What is coronary artery disease?

Coronary artery disease (CAD) is a type of heart disease caused by a problem with the blood vessels that bring blood and oxygen to the heart muscle. These arteries are called the coronary arteries. This disease increases your risk for heart attack and sudden death.

What is the cause?

Fatty deposits called plaque may build up in blood vessels and make them narrower. The narrowing decreases the amount of blood flow to the heart. Plaque also increases the chance that blood clots may form and block a blood vessel, which can cause a heart attack or stroke.

Your risk for CAD may be higher if you:

• Have a family history of coronary artery disease at an early age
• Smoke
• Have high blood pressure
• Have diabetes
• Are very overweight
• Don’t get enough exercise
• Have high levels of blood fat–for example, high cholesterol

What are the symptoms?

Coronary artery disease may not cause any symptoms. When there are symptoms, the most common one is chest pain, called angina. You may feel:

• A feeling of tightness or heaviness in the chest
• Squeezing, pressure, or burning in the chest

Angina symptoms usually:

• Last for 5 minutes or less and go away with rest or medicine such as nitroglycerin.
• Happen when the heart has to work harder, such as after a heavy meal or during physical activity or emotional stress.

Angina may also happen when you are resting.

Call 911 for emergency help right away if you have symptoms of a heart attack. The most common symptoms include:

• Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
• Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
• Trouble breathing
• Breaking out in a cold sweat for no known reason
• If your provider has prescribed nitroglycerin for angina, pain that does not go away after taking your nitroglycerin as directed

Along with these symptoms, you may also feel very tired, faint, or sick to your stomach.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat.
• An exercise treadmill test to see how your heart works when you exercise
• An echocardiogram, which uses sound waves (ultrasound) to see how well your heart is pumping
• Angiogram, which is a series of X-rays taken after your healthcare provider injects a special dye into your blood vessels to show the walls of the arteries and any blockage
• CT scan, which uses X-rays and a computer to show detailed pictures of the arteries

How is it treated?

Your treatment depends on many factors, such as your age, heart muscle function, and other health problems. At first, treatment may include diet changes and an exercise program. Your healthcare provider may prescribe medicine.

• Many people need to take 2 or more medicines to help prevent a heart attack or stroke. It may take several weeks or months to find the best treatment for you.
• Your provider may also prescribe other types of medicine to lower blood pressure, help stop chest pain, control an irregular heartbeat, help prevent blood clots, or lower blood fat (cholesterol).

Your provider may recommend a daily low dose of aspirin. Taking an aspirin every day may lower your risk for a heart attack or stroke. Not everyone should take aspirin. Daily use of aspirin can cause problems, such as stomach irritation, bleeding, and hearing loss. Ask your healthcare provider if you should take aspirin and if so, how much to take.

If your coronary arteries are badly blocked, you may need balloon angioplasty or bypass surgery.

• A balloon angioplasty opens blocked blood vessels and improves blood flow. A metal mesh device called a stent is usually left in the blood vessels to help keep them open.
• Bypass surgery uses blood vessels from other parts of the body, or manmade material, to make a new path around a blocked area.

How can I take care of myself?

If you have coronary artery disease, there are things you can do to take care of yourself now and prevent problems in the future.

• Follow your provider’s advice about activity, exercise, medicine, and follow-up visits.
• Lower the amount of salt, saturated and trans fats, and cholesterol in your diet.
• Work with your healthcare provider to control diabetes, blood pressure, or other health problems you may have.
• Try to keep a healthy weight. If you are overweight, talk to your provider about ways to lose weight.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• Ask your healthcare provider:
  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.

How can I help prevent coronary artery disease?

You can prevent this disease with a heart-healthy lifestyle:

• Eat a healthy diet and keep a healthy weight.
• Stay fit with the right kind of exercise for you.
• Find ways to manage stress.
• Don’t smoke.
• Limit your use of alcohol.

Talk to your healthcare provider about your personal and family medical history and your lifestyle habits. This will help you know what you can do to lower your risk for coronary artery disease.

If you have a strong family history of CAD, a healthy lifestyle may slow the start of the disease and maybe even keep you from getting it. However, you must have regular checkups to keep a close watch on the health of your heart.