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Coronary Artery Disease: How Modern Technology is Bringing a Brighter Future

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For 45-year-old Kavita, climbing a short flight of stairs became a task as it made her breathless and completely exhausted.

Her medical history and diagnostic tests revealed pre-existing co-morbidities such as high cholesterol, high blood pressure and diabetes that triggered plaque build-up and blockages in her coronary artery.

Given the progression of her condition, the doctor carried a minimally invasive procedure called Optical Coherence Tomography (OCT) to understand the appropriate treatment route.

Based on the microscopic images provided by the procedure, the doctor decided that stenting was required.

Kavita is not alone.

Coronary artery disease, that restricts the flow of oxygen-rich blood to the heart and other organs, is one of the leading causes of mortality in India that affects 272 people per 100, 000 population which is higher than the global average of 235 per 100,000.
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For such people, coping with the disease can be frustrating.

However, advanced procedures such as OCT are helping doctors to get accurate images of blood vessels, resulting in better patient outcomes.

This technology assists in 3D visual assessment of the blood vessels and helps in the right assessment of the lesion.

It which uses light to obtain images of the blood vessels.

During the procedure, a beam of light is directed at the artery and some of the light is scattered whereas some of it reflects from inside the artery tissue.

The smallest amount of reflected light that does not scatter can be detected and used to form the image of the artery.

High resolution imaging of the blocked coronary artery is crucial to recognise the vulnerable plaques that can cause acute coronary events and sudden death.

Based on the OCT images, the doctor can decipher if stenting is required to ensure a seamless flow of the blood.

It enables the doctor to clearly view the plaque inside the artery, find out how much clot or fat is deposited, and based on how calcified the artery is, accurate measurements can be taken before and after stent placement.

Helping doctors at the point of care, OCT gives a 3D view of the artery, addressing the challenges faced while using angiography that gives only a two-dimensional view of the coronary artery.

Credit it to years of research by scientists, whether it is the assistance doctor needs in selecting the stent or risk assessment, cutting-edge imaging technologies are opening new frontiers in cardiac care today.

Living a Heart-Healthy Life with Coronary Artery Disease

Sophisticated imaging breakthroughs are certainly critical for a country like India that has been battling its cardiovascular disease (CVD) burden for decades.

However, patients can live a heart-healthy life by making certain lifestyle changes as well, that can prevent build-up of plaque, decrease damage to the blood vessels and reduce the risk of heart attack and stroke.

These include, maintaining a healthy weight with exercising for at least 30 minutes a day for 5 days a week, consuming alcohol in moderation, quitting smoking, and doing stress management exercises.

If you have diabetes, keep it under control by lifestyle modification & medication that means keep your HbA1c between 6-7.

If you have Hypertension, keep it under control by adopting healthy lifestyle and medicines if needed. Good control means keeping your BP below 130/80.

For severe cases of coronary artery disease, technologically enabled procedures of heartcare such as OCT that eliminate the need of open-heart surgeries are bringing respite to many patients.

However, for minimally invasive treatment options, there lies a challenge – adoption of these today and in the future.

Therefore, our pivot agenda should be to build a conducive environment with high-tech to transition to a health ecosystem that is patient centric, information rich, and connected.

(Dr. Tarlochan Singh Kler is the CHAIRMAN of Fortis Memorial Research Institute, Gurugram.)

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