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Definition

Coronary artery disease (CAD) is the most common type of heart disease. The coronary arteries begin to narrow. This will slow or stop blood flow.

These arteries bring blood to the heart muscle. It supplies the busy heart with oxygen and other nutrients. Slowed or stopped blood flow will lead to damage of the heart muscle.

Coronary Artery Disease Copyright © Nucleus Medical Media, Inc.

Causes

Damage to blood vessel walls causes CAD. Most common factors include:

• Smoking, high blood pressure, and inflammation can all irritate and damage blood vessel walls.
• Certain types of fat and cholesterol in the blood can cause a build-up on the walls. This build-up is called plaque.

When plaque hardens it can tear blood vessel walls and cause bleeding. A blood clot will form to help the area heal. However, it can also add to plaque and further shrink paths for blood flow.

Risk Factors

The risk for CAD is greater in:

• Men (mostly those who are over 45 years of age)
• Women who are over 55 years of age

Factors that may increase your risk of CAD include:

• Strong family history of heart disease
• Obesity and being overweight
• Smoking
• High blood pressure
• Not being active often
• High cholesterol—especially low-density lipoprotein (LDL) (bad) cholesterol
• Low high-density lipoprotein (HDL) (good) cholesterol
• Diabetes
• Metabolic syndrome—when high blood pressure, high cholesterol, too much belly fat, and insulin resistance are all present

Other risk factors may include:

• Drinking too much alcohol
• Mental health conditions such as depression and anxiety
• A food plan that is high in saturated fat, trans fat, cholesterol, and/or calories
• Having sugary drinks often

Symptoms

CAD itself may not have any signs or symptoms. Often the first sign is a problem with the heart. Weak or blocked blood flow to the heart can cause:

• Angina—chest pain caused by low blood flow to heart muscle
• Heart attack—loss of blood flow that has caused severe damage to heart muscle
• Heart failure—the heart muscle is permanently harmed after years of poor blood flow

Call for emergency services right away if you think you may be having a heart attack. Early care can stop further harm.

Diagnosis

The doctor may suspect CAD based on your family and health past. If you have a high risk of CAD, these tests may be done:

• Electrocardiogram (ECG)—shows electrical action in your heart
• Exercise stress test—test your heart under stress
• Echocardiogram—image of your heart
• Coronary angiography—exam of blood vessels
• CT scan

Blood tests to check:

• Cholesterol levels in blood
• Glucose levels
• Signs of inflammation

CAD may not be found until after angina appears or a heart attack occurs.

Treatment

The goals of treatment include:

• Slow or stop growth of plaque in blood vessels. Decrease build-up if possible.
• Decrease risk of complications like blood clots or heart attack.
• Relieve symptoms if there are any.

Options to help reach these goals include:

Prevention

The risk of CAD may be lower with:

• Healthy weight.
• Heart healthy diet
• Regular exercise program.
• Never smoking or quit smoking
• Stress management