Multivessel Coronary Artery Disease: Causes, Symptoms, Treatment, Diagnosis, Prognosis

Multivessel coronary artery disease is a type of coronary artery disease in which several major arteries are affected. Coronary artery disease is the most common type of heart disease and the most common cause of mortality.^{(1, 2)} It occurs due to excess plaque build-up in the arteries making it hard for the blood to circulate affecting the supply of oxygen and nutrients to the heart muscle. This is known as atherosclerosis.

Multivessel coronary artery disease arises when plaque builds up in the coronary artery. This can be due to several reasons. Those at increased risk of coronary artery disease include people with:

• Older age
• Obesity
• High blood pressure
• Diabetes
• Family history of coronary artery disease
• Menopause
• History of smoking tobacco or current smokers
• Chronic inflammatory conditions including rheumatoid arthritis, lupus and HIV.

The symptoms of coronary artery disease depend on the severity of the disease and other health problems.

Those with stable multivessel coronary artery disease develop symptoms during exercise. Angina or chest pain is the most common symptom of coronary artery disease along with breathlessness.

The characteristics of chest pain may include:

• Worsening with emotional stress
• Rest or nitroglycerine can intensify the pain
• Radiation of the pain in the neck and left arm
• Pain starting from the sternum along with a feeling of discomfort and pressure
• Suffering from lightheadedness, nausea or sweating
• Elderly individuals may experience discomfort in the upper abdomen and vomiting. It is common in older people with diabetes.

There are various methods that can be used to diagnose multivessel coronary artery disease.⁽²⁾

ECG is performed to monitor the activities of the heart and circulatory system.

An echocardiogram is done in which ultrasound waves are used to create pictures of the heart. The images are used to examine the functioning of the vessels of the heart.

Other imaging techniques include coronary angiography in which x-rays are used to take the image of a person’s blood vessels.

A stress test is another test that is useful in monitoring a person’s heart rate, blood pressure, and heartbeat while exercising on a treadmill. The result can be helpful in assessing if the artery is blocked.

It is essential that these tests are performed by the suggestion of professionals. It is important to seek professional help if any artery blockage symptoms are experienced.

There are several treatment options that can be considered for multivessel coronary artery disease.

In coronary artery disease, it gets harder for the blood to reach various organs in the body. Doctors consider stenting to allow more blood to reach the organs.⁽³⁾ This is referred to as revascularization.

Revascularization can be useful as it reduces mortality in many individuals. It can be effective alongside lifestyle changes and other medical treatments.

According to a review, significant lifestyle modification and medical therapy can be helpful in treating coronary artery disease.

Lifestyle changes include:

• Stopping smoking
• Exercise
• Reducing alcohol intake
• Reducing salt intake
• Losing weight

There are medical therapies that can be helpful in multivessel coronary artery disease. These include:

• Antiplatelet drug therapy, in which aspirin can be given to allow blood to flow more easily through the arteries
• Beta-blockers, help in managing angina symptoms
• Statin therapy helps in reducing lipid levels and inflammation

The severity of the disease is assessed by the healthcare professional and the treatment plan is made.

The prognosis for people suffering from coronary artery disease depends on the severity of the condition and also the presence of other health conditions.

The prognosis is known to be worse in females than in males.⁽²⁾

In multivessel coronary artery disease, enough blood is blocked from reaching the heart, there are more chances of acute heart attack that can have a mortality rate of 5-30%.⁽⁴⁾

Multivessel coronary artery disease is a serious condition involving two or more large coronary arteries due to plaque build-up. People with this condition are at an increased risk of a heart attack. To improve the outlook for this condition it is important to bring in lifestyle changes such as exercising more, losing weight, and stopping smoking along with the medical treatments.