Triple Vessel Coronary Artery Disease: What It Is & How It’s Treated

Heart disease is among the most prevalent health issues globally, and coronary artery disease (CAD) is a common cause of heart disease. CAD results from narrowing or obstruction of the arteries supplying oxygenated blood to the heart as a consequence of plaque deposits. Triple Vessel Coronary Artery Disease (TVCAD) results when all three large coronary arteries are involved.

TVCAD is a very serious type of coronary artery disease, as it severely limits the flow of blood to the heart and poses an increased risk for heart attacks and heart failure. Knowing what triple vessel coronary artery disease is, its causes, symptoms, and treatments, can assist patients in taking the proper measures for the health of the heart.

What is Triple Vessel Coronary Artery Disease?

Triple Vessel Coronary Artery Disease (TVCAD) is the condition in which all three main coronary arteries – the left anterior descending (LAD) artery, right coronary artery (RCA), and left circumflex artery (LCX) – are blocked to some extent. This decreases the supply of blood to the heart muscle and puts the patient at a higher risk of severe cardiac complications.

Because more than one artery is involved, TVCAD is more severe than double or single vessel disease. The occlusion results in pain in the chest (angina), shortness of breath, and, in the worst-case scenario, a heart attack.

Causes of Triple Vessel Coronary Artery Disease

The major reason for coronary artery disease and TVCAD is atherosclerosis, which is a condition where fatty substances (plaque) accumulate within the arteries, narrowing them and limiting blood flow. The following factors contribute to this:
High cholesterol levels that cause plaque buildup.

• High blood pressure (hypertension), which weakens artery walls.
• Smoking, which speeds up the damage to the arteries.
• Diabetes, which raises the risk of vascular diseases.
• Obesity, which adds additional stress to the heart.
• Sedentary lifestyle, which contributes to poor heart health.
• Family history of heart disease, increasing genetic risk.
• Poor diet, particularly one that is high in saturated fats and sugars.
• Chronic stress, causing hormonal imbalance that influences the heart.

These risk factors, when present persistently, result in gradual narrowing of the arteries, giving rise to triple vessel coronary artery disease.
 

Symptoms of Triple Vessel Coronary Artery Disease

The signs and symptoms of TVCAD are comparable to other types of coronary artery disease but are more intense and long-lasting. They are characterized by:

• Chest pain (angina) – Pressure-like or squeezing pain in the chest, particularly with exertion.
• Shortness of breath even on minimal exertion.
• Fatigue caused by inadequate oxygen supply to the body.
• Dizziness or lightheadedness, particularly with exertion.
• Shoulder, arm, neck, or jaw pain, which is often confused with muscle pain.
• Irregular heartbeat (arrhythmia), which may result in palpitations.
• Swollen legs or feet, showing signs of heart failure in advanced stages.

These get aggravated with time if not treated and may cause a heart attack or heart failure.
 

Diagnosis of Triple Vessel Coronary Artery Disease

Early treatment of coronary artery disease is vital. To establish TVCAD, physicians employ some tests:

1. Electrocardiogram (ECG)

An ECG identifies abnormal heart rhythms and symptoms of inadequate blood flow.

2. Stress Test

A treadmill or exercise test assesses heart function under conditions of stress.

3. Echocardiogram

This ultrasound examination tests heart size, shape, and blood flow.

4. Coronary Angiography (Gold Standard Test)

A coronary angiogram employs a special dye that is injected into the arteries to identify blockages on an X-ray. When all three large arteries are largely blocked, the patient is diagnosed with triple vessel coronary artery disease.

5. CT Coronary Angiography

A test that is non-invasive and assists in evaluating the severity of artery blockage.
 

Treatment of Triple Vessel Coronary Artery Disease

Treatment for TVCAD is based on the extent of the obstructions and the health status of the patient. The three major methods employed are lifestyle modification, drug therapy, and surgery.

1. Lifestyle Changes

Heart disease can be managed through a healthy lifestyle and avoiding further damage. TVCAD patients are required to:

• Adhere to a diet rich in fruits, vegetables, whole grains, and lean proteins, but should not include processed foods, excessive salt, and trans fats.
• Exercise on a daily basis by swimming or walking moderately for at least 30 minutes per day.
• Quit smoking immediately since it worsens artery blockage and its likelihood to result in heart attack.
• Manage stress through techniques like meditation, deep breathing, and yoga.
• Maintain healthy weight to reduce the heart's workload and minimize the occurrence of complications.

These changes slow the progress of TVCAD and reduce cardiac-related complications.

2. Medicine

Medicine alleviates symptoms, inhibits clot formation, and improves heart function. Some of the most frequently prescribed medications include:

• Anticoagulants  – Inhibit clot formation in narrowed arteries.
• Statins  – Reduce cholesterol and retard plaque buildup.
• Beta-blockers – Retard heart rate and lower blood pressure.
• ACE inhibitors – Dilate blood vessels and improve circulation.
• Nitrates – Relieve chest pain by opening up blood vessels.
• Diuretics – Remove excess water and ease pressure on the heart.

They inhibit TVCAD activity but do not remove arterial occlusions.

3. Surgical Treatment

When the occlusion is too large, then a surgery would typically be the solution to restoring normal circulation of blood.

Coronary Angioplasty & Stenting

Here, a small tube (catheter) is inserted through the blocked artery. A small balloon is inflated to widen the artery, and a stent (metal mesh tube) is put in place to keep the artery open. It is useful in people with a moderate blockage but not in people with severe blockage.

Coronary Artery Bypass Grafting (CABG)

For severe triple vessel disease, CABG is the gold standard of treatment. The procedure involves taking a healthy vessel from another part of the body (e.g., leg or chest) and using it to bypass the affected arteries, thereby creating an alternative pathway for blood to reach the heart. CABG has long-term advantages and successfully reduces the risk of heart attacks. It does, however, involve open-heart surgery and a longer recovery.
 

Life After Treatment: Prevention and Recovery

After treatment for TVCAD, patients need to embrace long-term lifestyle modifications to prevent future complications. It is important to:

• Have regular follow-ups with the cardiologist to monitor heart status.
• Take medications as directed to control symptoms.
• Participate in cardiac rehabilitation programs to enhance strength levels and heart function.
• Follow a healthy diet and exercise program to prevent secondary blockages.
• Do not drink alcohol in excess and do not smoke, as both can damage blood vessels and aggravate heart disease.
   

Conclusion

Triple Vessel Coronary Artery Disease is an acute heart condition that must be diagnosed early and treated appropriately in order to avert life-threatening complications. By making lifestyle changes, taking medicines, and having surgery, the disease can be controlled by the patient and lived with a healthy life. Getting advice from a heart specialist to determine the most suitable treatment path for long-term cardiovascular well-being is important.