A cardiologist may recommend a coronary artery bypass graft (CABG) to lower the risk of a heart attack in the face of severe coronary artery disease (CAD) - in other words, before a heart attack ever happens. A CABG is also performed, of course, in an emergency to treat a severe heart attack that is a threat to life. CABG also may be used to treat people who have heart damage after a heart attack and still have blocked arteries.
Symptoms of coronary artery disease (CAD)
Chest pain (called angina)
Frequent or persistent fatigue, maybe weakness
Faster than normal heartbeat at rest (normal is 60-100 beats per minute)
An irregular heartbeat (called arrhythmia)
Shortness of breath, usually with activity and not at rest
Swelling in the hands, feet/ankles, or even face
Frequent or persistent indigestion (heartburn, acid reflux)
Lightheadedness, maybe nausea
When CABG may be recommended
Other treatments, such as lifestyle changes (diet, exercise, habits) and/or medications haven't worked.
There are blockages in the heart that can't be treated with angioplasty (balloon or stent)
There are significant to severe blockages (> 70%) in one or more of the three large coronary arteries* that supply a major part of the heart muscle with blood, especially if the heart's pumping action is already weakened
*Left anterior descending artery and circumflex artery (that make up the left main coronary artery), and the right main coronary artery
Candidacy for CABG is based on several factors
The presence and severity of CAD symptoms
The severity and location of blockages in the coronary arteries
History and past treatment of heart disease, including surgeries, procedures, and medications
Response to other treatments
History of other medical problems, diseases, and conditions (called comorbidities)
Current quality of life
Age and general health and well-being
Family history of heart disease, heart attack, or other heart conditions
The goals of CABG
Improve survival odds
Improve the quality of life and decrease angina and other symptoms of CAD
Resume a more active lifestyle
Improve the pumping action of the heart
Lower the chances of an initial heart attack or second heart attack
