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Coronary Artery Disease

Coronary artery disease (CAD) starts when the wall of a coronary artery is damaged. This can be caused by risk factors such as smoking or high blood pressure. Plaque (a fatty substance) then builds up inside the artery along the artery walls. Over time, the buildup of plaque narrows the path for the blood to flow through the artery. It also makes the artery walls stiff and less able to expand.

At times when the heart needs more oxygen, not enough blood can get through the artery to meet the need. This can cause angina (pressure, tightness or pain in the chest, neck, jaw, shoulder, arm or back). Also, plaque or a blood clot can completely block the artery. When this happens, blood flow stops. Without oxygen-rich blood, part of the heart muscle dies. This is called a heart attack.

What happens once you have coronary artery disease?

Angina, or chest pain and discomfort, is the most common symptom of CAD. Narrowed arteries can cause angina because they can block blood flow to your heart muscle and the rest of your body. The process of plaque buildup is called atherosclerosis.

For many people, the first clue that they have CAD is a heart attack. Symptoms of heart attack include:

  • Shortness of breath.

  • Chest pain or discomfort (angina).

  • Pain or discomfort in the arms or shoulder.

  • Weakness, light-headedness, nausea (feeling sick to your stomach), or a cold sweat.

Over time, CAD can weaken the heart muscle. This may lead to heart failure, a serious condition where the heart can’t pump blood the way it should.

What causes coronary artery disease?

CAD is caused by plaque buildup (atherosclerosis) in the walls of the coronary arteries that supply blood to the heart and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery.

Overweight, physical inactivity, unhealthy eating, and smoking tobacco are risk factors for CAD. A family history of heart disease also increases your risk for CAD, especially a family history of having heart disease at an early age (50 or younger).

What types of tests are used to diagnosis coronary artery disease?

If you’re at high risk for heart disease or already have symptoms, your doctor can use these tests to diagnose CAD.

  • Exercise stress test: This test is also called a stress electrocardiogram (ECG). This test records your heart’s electrical activity while you walk on a treadmill or ride a stationary bike. This test helps your healthcare team assess whether enough oxygen is getting to your heart muscle. Results of this test will help plan your cardiac rehab program.

  • Echocardiogram: This test uses harmless sound waves to take live pictures of your heart. It shows the size and shape of your heart. It will also help your healthcare provider see how well your heart is pumping blood.

What types of treatments and procedures are used to treat coronary artery disease?

If you have CAD, your health care team may suggest the following treatments:

  • Cardiac catheterization: This procedure can help diagnose your heart problems. In some cases, it can also be used to treat heart disease. During the procedure, a thin, flexible tube called a catheter is put into a blood vessel. It is then gently guided toward your heart. With the catheter in place, your doctor may then perform:

    • Angiography: A special type of x-ray that helps show narrowing or blockages in the coronary arteries.
    • Angioplasty: A procedure that uses a tiny balloon to widen the channel of the blood vessel where the blood flows.
    • Stent placement: A procedure that puts a stent (a tiny wire-mesh tube) inside an artery to help keep the artery open and blood flowing in it.
    • Atherectomy: A procedure that removes plaque from artery walls using a special catheter.

  • Medications: These may be used to manage symptoms or other underlying health problems. For example, these may be used to help improve blood flow, lower blood pressure, manage high cholesterol, or regulate heart rate or rhythm. Some medications may also help reduce the changes of a heart attack or stroke.

  • Bypass surgery: This procedure creates a new pathway for blood to flow around blocked coronary arteries. This helps restore blood flow to the heart muscle.

What can I do to support my health when I have coronary artery disease?

Take your medications as prescribed. See your doctor regularly so they can monitor how you are doing. Make healthy lifestyle changes to slow the progression of heart disease.

Lifestyle changes you can make to improve your heart health include:

  • Reduce salt in your diet.
  • Maintain a healthy body weight.
  • Never smoke, or stop smoking.
  • Drink only moderate amounts of alcohol, if any. This means an average of one to two drinks per day for men and one drink per day for women.
  • Eat a healthy, well-balanced diet, rich in fresh fruit and vegetables but low in saturated fats, processed sugar, and salt.
  • If you have diabetes, work closely with your doctor to make sure it is controlled.
  • Get at least 150 minutes of moderate to intense physical exercise every week.

Why choose Presbyterian for coronary artery disease treatment?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.