressure, abnormal cholesterol levels and diabetes, are critical for treating multivessel heart disease. Most people with this disease also benefit from taking a daily aspirin to reduce heart attack risk. Quitting smoking and avoiding secondhand smoke are imperative for preventing progression of multivessel heart disease.
When someone with multivessel heart disease develops symptoms, such as chest pain and shortness of breath, treatment with angioplasty or coronary artery bypass surgery may be considered. During angioplasty, doctors insert a tiny balloon into an artery in the leg or arm and thread it into the heart. The balloon is then inflated to compress blockages in the coronary arteries. Small mesh stents may also be placed to keep the arteries open. With coronary artery bypass surgery, surgeons use blood vessels from other parts of the body to reroute blood around blocked coronary arteries. Age and the presence of other medical conditions, including diabetes, are taken into account when deciding on the best strategy to address multivessel heart disease.