Definition

What is coronary artery disease?

Coronary artery disease (CAD) develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing deposits (plaque) in your arteries and inflammation are usually to blame for coronary artery disease.

When plaque builds up, they narrow your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.

Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack. But there’s plenty you can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.

How common is coronary artery disease?

Coronary artery disease is very common. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of coronary artery disease?

The most common symptom is angina, or chest pain.

Angina can be described as a:

  • Heaviness
  • Pressure
  • Aching
  • Burning
  • Numbness
  • Fullness
  • Squeezing
  • Painful feeling

It can be mistaken for indigestion or heartburn.

Angina is usually felt in the chest, but may also be felt in the:

  • Left shoulder
  • Arms
  • Neck
  • Back
  • Jaw

Symptoms are often subtler in women. Nausea, sweating, fatigue, or shortness of breath can join the typical pressure-like chest pain.

Other symptoms that can occur with coronary artery disease include:

  • Shortness of breath
  • Palpitations (irregular heartbeats, skipped beats, or a “flip-flop” feeling in your chest)
  • A faster heartbeat
  • Weakness or dizziness
  • Nausea
  • Sweating

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you suspect you’re having a heart attack, immediately call your local emergency number. If you don’t have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort.

If you have risk factors for coronary artery disease — such as high blood pressure, high cholesterol, tobacco use, diabetes, a strong family history of heart disease or obesity — talk to your doctor. He or she may want to test you for the condition, especially if you have signs or symptoms of narrowed arteries.

Causes

What causes coronary artery disease?

Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including:

  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes or insulin resistance
  • Sedentary lifestyle

Once the inner wall of an artery is damaged, fatty deposits (plaque) made of cholesterol and other cellular waste products tend to accumulate at the site of injury in a process called atherosclerosis. If the surface of the plaque breaks or ruptures, blood cells called platelets will clump at the site to try to repair the artery. This clump can block the artery, leading to a heart attack.

Risk factors

What increases my risk for coronary artery disease?

There are many risk factors for coronary artery disease, such as:

  • Simply getting older increases your risk of damaged and narrowed arteries.
  • Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.
  • Family history. A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55 or if your mother or a sister developed it before age 65.
  • People who smoke have a significantly increased risk of heart disease. Exposing others to your secondhand smoke also increases their risk of coronary artery disease.
  • High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel through which blood can flow.
  • High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis. High cholesterol can be caused by a high level of low-density lipoprotein (LDL), known as the “bad” cholesterol. A low level of high-density lipoprotein (HDL), known as the “good” cholesterol, can be a sign of atherosclerosis.
  • Diabetes is associated with an increased risk of coronary artery disease. Type 2 diabetes and coronary artery disease share similar risk factors, such as obesity and high blood pressure.
  • Overweight or obesity. Excess weight typically worsens other risk factors.
  • Physical inactivity. Lack of exercise also is associated with coronary artery disease and some of its risk factors, as well.
  • High stress. Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for coronary artery disease.

Risk factors often occur in clusters and may build on one another, such as obesity leading to type 2 diabetes and high blood pressure. When grouped together, certain risk factors put you at an even greater risk of coronary artery disease. For example, metabolic syndrome — a cluster of conditions that includes elevated blood pressure, high triglycerides, elevated insulin levels and excess body fat around the waist — increases the risk of coronary artery disease.

Sometimes coronary artery disease develops without any classic risk factors. Researchers are studying other possible factors, including:

  • Sleep apnea. This disorder causes you to repeatedly stop and start breathing while you’re sleeping. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system, possibly leading to coronary artery disease.
  • High sensitivity C-reactive protein. High sensitivity C-reactive protein (hs-CRP) is a normal protein that appears in higher amounts when there’s inflammation somewhere in your body. High hs-CRP levels may be a risk factor for heart disease. It’s thought that as coronary arteries narrow, you’ll have more hs-CRP in your blood.
  • High triglycerides. This is a type of fat (lipid) in your blood. High levels may raise the risk of coronary artery disease, especially for women.
  • Homocysteine is an amino acid your body uses to make protein and to build and maintain tissue. But high levels of homocysteine may increase your risk of coronary artery disease.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is coronary artery disease diagnosed?

  • Your doctor can tell if you He learns your symptoms, medical history, and risk factors
  • A physical exam.
  • Diagnostic tests, including an electrocardiogram (ECG or EKG), echocardiogram, exercise stress tests, electron beam (ultrafast) CT scans, cardiac catheterization, and others. These tests help your doctor know the extent of your coronary heart disease, its effect on your heart, and the best treatment for you.

How is coronary artery disease treated?

Various drugs can be used to treat coronary artery disease, including:

  • Cholesterol-modifying medications. By decreasing the amount of cholesterol in the blood, especially low-density lipoprotein (LDL, or the “bad”) cholesterol, these drugs decrease the primary material that deposits on the coronary arteries. Your doctor can choose from a range of medications, including statins, niacin, fibrates and bile acid sequestrants.
  • Your doctor may recommend taking a daily aspirin or other blood thinner. This can reduce the tendency of your blood to clot, which may help prevent obstruction of your coronary arteries. If you’ve had a heart attack, aspirin can help prevent future attacks. There are some cases where aspirin isn’t appropriate, such as if you have a bleeding disorder or you’re already taking another blood thinner, so ask your doctor before starting to take aspirin.
  • Beta blockers. These drugs slow your heart rate and decrease your blood pressure, which decreases your heart’s demand for oxygen. If you’ve had a heart attack, beta blockers reduce the risk of future attacks.
  • Nitroglycerin tablets, sprays and patches can control chest pain by temporarily dilating your coronary arteries and reducing your heart’s demand for blood.
  • Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). These similar drugs decrease blood pressure and may help prevent progression of coronary artery disease.

Sometimes more aggressive treatment is needed. Here are some options:

  • Angioplasty and stent placement (percutaneous coronary revascularization). Your doctor inserts a long, thin tube (catheter) into the narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls. A stent is often left in the artery to help keep the artery open. Some stents slowly release medication to help keep the artery open.
  • Coronary artery bypass surgery. A surgeon creates a graft to bypass blocked coronary arteries using a vessel from another part of your body. This allows blood to flow around the blocked or narrowed coronary artery. Because this requires open-heart surgery, it’s most often reserved for cases of multiple narrowed coronary arteries.

 

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage coronary artery disease?

The following lifestyles and home remedies might help you cope with coronary artery disease:

  • Stop smoking. Smoking is a major risk factor for coronary artery disease. Nicotine constricts blood vessels and forces your heart to work harder, and carbon monoxide reduces oxygen in your blood and damages the lining of your blood vessels. If you smoke, quitting is one of the best ways to reduce your risk of a heart attack.
  • Control your blood pressure. Ask your doctor for a blood pressure measurement at least every two years starting at age 18. If you’re age 40 or older, or you’re age 18-39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year. He or she may recommend more frequent measurements if your blood pressure is higher than normal or you have a history of heart disease. The ideal blood pressure is generally below 120 systolic and 80 diastolic, as measured in millimeters of mercury (mm Hg).
  • Check your cholesterol. Ask your doctor for a baseline cholesterol test when you’re in your 20s and at least every five years after. If your test results aren’t within desirable ranges, your doctor may recommend more-frequent measurements. Most people should aim for an LDL level below 130 milligrams per deciliter (mg/dL), or 3.4 millimoles per liter (mmol/L). If you have other risk factors for heart disease, your target LDL may be below 100 mg/dL (2.6 mmol/L).
  • Keep diabetes under control. If you have diabetes, tight blood sugar management can help reduce the risk of heart disease.
  • Get moving. Exercise helps you achieve and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure — all risk factors for coronary artery disease. With your doctor’s OK, aim for about 30 to 60 minutes of moderate to physical activity most or all days of the week.
  • Eat healthy foods. A heart-healthy diet, such as the Mediterranean diet, that emphasizes plant-based foods, such as fruits, vegetables, whole grains, legumes and nuts — and is low in saturated fat, cholesterol and sodium — can help you control your weight, blood pressure and cholesterol. Eating one or two servings of fish a week also is beneficial.
  • Maintain a healthy weight. Being overweight increases your risk of coronary artery disease. Losing even just a few pounds can help lower your blood pressure and reduce your risk of coronary artery disease.
  • Manage stress. Reduce stress as much as possible. Practice healthy techniques for managing stress, such as muscle relaxation and deep breathing.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: December 27, 2017 | Last Modified: December 27, 2017

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