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Overview



What Is Coronary Artery Disease?


Coronary Artery Disease (CAD), also called coronary heart disease, is a condition in which plaque (plak) builds up inside the coronary arteries. These arteries supply your heart muscle with oxygen-rich blood.

Plaque is made up of fat, cholesterol (ko-LES-ter-ol), calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called Atherosclerosis (ATH-er-o-skler-O-sis).

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Figure A shows a normal artery with normal blood flow. Figure B shows an artery with plaque buildup.




Plaque narrows the arteries and reduces blood flow to your heart muscle. It also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow.



Overview


When your coronary arteries are narrowed or blocked, oxygen-rich blood can't reach your heart muscle. This can cause angina (an-JI-nuh or AN-juh-nuh) or a heart attack.

Angina is chest pain or discomfort that occurs when not enough oxygen-rich blood is flowing to an area of your heart muscle. Angina may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back.

A heart attack occurs when blood flow to an area of your heart muscle is completely blocked. This prevents oxygen-rich blood from reaching that area of heart muscle and causes it to die. Without quick treatment, a heart attack can lead to serious problems and even death.



Diagnostic Tests And Procedures


Your doctor will diagnose coronary artery disease (CAD) based on:
  • Your medical and family histories
  • Your risk factors
  • The results of a physical exam and diagnostic tests and procedures


No single test can diagnose CAD. If your doctor thinks you have CAD, he or she will probably do one or more of the following tests:

EKG (Electrocardiogram)

Stress Testing

Echocardiography

Chest X Ray

Blood Tests

Electron-Beam Computed Tomography

Coronary Angiography and Cardiac Catheterization



Risk Factors


Some of the main risk factors that increase the risk for CAD are:
  • Smoking
  • Unhealthy cholesterol and lipid levels
  • High blood pressure
  • Diabetes
  • Lack of exercise
  • Obesity


What Causes Coronary Artery Disease?


Research suggests that coronary artery disease (CAD) starts when certain factors damage the inner layers of the coronary arteries. These factors include:

  • Smoking
  • High amounts of certain fats and cholesterol in the blood
  • High blood pressure
  • High amounts of sugar in the blood due to insulin resistance or diabetes
When damage occurs, your body starts a healing process. Excess fatty tissues release compounds that promote this process. This healing causes plaque to build up where the arteries are damaged.



Treatment


  • Lifestyle changes (such as a healthy diet and regular physical activity) are essential for preventing and treating CAD.
  • Medications for preventing and treating CAD include aspirin, cholesterol-lowering drugs (statins), and high blood pressure medications. Some patients take nitroglycerin or other nitrate drugs to treat angina.
  • Surgery may be needed to open blocked or narrowed coronary artery and improve blood flow to the heart. Percutaneous coronary intervention (PCI), also called angioplasty, uses a small balloon to open the blood vessel. Coronary artery bypass graft (CABG) is a more invasive procedure that is generally for patients with severe heart disease. It uses grafts from arteries or veins to reroute blood flow.










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