Coronary Artery Disease

What is coronary artery disease?

Coronary heart disease is a condition where the arteries which supply the heart become hardened and narrowed over time. This results in a decreased supply of blood and oxygen to the heart muscle (myocardium). This can cause serious complications, such as heart attacks and heart failure. It usually has a slow onset. The main symptom is chest pain or pressure that can radiate to the jaw, shoulder, back or arm. Treatment depends on the severity of symptoms, and involves managing other health conditions, making lifestyle changes, using medications and in some cases undergoing a procedure to widen the blood vessels of the heart. These treatments can help to prevent severe consequences.

Risks

Coronary artery disease is slightly more common in men than women, and is most common in middle-aged and older adults. Important risk factors are diabetes, high blood pressure, smoking, drinking alcohol, obesity and having a family member who has coronary artery disease.

Symptoms

Symptoms of coronary artery disease include angina (short-lived episodes of chest pain) and shortness of breath. Angina is usually brought on by exercise, and gets better with rest. Some people may experience angina whilst resting. The chest pain is often in the center of the chest, and may spread to the arm and jaw. Some people might also have nausea, a cold sweat, dizziness or fainting spells.

Diagnosis

Diagnosis is based on the symptoms and physical examination. An electrocardiogram (ECG or EKG) may show signs of heart muscle damage, and an exercising ECG/EKG may show heart damage that only occurs when exercising. Blood tests for cholesterol levels and blood sugar levels can also be helpful. Cardiac angiography, where dye is injected into the heart blood vessels and x-rays are taken, may help identify areas of narrowing or blockage in the heart arteries. Rarely, a magnetic resonance image (MRI) can be performed on the heart to examine the vessels.

Treatment

Treatment depends on the specific symptoms and their severity. For people with mild, predictable chest pain symptoms, treatment involves thinning the blood to prevent blockages, and taking a medication to help open up the blood vessels when there is pain present. As the condition progresses, it might be necessary to have cardiac catheterization (insertion of a tube through the leg blood vessels into the heart blood vessels) to widen narrowed or blocked blood vessels with a stent (a small wire cage). Eventually, some people may need bypass surgery.

Prevention

Preventing coronary artery disease involves lifestyle and diet changes. Being physically active, losing weight, ceasing to smoke and excluding alcohol from the diet can all help. Good management of other medical conditions, such as high blood pressure, diabetes and high cholesterol levels also help prevent the progression of coronary artery disease.

Other names for coronary artery disease

  • CAD
  • Coronary heart disease
  • Ischemic heart disease