Coronary Artery Disease

Medically Reviewed By William C. Lloyd III, MD, FACS

What is coronary artery disease?

Coronary artery disease (CAD) is the most common form of heart disease. Coronary heart disease and ischemic heart disease are other names for CAD. CAD affects the arteries that supply blood to the heart muscle. These are the coronary arteries. In CAD, the coronary arteries become narrow and stiff due to atherosclerosis and inflammation.

Atherosclerosis is the buildup of plaque inside arteries. Plaque contains cholesterol and other substances. As the plaque grows bigger, it limits the amount of blood that can flow through the artery. Without adequate blood flow, the heart muscle can’t get the oxygen it needs. This can eventually lead to angina (chest pain), arrhythmias, heart failure, and heart attack.

CAD can develop without many symptoms in the beginning. As the disease continues, the heart struggles to work without enough oxygen. Chest pain and shortness of breath are common symptoms. However, heart attack is often the first sign of CAD. Heart attack happens when blood flow through a coronary artery becomes completely blocked. In most cases, a blood clot that forms around the plaque is responsible for the blockage.

Lifestyle choices, even during childhood and early in life, play a role in CAD. This includes smoking, being overweight or obese, and eating a diet high in cholesterol and saturated fats. However, there are also risk factors for CAD that are out of your control. This includes being male or a postmenopausal woman. A family history of CAD also increases your risk of the disease.

Fortunately, changing your lifestyle choices can have a positive effect on your heart health. In fact, lifestyle changes are typically the first step in treating CAD. If necessary, doctors also prescribe drugs to decrease cholesterol levels, relieve chest pain, prevent blood clots, and ease the heart’s workload. Sometimes, surgery or a catheter-based procedure is necessary to restore proper blood flow.

If you have CAD, it’s important to follow all of your doctor’s recommendations. Without proper treatment, CAD can have life-threatening consequences. Seek immediate medical care (call 911) for symptoms of a heart attack, such as chest pain and difficulty breathing, along with dizziness, sweating, fainting and anxiety.

What are the symptoms of coronary artery disease?

Coronary artery disease tends to develop over decades. In the early stages, it is quite common to not have symptoms. Symptoms are more likely to develop as the narrowing becomes more severe. Symptoms may be worse during exercise and other times the heart is working hard.

Common symptoms of coronary artery disease

The most common coronary artery disease symptoms include:

  • Chest pain or discomfort
  • Fatigue and weakness
  • Shortness of breath
  • Tightness or discomfort in the jaw, neck, back or arms

Serious symptoms that might indicate a life-threatening condition

For some people, a heart attack is the first sign of CAD. Seek immediate medical care (call 911) if you, or someone you are with, have these life-threatening symptoms, including:

Some people having a heart attack do not experience the typical symptoms. It is also possible to have very mild symptoms that may not seem concerning.

Symptoms can develop suddenly or over hours or days, as well. The bottom line—do not wait to seek medical care if you suspect, even a little bit, you are having heart attack symptoms. Time is critical for preserving heart muscle when it comes to a heart attack. The longer it takes to recognize and treat a heart attack, the more likely it is the heart muscle will die or sustain severe damage.

What causes coronary artery disease?

Atherosclerosis and inflammation are the main cause of coronary artery disease. In atherosclerosis, cholesterol-containing plaque builds up on the inside wall of arteries. It narrows and hardens the artery. Plaque growth further limits blood flow to the heart muscle. This keeps the heart muscle from getting the oxygen it needs. The lack of oxygen causes the symptoms of CAD. It also increases the risk of other forms of heart disease (such as heart failure) and heart attack.

What are the risk factors for coronary artery disease?

Several factors increase the risk of developing coronary artery disease. However, not all people with risk factors will get CAD. Risk factors include:

  • Being male or a postmenopausal woman
  • Being overweight or obese
  • Eating a poor diet high in cholesterol and saturated fats
  • Having a family history of heart disease, especially early heart disease before age 55 in a father or brother and before age 65 in a mother or sister
  • Having diabeteshigh blood pressure, or high cholesterol
  • Leading a sedentary lifestyle without enough physical activity
  • Smoking

Reducing your risk of coronary artery disease

Reducing your risk of a disease involves changing risk factors under your control. Fortunately, you can do a lot to improve your heart health. You may be able to lower your risk of CAD by:

  • Eating heart-healthy foods low in saturated and trans fats and high in fiber
  • Following your treatment plan for other medical conditions
  • Getting regular physical exercise with 30 minutes of moderate exercise on most days of the week
  • Maintaining a healthy weight
  • Managing stress
  • Stopping smoking

If you need help in any of these areas, talk with your doctor. The sooner you make the necessary lifestyle changes, the less likely it is that serious heart problems will develop.

How is coronary artery disease treated?

Coronary artery disease treatment starts with the same lifestyle changes to reduce your risk of CAD. But sometimes these changes are not enough. When this is the case, doctors add medicines to the treatment plan. Drugs can help treat high cholesterol, prevent blood clots, ease chest pain with exertion, and reduce the heart’s workload.

For severely narrowed arteries, doctors may recommend a procedure to restore blood flow. Catheter-based procedures—percutaneous coronary interventions—are one option. Coronary artery bypass graft (CABG) surgery is another option. Cardiac rehabilitation may also be beneficial.

Your treatment options will depend on the location and severity of the blockage. It also depends on how many arteries are affected. Your age, overall health, and preferences will play a role as well. Check with your doctor for recommendations and your health insurance plan for coverage of cardiac rehabilitation, procedures, and other treatments.

What are the potential complications of coronary artery disease?

In some cases, coronary artery disease causes serious and even life-threatening complications. It is the leading cause of death for both men and women in the United States. CAD kills more than 370,000 Americans each year. Potential complications include:

  • Heart attack, which occurs when there is complete blockage of a coronary artery. Typically, this happens when a plaque ruptures and triggers the formation of a blood clot. The complete lack of blood flow can quickly lead to heart muscle damage or death.
  • Heart arrhythmias, which are abnormal heart rhythms. Lack of oxygen and heart muscle damage can interfere with the heart’s normal electrical activity resulting in an arrhythmia.
  • Heart failure, which occurs when the heart muscle is too weak to adequately pump blood to the rest of the body. Chronic oxygen deprivation and heart muscle damage can cause this weakness and heart failure.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Sep 11
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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