Coronary Artery Disease

A sudden and emergency form of CAD. This happens when the blockage or plaque in your coronary artery suddenly ruptures and forms a blood clot that blocks blood flow to the heart. This abrupt blockage causes a heart attack.

A severe form of obstructive CAD, CTO is a condition that occurs with a complete or near complete blockage in an artery for an extended period (90 days or more).

Also called ischemic heart disease, obstructive CAD often develops slowly overtime due to atherosclerosis, the build of cholesterol and fats (called plaque) in and along blood vessel walls. When the vessel becomes so narrow that not enough blood is given to the heart muscle, a heart attack occurs.

This condition occurs when the narrowing of the arteries or blood vessels happens from a cause other than plaque buildup, like coronary vasospasm (blood vessel constrictions or tightening) or endothelial disfunction, damage to the blood vessel lining.

This condition occurs when the inner wall of the coronary artery tears away from the outer wall, blocking blood flow to the heart. This condition often causes sudden heart attack symptoms and is typically considered a life-threatening emergency.

This procedure allows your cardiologist to test pressures inside your heart and look at how the coronary arteries are functioning. To view the arteries, a specialized cardiologist uses an imaging process called coronary angiography where contrast material and x-rays are used to see and photograph areas of the heart’s blood vessels as the contrast moves through. If needed, your cardiologist can also take a biopsy through the catheter as well.

• BayCare Hospital Wesley Chapel
• Bartow Regional Medical Center
• Mease Countryside Hospital
• Mease Dunedin Hospital
• Morton Plant Hospital
• Morton Plant North Bay Hospital
• South Florida Baptist Hospital
• St. Anthony's Hospital
• St. Joseph's Hospital
• St. Joseph's Hospital-North
• Winter Haven Hospital

Also referred to as coronary calcium scan, this non-invasive test uses x-rays from a CT scanner to show calcium and plaque buildup in your coronary arteries, that can narrow the arteries. Cardiac CT scans can be scheduled at a BayCare Imaging Center.

This non-invasive test/imaging study uses sound waves to produce images of the heart's chambers, valves and walls. It helps to show the heart’s overall function and structure. Echocardiograms can be scheduled at a BayCare Imaging Center.

Also referred to as an ECG or EKG, these non-invasive tests measure the heart's electrical activity and helps to show any heart rhythm (arrhythmias) issues and/or heart muscle damage. These tests are often performed in your cardiologist's office.

This test involves exercising on a treadmill, while being closely monitored, to see how well the heart is working. This test measures the heart's response to stress or exercise and can detect any coronary blockages. Stress tests can be performed at the following BayCare hospitals:

• Bartow Regional Medical Center
• Mease Countryside Hospital
• Mease Dunedin Hospital
• Morton Plant Hospital
• Morton Plant North Bay Hospital
• South Florida Baptist Hospital
• St. Anthony's Hospital
• St. Joseph's Hospital
• St. Joseph's Hospital-North
• Winter Haven Hospital

This version of a stress test involves the elements of a regular stress test but adds taking special images of the heart. A nuclear tracer is given through an IV and a special camera takes images of the heart as the tracer moves through it before and after exercise is completed. Nuclear stress tests can be performed by the following BayCare hospitals:

• Bartow Regional Medical Center
• Mease Countryside Hospital
• Mease Dunedin Hospital
• Morton Plant Hospital
• Morton Plant North Bay Hospital
• South Florida Baptist Hospital
• St. Anthony's Hospital
• St. Joseph's Hospital
• St. Joseph's Hospital-North
• Winter Haven Hospital

In this version of a stress test, instead of using exercise to test your heart, medication is given to increase your heart rate. Pharmacologic stress tests are performed under the close supervision of a medical team at these BayCare locations:

• Bartow Regional Medical Center
• Mease Countryside Hospital
• Mease Dunedin Hospital
• Morton Plant Hospital
• Morton Plant North Bay Hospital
• South Florida Baptist Hospital
• St. Anthony's Hospital
• St. Joseph's Hospital
• St. Joseph's Hospital-North
• Winter Haven Hospital

Your doctor may suggest changes to your lifestyle that can help you manage CAD, such as:

• Eating a heart-healthy diet. Your doctor may give you more information about what foods to eat and what to avoid, such as those high in fats, cholesterol or salt (sodium).
• Becoming more physically active and having an exercise routine. Always talk with your doctor before you start a new exercise.
• Quit smoking. Smoking is a major cause of CAD and other forms of heart disease.
• Losing weight or maintaining a healthy weight.
• Avoiding alcohol.
• Getting enough rest and sleep.

Different medications can be used to treat CAD symptoms, and they are usually prescribed or managed by a cardiologist:

• Aspirin: This common medication helps thin the blood and prevent blood clots. It can be used alone or in combination with other medications.
• Angiotensin-Converting Enzyme (ACE) Inhibitors: Drugs that prevent your body from changing the angiotensin hormone to angiotensin II and work by blocking the renin-angiotensin-aldosterone system (RAAS) to create a “widening” or dilating effect on blood vessels. ARC inhibitors may be used if CAD patients have additional conditions such as heart failure, diabetes or kidney disease. 
• Angiotensin II Receptor Blockers (ARBs): For someone with CAD whose blood vessels already have narrowing, this medication works to prevent narrowing the blood vessels as well as keeping salt and fluid from building up in the body. These are often used as an alternative to ACE inhibitors.
• Beta Blockers: Drugs that can help widen the blood vessels and help the heart beat slower.
• Calcium Channel Blockers: Medications that block calcium to relax the muscles in the blood vessels.
• Cholesterol lowering medications: These drugs are used to lower LDL cholesterol, preventing it from building up and forming plaque in the blood vessels.
• Nitroglycerin: This medication relaxes and widens blood vessels. It’s often prescribed to help relieve or prevent chest pain for non-obstructive CAD.

Commonly known as angioplasty, percutaneous coronary intervention (PCI) is a minimally invasive procedure used to open blocked or narrowed heart arteries and restore blood flow to the heart. During the procedure, a catheter is inserted into the blocked artery. An interventional cardiologist uses the catheter to place a balloon or an intracoronary stent to widen the artery. Many of our BayCare Hospitals perform PCI procedures:

• Mease Countryside Hospital
• Morton Plant Hospital
• Morton Plant North Bay Hospital
• South Florida Baptist Hospital
• St. Anthony's Hospital
• St. Joseph's Hospital
• St. Joseph's Hospital-North
• St. Joseph's Hospital-South
• Winter Haven Hospital

PCI for Chronic Coronary Total Occlusion (CTO): BayCare has specialists skilled in performing PCI for CTOs. This treatment is available at the following BayCare locations:

• Morton Plant Hospital
• St. Joseph's Hospital
• Winter Haven Hospital

For people who have previously undergone PCI to clear a blocked blood vessel, a small percentage may experience "restenosis," where the vessel or stent begins to narrow again. This additional narrowing is often due to the formation of scar tissue. In such cases, IVBT may be considered as an additional treatment option. IVBT is a specialized procedure in which an interventional cardiologist, a radiation oncologist, and a radiation physicist collaborate to deliver targeted radiation through a catheter to the area of restenosis (re-narrowing). This radiation helps to inhibit the growth of scar tissue. IVBT is performed at the below BayCare location:

• Winter Haven Hospital

A coronary IVL procedure uses soundwaves to help break up calcium in narrowed or blocked blood vessels. A special catheter with a saline-filled balloon is inserted, and sonic sound waves are emitted to break up the calcium. This procedure can be performed on its own or alongside a PCI stenting procedure. Coronary IVL is performed at the below BayCare locations:

• Bartow Regional Medical Center
• Mease Countryside Hospital
• Morton Plant Hospital
• Morton Plant North Bay Hospital
• South Florida Baptist Hospital
• St. Anthony's Hospital
• St. Joseph's Hospital
• St. Joseph's Hospital-North
• St. Joseph's Hospital-South
• Winter Haven Hospital

Atherectomy is a catheter-based procedure used to open blocked or narrowed blood vessels by removing the plaque buildup with special cutting devices or lasers. This minimally invasive procedure is available at the following BayCare Locations:

• Morton Plant Hospital
• St. Joseph's Hospital
• Winter Haven Hospital

Coronary artery bypass grafting (CABG) is a type of open-heart surgery that improves blood flow to the heart by redirecting blood flow around the blocked or narrowed coronary arteries that supply blood to the heart. CABG is the most common form of open-heart surgery. BayCare has three top-rated, high quality open-heart surgery programs at the following locations:

• Morton Plant Hospital
• St. Joseph's Hospital
• Winter Haven Hospital