Cardiologist warns young adults of diffuse coronary artery disease

Heart diseases are increasing among young adults. 

While common cardiovascular conditions, such as high cholesterol or irregular heartbeats, are widely known and can lead to heart attacks, there's one type of heart disease that's surging among young adults, where the artery blockages are spread throughout.

Dr Surinder Bazaz, senior director of cardiac surgery at Medanta –The Medicity, shared with HT Lifestyle that when the blockage is spread all over the artery, it is called diffuse coronary artery disease (CAD).

The blockage formation of this disease is more concerning, as the cardiologist noted, "Of particular concern is diffuse coronary artery disease, a form in which blockages are spread all along the length of the arteries rather than being confined to discrete points. This pattern makes treatment more complex and outcomes potentially more serious. In diffuse disease, these plaques are distributed extensively along the vessel length, often affecting multiple branches."

The plaque buildup inside the heart's arteries makes them narrow and reduces the blood flow. The cardiologist further added that in diffuse CAD, the blockages are alarmingly spread over and sometimes may even affect multiple branches. Regular blockages are more confined to one spot, easier to treat with stents or bypass surgery, but diffuse coronary artery disease is harder to treat because it affects many branches.

The treatment of this disease is complicated, as Dr Bazaz elaborated, "The narrowing is widespread, limiting the feasibility of stenting. Secondly, surgical bypass options may be restricted due to the lack of suitable healthy vessel segments. Medical therapy becomes the mainstay, but disease progression can still be aggressive." It shows the urgency for early detection and prevention by changing lifestyle habits.

Dr Surinder Bazaz shared a guide, covering symptoms, reasons and management for this disease:

Symptoms

• Symptoms are often late.
• Early symptoms like mild chest discomfort, fatigue, or shortness of breath are ignored.
• By the time diagnosis is made, the disease may be advanced, with multiple arteries affected.
• Top reasons why the younger population is at risk

1. Lifestyle and dietary habits

• Modern urban lifestyles often involve high stress, irregular sleep, and reduced physical activity.
• Diets rich in processed foods, refined carbohydrates, and unhealthy fats contribute to early arterial damage.
• Fast food consumption, high in trans fats and sodium, accelerates plaque formation.

2. Smoking and tobacco use

• Cigarette smoking, as well as smokeless tobacco, significantly increases the risk of early-onset CAD.
• Tobacco damages the endothelium (inner lining of blood vessels), promotes inflammation, and accelerates plaque buildup.

3. Metabolic disorders

• Conditions such as diabetes mellitus, hypertension, and dyslipidemia are increasingly seen in younger age groups.
• Poorly controlled blood sugar and lipid levels directly contribute to arterial damage and diffuse plaque formation.

4. Genetic and family history

• A strong family history of premature heart disease increases risk, particularly when combined with lifestyle-related factors.
• Genetic predisposition can make arteries more vulnerable to early atherosclerosis.

5. Environmental and food safety concerns

• The rising incidence of certain malignancies and chronic diseases has been linked to environmental toxins, including pesticides in food.
• Prevention and management tips

Prevention

• Early screening for cardiovascular risk factors in individuals as young as their 20s
• Education on the dangers of smoking, unhealthy diets, and sedentary lifestyles, and encourage a healthier lifestyle.

Management

Medical therapy: Antiplatelet agents, statins, beta-blockers, and medications to control blood pressure and blood sugar.

Lifestyle changes: Adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins; avoiding processed and pesticide-laden foods; quitting smoking; and engaging in regular physical activity.

Interventional options: In select cases, advanced techniques such as drug-eluting stents for long lesions or hybrid surgical approaches may be considered, though these are technically challenging.

Surgical options: In select cases, surgery is also required to treat diffusely diseased patients with coronary artery disease. Some of these patients with diffused disease require endarterectomies. In some patients with good vessels, total arterial grafting is also considered.

Monitoring and follow-up: Regular cardiac check-ups, lipid monitoring, and stress testing to track disease progression.