Related Media: What is Angina Pectoris?

Learning about Risk Factors

Definition    TOP

Coronary arteries bring oxygen rich blood to the heart muscle. Coronary artery disease (CAD) is blockage of these arteries. If the blockage is complete, areas of the heart muscle may be damaged. In severe case the heart muscle dies. This can lead to a heart attack, also known as a myocardial infarction (MI).

Coronary artery disease is the most common form of heart disease. It is the leading cause of death worldwide.

Coronary Artery Disease 2009 Nucleus Medical Media, Inc.

Causes    TOP

Causes include:

• Thickening of the walls of the arteries feeding the heart muscle
• Accumulation of fatty plaques within the coronary arteries
• Sudden spasm of a coronary artery
• Narrowing of the coronary arteries
• Inflammation within the coronary arteries
• Development of a blood clot within the coronary arteries that blocks blood flow

Risk Factors    TOP

Major risk factors include:

• Sex: male (men have a greater risk of heart attack than women)
• Age: 45 and older for men, 55 and older for women
• Heredity: strong family history of heart disease
• Obesity and being overweight
• Smoking
• High blood pressure
• Sedentary lifestyle—Poor fitness can also increase your risk of CAD and premature death.
• High cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)
• Diabetes
• Depression
• A diet that is high in saturated fat, trans fat, cholesterol, and/or calories—drinking sugary beverages on a regular basis may increase your risk of CAD.

Other risk factors include:

• Stress
• Excessive alcohol use
• Metabolic syndrome —combination of high blood pressure, abdominal obesity, and insulin resistance

Symptoms    TOP

CAD may progress without any symptoms.

Angina is chest pain that comes and goes. It often has a squeezing or pressure-like quality. It may radiate into the shoulder(s), arm(s), or jaw. Angina usually lasts for about 2-10 minutes. It is often relieved with rest. Angina can be triggered by:

• Exercise or exertion
• Emotional stress
• Cold weather
• A large meal

• It is unrelieved by rest or nitroglycerin
• Severe angina
• Angina that begins at rest (with no activity)
• Angina that lasts more than 15 minutes

• Shortness of breath
• Sweating
• Nausea
• Weakness

Immediate medical attention is needed for unstable angina. CAD in women may cause less classic chest pain. It is likely to start with shortness of breath and fatigue.

Diagnosis    TOP

If you go to the emergency room with chest pain, some tests will be done right away. The tests will attempt to see if you are having angina or a heart attack. If you have a stable pattern of angina, other tests may be done to determine the severity of your disease.

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

• Blood tests—to look for certain substances in the blood called troponins which help the doctor determine if you are having a heart attack
• Electrocardiogram (ECG, EKG)— records the heart's activity by measuring electrical currents through the heart muscle, and can reveal evidence of past heart attacks, acute heart attacks, and heart rhythm problems
• Echocardiogram —uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart, giving information about the structure and function of the heart
• Exercise stress test —records the heart's electrical activity during increased physical activity
• Nuclear stress test—the heart is observed while exercising and radioactive material highlights impaired blood flow to help locate problem areas
• Coronary calcium scoring—a type of x-ray called a CAT scan that uses a computer to look for the presence of calcium in the heart arteries
• Coronary angiography —x-rays taken after a dye is injected into the arteries to allows the doctor to look for abnormalities in the arteries

Treatment    TOP

Treatment may include:

Prevention    TOP

To reduce your risk of getting coronary artery disease:

• Maintain a healthy weight.
• Eat a heart healthy diet that is low in saturated fat, red meat and processed meats, and rich in whole grains, fruits, and vegetables.
• Begin a safe exercise program with the advice of your doctor.
• If you smoke, quit.
• For example, a study found that eating a lot of red meat or processed meat
• Treat your high blood pressure and/or diabetes.
• Treat high cholesterol or triglycerides.