Heart muscle needs oxygen and nutrient rich blood to function properly and it is supplied by coronary arteries. When healthy, the coronary arteries remain strong, elastic and flexible which ensures the blood flow without any restrictions. However, the arterial health is compromised in some situations because of an underlying pathologic process called atherosclerosis which results in the thickening, loss of elasticity and calcification of coronary arteries. So build up of plaques in the coronary arteries coronary artery stenosis obstructs the blood flow to the heart, thereby weakening or damaging the heart muscles and this condition is termed as coronary heart disease or coronary artery stenosis disease (CAD). Whenever there is a partial blockage in blood supply, it leads to angina (chest pain or discomfort), while a complete blockage of blood flow causes myocardial infarction (heart attack).
Coronary Artery Disease treatment mainly includes medications, procedures and surgeries. Even some lifestyle changes can improve the quality of life. Medications are prescribed to treat the risk factors such as blood pressures, diabetes or high cholesterol levels so that it prevents the CAD from getting worse. Surgical options include angioplasty and stenting (Percutaneous Coronary Intervention) or coronary artery disease treatment or Bypass Grafting (CABG). Depending on the severity of coronary lesions, an appropriate treatment plan is chosen by the cardiologist. Several advanced catheterization procedures and imaging techniques guide the interventional cardiologists to assess the physiological significance of lesions. Angiography, Fractional Flow Reserve (FFR), Intra Vascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT) are some of the indispensable tools used in the catheterization laboratory.
Another heart disease that has gained considerable interest in the medical community is coronary microvascular disease (CMD), which particularly occurs in women. Damage or inflammation of the inner walls of the heart’s tiny arteries is the cause of CMD. Though the presence of this dysfunction can have prognostic implications in many heart vv diseases, there are no reliable standard tests available to detect this micrhovascular disease. Diagnostic techniques developed for CAD can’t be used to assess the microvasculature of the myocardium. For now, index of microvascular resistance (IMR) is a method to investigate the microvascular integrity and functional status of micro circulation. So, FFR and IMR measurements taken simultaneously during the catheterization can help in assessing the coronary artery disease and coronary microvascular resistance disease.
