Coronary artery disease (CAD) is a narrowing or blockage of your coronary arteries, usually due to plaque buildup. Your coronary arteries supply oxygen-rich blood to your heart. Plaque buildup in these arteries limits how much blood can reach your heart.
Picture two traffic lanes that merge into one due to construction. Traffic keeps flowing, just more slowly. With CAD, you might not notice anything is wrong until the plaque triggers a blood clot. The blood clot is like a concrete barrier in the middle of the road. Traffic stops. Similarly, blood can’t reach your heart, and this causes a heart attack.
You might have CAD for many years and not have any symptoms until you experience a heart attack. That’s why CAD is a “silent killer.”
Other names for CAD include coronary heart disease (CHD) and ischemic heart disease. It’s also what most people mean when they use the general term “heart disease.”
What are the symptoms of coronary artery disease?
You may have no symptoms of coronary artery disease for a long time. CAD is a chronic condition. Plaque buildup takes many years, even decades. But as your arteries narrow, you may notice mild symptoms. These symptoms indicate your heart is pumping harder to deliver oxygen-rich blood to your body.
Symptoms of chronic CAD include:
Stable angina: This is the most common symptom. Stable angina is temporary chest pain or discomfort that comes and goes in a predictable pattern. You’ll usually notice it during physical activity or emotional distress. It goes away when you rest or take nitroglycerin (medicine that treats angina).
Sometimes, the first symptom of CAD is a heart attack. Symptoms of a heart attack include:
Chest pain or discomfort (angina). Angina can range from mild discomfort to severe pain. It may feel like heaviness, tightness, pressure, aching, burning, numbness, fullness, squeezing or a dull ache. The discomfort may spread to your shoulder, arm, neck, back or jaw.
What is the treatment for coronary artery disease?
Treatment for CAD often includes lifestyle changes, risk factor management and medications. Some people may also benefit from a procedure or surgery.
Your healthcare provider will talk with you about the best treatment plan for you. It’s important to follow your treatment plan so you can lower your risk of serious complications from CAD.
Lifestyle changes
Lifestyle changes play a big role in managing CAD. Such changes include:
Be sure to talk with your provider before starting any new exercise program. Your provider can also offer guidance on lifestyle changes tailored to your needs. Your provider may recommend meeting with a dietitian to discuss healthy eating plans and smoking cessation options.
Risk factor management
Managing your risk factors for CAD can help slow down the progression of your disease. Work with your provider to manage the following conditions:
Diabetes.
High blood pressure.
High cholesterol.
High triglycerides (hypertriglyceridemia).
Overweight/obesity.
Medications
Medications can help you manage your risk factors plus treat symptoms of coronary artery disease. Your provider may prescribe one or more of the medications listed below.
Some people need a procedure or surgery to manage coronary artery disease, including:
Percutaneous coronary intervention (PCI): Another name for this procedure is coronary angioplasty. It’s minimally invasive. Your provider uses a small balloon to reopen your blocked artery and help blood flow through it better. Your provider may also insert a stent to help your artery stay open.
Coronary artery bypass grafting (CABG): This surgery creates a new path for your blood to flow around blockages. This “detour” restores blood flow to your heart. CABG helps people who have severe blockages in several coronary arteries.
Your provider will recommend which of these treatment options would be best in your unique case.
How is coronary artery disease diagnosed?
Healthcare providers diagnose coronary artery disease through a physical exam and testing.
Coronary calcium scan: Measures the amount of calcium in the walls of your coronary arteries (a sign of atherosclerosis). This doesn’t determine if you have significant blockages, but it does help determine your risk for CAD.
Echocardiogram (echo): Uses sound waves to evaluate your heart’s structure and function.
Electrocardiogram (EKG/ECG): Records your heart’s electrical activity. Can detect old or current heart attacks, ischemia and heart rhythm issues.
Exercise stress test: Checks how your heart responds when it’s working very hard. Can detect angina and blockages in your coronary arteries.
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