Coronary artery disease refers to blockages in the arteries that feed the heart, that tend to develop over many years and decades. These blockages can cause chest pain (angina) and can also cause myocardial infarction (heart attack), which is when an area of the heart is acutely deprived of its necessary blood supply. A myocardial infarction can be life-threatening and can cause permanent damage to the heart muscle. This damage can cause scarring of the heart muscle and may cause weakening of the heart pumping function and lead to CHF.
Blockages can be detected non-invasively by stress testing, or invasively by cardiac catheterization. A catheterization is when small thin tubes (catheters) are passed up to the heart through blood vessels, using a small hole next to the groin. These catheters are used to take angiograms (pictures) of the coronary arteries, and to assess the function of the heart valves.
A blockage can be treated with medicines, with coronary artery stenting during a cardiac catheterization (using an inflatable balloon to break open the blockage), or with surgery known as CABG. This is open-heart surgery and involves sewing a grafted vessel (or re-routing a chest wall artery) onto the affected coronary artery to “bypass” the blockage, and re-route the blood flow around the blockage.
Coronary artery disease medical expert witness specialties include cardiology, interventional cardiology, cardiovascular surgery, pathology, cardiac electrophysiology, cardiac anesthesiology, internal medicine, and family medicine.