Diffuse Coronary Artery Disease : Causes, Diagnosis, Treatment, Outlook

Coronary artery disease is a condition in which the coronary artery narrows due to the build-up of plaque. These plaques are clumps of cholesterol, fats, blood cells, and other materials. If this condition is not treated, it can lead to a heart attack.

Diffuse coronary artery disease is a less common condition and is a more challenging type of heart disease. In this condition, there are multiple, long, and continuous plaques in the arteries supplying blood to the heart.

The causes of diffuse coronary artery disease are similar to coronary artery disease. The plaque builds up more commonly in the arteries that are damaged by health problems such as high cholesterol levels and high blood pressure.

The risk factors for diffuse coronary artery disease include:

• Diabetes
• Smoking
• Obesity
• Sedentary lifestyle

Diffuse coronary artery disease is a more advanced stage of coronary artery disease, still, sometimes it is difficult knowing that a person is suffering from it. It is just after a comprehensive heart examination or heart attack that a person comes to know about it.

Coronary computed tomography is the main imaging test that helps in confirming diffuse coronary artery disease. In this, a contrast medium is inserted and a CT scan is done to reveal detailed images showing how much the coronary artery has narrowed.

Other imaging techniques used in diagnosing coronary artery disease are:

• X-ray of the chest
• Echocardiogram
• Electrocardiogram
• Exercise stress test and nuclear stress test

Just like coronary artery disease, diffuse coronary artery disease can be treated in different ways including:

• Medication: The mild cases of diffuse coronary artery disease are treated with medications including beta-blockers, statins, high blood pressure drugs, and nitroglycerine.
• Stent Placement: Stents are small flexible tubes that can be placed with a catheter inside the coronary at the blockage site. A study shows that a new generation of drug-eluting stents are there, that are more effective for certain people with coronary artery disease.⁽¹⁾ These stents are coated with medication that is slowly released to prevent the narrowing of the arteries.
• Bypass Surgery: People with diffuse coronary artery disease may benefit from coronary artery bypass surgery, a procedure that takes blood from elsewhere in the body and attaches it to the coronary artery affected with coronary artery disease.⁽²⁾ In the procedure, a graft is attached above and below the narrowed portion of the artery that allows the blood to flow around the section that is blocked by plaque.

Stem cells have the capability of becoming health cells that play a role in replacing the damaged tissue.

A study done in 2020 suggested that people with diffuse coronary artery disease would benefit from this therapy.⁽³⁾

The option depends on the severity of the condition, age, and overall health. A coronary artery, if narrowed by multiple plaques is difficult to treat with stenting and surgery.

A study done in 2019 showed that people with diffuse coronary artery disease benefitted more from surgery than medications.⁽⁴⁾ The mortality rate is 3% for those with surgery and 14% for those taking medication. However, more studies are needed to confirm the role of stem cell therapy in diffuse coronary artery disease.

Also, the outlook of diffuse coronary artery disease is less positive than standard coronary artery disease. Certain people with diffuse coronary artery disease are seen being effectively treated with stents or bypass surgery while a few individuals undergoing life-saving bypass surgery may face a higher mortality rate.

Those at risk of coronary artery disease should speak with the doctor regarding the screening. The sooner the plaques are noticed better the chances of avoiding diffuse coronary artery disease.

Diffuse coronary artery disease can be more life-threatening than other heart diseases. It is important to look for a cardiologist with good experience in managing coronary artery disease. Along with it, it is important to follow a healthy lifestyle and eat a balanced diet to keep the heart-healthy.