What Is Coronary Artery Disease?
Coronary artery disease (CAD) is a condition in
which plaque (plak) builds up inside the coronary arteries. These arteries
supply your heart muscle with oxygen-rich blood.
Plaque is made up of fat, cholesterol
(ko-LES-ter-ol), calcium, and other substances found in the blood. When plaque
builds up in the arteries, the condition is called
atherosclerosis
(ATH-er-o-skler-O-sis).
Atherosclerosis
![Illustration of a normal artery with normal blood flow and an artery with plaque buildup.](https://webarchive.library.unt.edu/eot2008/20090117204530im_/http://www.nhlbi.nih.gov/health/dci/images/ather_lowres.gif)
Figure A shows a normal artery with
normal blood flow. Figure B shows an artery with plaque buildup.
Plaque narrows the arteries and reduces blood flow
to your heart muscle. It also makes it more likely that blood clots will form
in your arteries. Blood clots can partially or completely block blood flow.
Overview
When your coronary arteries are narrowed or blocked,
oxygen-rich blood can't reach your heart muscle. This can cause
angina
(an-JI-nuh or AN-juh-nuh) or a
heart
attack.
Angina is chest pain or discomfort that occurs when
not enough oxygen-rich blood is flowing to an area of your heart muscle. Angina
may feel like pressure or squeezing in your chest. The pain also may occur in
your shoulders, arms, neck, jaw, or back.
A heart attack occurs when blood flow to an area of
your heart muscle is completely blocked. This prevents oxygen-rich blood from
reaching that area of heart muscle and causes it to die. Without quick
treatment, a heart attack can lead to serious problems and even death.
Over time, CAD can weaken the heart muscle and lead
to heart
failure and
arrhythmias
(ah-RITH-me-ahs). Heart failure is a condition in which your heart can't pump
enough blood throughout your body. Arrhythmias are problems with the speed or
rhythm of your heartbeat.
Outlook
CAD is the most common type of heart disease. It's
the leading cause of death in the United States for both men and women.
Lifestyle changes, medicines, and/or medical procedures can effectively prevent
or treat CAD in most people.
Other Names for Coronary Artery Disease
- Atherosclerosis
- Coronary heart disease
- Hardening of the arteries
- Heart disease
- Ischemic (is-KE-mik) heart disease
- Narrowing of the arteries
What Causes Coronary Artery Disease?
Research suggests that coronary artery disease (CAD)
starts when certain factors damage the inner layers of the coronary arteries.
These factors include:
When damage occurs, your body starts a healing
process. Excess fatty tissues release compounds that promote this process. This
healing causes plaque to build up where the arteries are damaged.
The buildup of plaque in the coronary arteries may
start in childhood. Over time, plaque can narrow or completely block some of
your coronary arteries. This reduces the flow of oxygen-rich blood to your
heart muscle.
Plaque also can crack, which causes blood cells
called platelets (PLATE-lets) to clump together and form blood clots at the
site of the cracks. This narrows the arteries more and worsens
angina
or causes a
heart
attack.
Who Is At Risk for Coronary Artery Disease?
Coronary artery disease (CAD) is the leading cause
of death in the United States for both men and women. Each year, more than half
a million Americans die from CAD.
Certain traits, conditions, or habits may raise your
chance of developing CAD. These conditions are known as risk factors.
You can control most risk factors and help prevent
or delay CAD. Other risk factors can't be controlled.
Major Risk Factors
Many factors raise the risk of developing CAD. The
more risk factors you have, the greater chance you have of developing CAD.
- Unhealthy
blood cholesterol levels. This includes high LDL cholesterol (sometimes
called bad cholesterol) and low HDL cholesterol (sometimes called good
cholesterol).
- High
blood pressure. Blood pressure is considered high if it stays at or above
140/90 mmHg over a period of time.
- Smoking. This can damage and tighten blood
vessels, raise cholesterol levels, and raise blood pressure. Smoking also
doesn't allow enough oxygen to reach the body's tissues.
- Insulin resistance. This condition occurs when
the body can't use its own insulin properly. Insulin is a hormone that helps
move blood sugar into cells where it's used.
- Diabetes. This is a disease in which the body's blood sugar
level is high because the body doesn't make enough insulin or doesn't use its
insulin properly.
- Overweight
or obesity. Overweight is having extra body weight from muscle, bone, fat,
and/or water. Obesity is having a high amount of extra body fat.
- Metabolic
syndrome. Metabolic syndrome is the name for a group of risk factors linked
to overweight and obesity that raise your chance for heart disease and other
health problems, such as diabetes and stroke.
- Lack of physical activity. Lack of activity can
worsen other risk factors for CAD.
- Age. As you get older, your risk for CAD
increases. Genetic or lifestyle factors cause plaque to build in your arteries
as you age. By the time you're middle-aged or older, enough plaque has built up
to cause signs or symptoms.
- In men, the risk for CAD increases after age
45.
- In women, the risk for CAD risk increases
after age 55.
- Family history of early heart disease. Your risk
increases if your father or a brother was diagnosed with CAD before 55 years of
age, or if your mother or a sister was diagnosed with CAD before 65 years of
age.
Although age and a family history of early heart
disease are risk factors, it doesn't mean that you will develop CAD if you have
one or both.
Making lifestyle changes and/or taking medicines to
treat other risk factors can often lessen genetic influences and prevent CAD
from developing, even in older adults.
Emerging Risk Factors
Scientists continue to study other possible risk
factors for CAD.
High levels of a protein called C-reactive protein
(CRP) in the blood may raise the risk for CAD and
heart
attack. High levels of CRP are proof of inflammation in the body.
Inflammation is the body's response to injury or infection. Damage to the
arteries' inner walls seems to trigger inflammation and help plaque grow.
Research is under way to find out whether reducing
inflammation and lowering CRP levels also can reduce the risk of developing CAD
and having a heart attack.
High levels of fats called triglycerides in the
blood also may raise the risk of CAD, particularly in women.
Other Factors That Affect Coronary Artery
Disease
Other factors also may contribute to CAD. These
include:
- Sleep
apnea. Sleep apnea is a disorder in which your breathing stops or gets very
shallow while you're sleeping. Untreated sleep apnea can raise your chances of
having high blood pressure, diabetes, and even a heart attack or
stroke.
- Stress. Research shows that the most commonly
reported "trigger" for a heart attack is an emotionally upsetting
eventparticularly one involving anger.
- Alcohol. Heavy drinking can damage the heart
muscle and worsen other risk factors for heart disease. Men should have no more
than two drinks containing alcohol a day. Women should have no more than one
drink containing alcohol a day.
What Are the Signs and Symptoms of Coronary Artery
Disease?
A common symptom of coronary artery disease (CAD) is
angina.
Angina is chest pain or discomfort that occurs when your heart muscle doesn't
get enough oxygen-rich blood.
Angina may feel like pressure or a squeezing pain in
your chest. You also may feel it in your shoulders, arms, neck, jaw, or back.
This pain tends to get worse with activity and go away when you rest. Emotional
stress also can trigger the pain.
Another common symptom of CAD is shortness of
breath. This symptom happens if CAD causes
heart
failure. When you have heart failure, your heart can't pump enough blood
throughout your body. Fluid builds up in your lungs, making it hard to breathe.
The severity of these symptoms varies. The symptoms
may get more severe as the buildup of plaque continues to narrow the coronary
arteries.
Signs and Symptoms of Heart Problems Linked to
Coronary Artery Disease
Some people who have CAD have no signs or symptoms.
This is called silent CAD. It may not be diagnosed until a person show signs
and symptoms of a
heart
attack, heart failure, or an
arrhythmia
(an irregular heartbeat).
Heart Attack
A heart attack happens when an area of plaque in a
coronary artery breaks apart, causing a blood clot to form.
The blood clot cuts off most or all blood to the
part of the heart muscle that's fed by that artery. Cells in the heart muscle
die because they don't receive enough oxygen-rich blood. This can cause lasting
damage to your heart. For more information, see the animation in
"What
Causes a Heart Attack?"
Heart With Muscle Damage and a
Blocked Artery
![Illustration showing an overview of a heart and coronary artery showing damage caused by a heart attack. The illustration also shows a cross-section of the coronary artery with plaque buildup and a blood clot.](https://webarchive.library.unt.edu/eot2008/20090117204530im_/http://www.nhlbi.nih.gov/health/dci/images/heart_coronary_artery.gif)
Figure A is an overview of a heart
and coronary artery showing damage (dead heart muscle) caused by a heart
attack. Figure B is a cross-section of the coronary artery with plaque buildup
and a blood clot.
The most common symptom of heart attack is chest
pain or discomfort. Most heart attacks involve discomfort in the center of the
chest that lasts for more than a few minutes or goes away and comes back. The
discomfort can feel like pressure, squeezing, fullness, or pain. It can be mild
or severe. Heart attack pain can sometimes feel like indigestion or heartburn.
Heart attacks also can cause upper body discomfort
in one or both arms, the back, neck, jaw, or stomach. Shortness of breath or
fatigue (tiredness) often may occur with or before chest discomfort. Other
symptoms of heart attack are nausea (feeling sick to your stomach), vomiting,
lightheadedness or fainting, and breaking out in a cold sweat.
Heart Failure
Heart failure is a condition in which your heart
can't pump enough blood to your body. Heart failure doesn't mean that your
heart has stopped or is about to stop working. It means that your heart can't
fill with enough blood or pump with enough force, or both.
This causes you to have shortness of breath and
fatigue that tends to increase with activity. Heart failure also can cause
swelling in your feet, ankles, legs, and abdomen.
Arrhythmia
An arrhythmia is a problem with the speed or rhythm
of the heartbeat. When you have an arrhythmia, you may notice that your heart
is skipping beats or beating too fast. Some people describe arrhythmias as a
fluttering feeling in their chests. These feelings are called palpitations.
Some arrhythmias can cause your heart to suddenly
stop beating. This condition is called
sudden
cardiac arrest (SCA). SCA can make you faint and it can cause death
if its not treated right away.
For more information, see the animations in
"Types
of Arrhythmia."
How Is Coronary Artery Disease Diagnosed?
Your doctor will diagnose coronary artery disease
(CAD) based on:
- Your medical and family histories
- Your risk factors
- The results of a physical exam and diagnostic
tests and procedures
Diagnostic Tests and Procedures
No single test can diagnose CAD. If your doctor
thinks you have CAD, he or she will probably do one or more of the following
tests.
EKG (Electrocardiogram)
An
EKG
is a simple test that detects and records the electrical activity of your
heart. An EKG shows how fast your heart is beating and whether it has a regular
rhythm. It also shows the strength and timing of electrical signals as they
pass through each part of your heart.
Certain electrical patterns that the EKG detects can
suggest whether CAD is likely. An EKG also can show signs of a previous or
current
heart
attack.
Stress Testing
During
stress
testing, you exercise to make your heart work hard and beat fast while
heart tests are performed. If you can't exercise, you're given medicine to
speed up your heart rate.
When your heart is beating fast and working hard, it
needs more blood and oxygen. Arteries narrowed by plaque can't supply enough
oxygen-rich blood to meet your heart's needs. A stress test can show possible
signs of CAD, such as:
- Abnormal changes in your heart rate or blood
pressure
- Symptoms such as shortness of breath or chest
pain
- Abnormal changes in your heart rhythm or your
heart's electrical activity
During the stress test, if you can't exercise for as
long as what's considered normal for someone your age, it may be a sign that
not enough blood is flowing to your heart. But other factors besides CAD can
prevent you from exercising long enough (for example, lung diseases,
anemia,
or poor general fitness).
Some stress tests use a radioactive dye, sound
waves, positron emission tomography (PET), or
cardiac
magnetic resonance imaging (MRI) to take pictures of your heart when it's
working hard and when it's at rest.
These imaging stress tests can show how well blood
is flowing in the different parts of your heart. They also can show how well
your heart pumps blood when it beats.
Echocardiography
This test uses sound waves to create a moving
picture of your heart.
Echocardiography
provides information about the size and shape of your heart and how well your
heart chambers and valves are working.
The test also can identify areas of poor blood flow
to the heart, areas of heart muscle that aren't contracting normally, and
previous injury to the heart muscle caused by poor blood flow.
Chest X Ray
A
chest x ray takes a picture of the organs and structures
inside the chest, including your heart, lungs, and blood vessels.
A chest x ray can reveal signs of
heart
failure, as well as lung disorders and other causes of symptoms that aren't
due to CAD.
Blood Tests
Blood tests check the levels of certain fats,
cholesterol, sugar, and proteins in your blood. Abnormal levels may show that
you have risk factors for CAD.
Electron-Beam Computed Tomography
Your doctor may recommend
electron-beam
computed tomography (EBCT). This test finds and measures calcium deposits
(called calcifications) in and around the coronary arteries. The more calcium
detected, the more likely you are to have CAD.
EBCT isn't used routinely to diagnose CAD, because
its accuracy isn't yet known.
Coronary Angiography and Cardiac
Catheterization
Your doctor may ask you to have
coronary
angiography (an-jee-OG-ra-fee) if other tests or factors show that you're
likely to have CAD. This test uses dye and special x rays to show the insides
of your coronary arteries.
To get the dye into your coronary arteries, your
doctor will use a procedure called
cardiac
catheterization (KATH-e-ter-i-ZA-shun). A long, thin, flexible tube called
a catheter is put into a blood vessel in your arm, groin (upper thigh), or
neck. The tube is then threaded into your coronary arteries, and the dye is
released into your bloodstream. Special x rays are taken while the dye is
flowing through your coronary arteries.
Cardiac catheterization is usually done in a
hospital. You're awake during the procedure. It usually causes little to no
pain, although you may feel some soreness in the blood vessel where your doctor
put the catheter.
How Is Coronary Artery Disease Treated?
Treatment for coronary artery disease (CAD) may
include lifestyle changes, medicines, and medical procedures. The goals of
treatments are to:
- Relieve symptoms
- Reduce risk factors in an effort to slow, stop,
or reverse the buildup of plaque
- Lower the risk of blood clots forming, which can
cause a
heart
attack
- Widen or bypass clogged arteries
- Prevent complications of CAD
Lifestyle Changes
Making lifestyle changes can often help prevent or
treat CAD. For some people, these changes may be the only treatment needed:
- Follow a heart healthy eating plan to prevent or
reduce
high
blood pressure and
high
blood cholesterol and to maintain a healthy weight
- Increase your physical activity. Check with your
doctor first to find out how much and what kinds of activity are safe for you.
- Lose weight, if you're overweight or obese.
- Quit smoking, if you smoke. Avoid exposure to
secondhand smoke.
- Learn to cope with and
reduce stress.
Follow a Heart Healthy Eating Plan
For a heart healthy eating plan, go to the National
Heart, Lung, and Blood Institute's (NHLBI's)
Aim
for a Healthy Weight Web site. This site provides practical tips on healthy
eating, physical activity, and controlling your weight.
Therapeutic Lifestyle Changes
(TLC). Your doctor may recommend TLC if you have high cholesterol. TLC
is a three-part program that includes a healthy diet, physical activity, and
weight management.
With the TLC diet, less than 7 percent of your daily
calories should come from saturated fat. This kind of fat is mainly found in
meat and poultry, including dairy products. No more than 25 to 35 percent of
your daily calories should come from all fats, including saturated,
trans, monounsaturated, and polyunsaturated fats.
You also should have less than 200 mg a day of
cholesterol. The amounts of cholesterol and the different kinds of fat in
prepared foods can be found on the Nutrition Facts label.
Foods high in soluble fiber also are part of a
healthy eating plan. They help block the digestive track from absorbing
cholesterol. These foods include:
- Whole grain cereals such as oatmeal and oat bran
- Fruits such as apples, bananas, oranges, pears,
and prunes
- Legumes such as kidney beans, lentils, chick
peas, black-eyed peas, and lima beans
A diet high in fruits and vegetables can increase
important cholesterol-lowering compounds in your diet. These compounds, called
plant stanols or sterols, work like soluble fiber.
Fish are an important part of a heart healthy diet.
They're a good source of omega-3 fatty acids, which may help protect the heart
from blood clots and inflammation and reduce the risk for heart attack. Try to
have about two fish meals every week. Fish high in omega-3 fats are salmon,
tuna (canned or fresh), and mackerel.
You also should try to limit the amount of sodium
(salt) that you eat. This means choosing low-sodium and low-salt foods and "no
added salt" foods and seasonings at the table or when cooking. The Nutrition
Facts label on food packaging shows the amount of sodium in the item.
Try to limit alcoholic drinks. Too much alcohol will
raise your blood pressure and triglyceride level. (Triglycerides are a type of
fat found in the blood.) Alcohol also adds extra calories, which will cause
weight gain. Men should have no more than two alcoholic drinks a day. Women
should have no more than one alcoholic drink a day.
See the NHLBI's
"Your
Guide to Lowering Your Cholesterol With TLC" for more information.
Dietary Approaches to Stop Hypertension
(DASH) eating plan. Your doctor may recommend the DASH eating plan if
you have high blood pressure. The DASH eating plan focuses on fruits,
vegetables, whole grains, and other foods that are heart healthy and lower in
salt/sodium.
This eating plan is low in fat and cholesterol. It
also focuses on fat-free or low-fat milk and dairy products, fish, poultry, and
nuts. The DASH eating plan is reduced in red meat (including lean red meat),
sweets, added sugars, and sugar-containing beverages. It's rich in nutrients,
protein, and fiber.
The DASH eating plan is a good heart healthy eating
plan, even for those who don't have high blood pressure. See the NHLBI's
"Your
Guide to Lowering Your Blood Pressure With DASH" for more information.
Increase Physical Activity
Regular physical activity can lower many CAD risk
factors, including LDL ("bad") cholesterol, high blood pressure, and excess
weight. Physical activity also can lower your risk for
diabetes and raise your levels of HDL cholesterol (the "good"
cholesterol that helps prevent CAD).
Check with your doctor about how much and what kinds
of physical activity are safe for you. Unless your doctor tells you otherwise,
try to get at least 30 minutes of moderate-intensity activity on most or all
days of the week. You can do the activity all at once or break it up into
shorter periods of at least 10 minutes each.
Moderate-intensity activities include brisk walking,
dancing, bowling, bicycling, gardening, and housecleaning.
More intense activities, such as jogging, swimming,
and various sports, also may be appropriate for shorter periods. See the
NHLBI's
"Your
Guide to Physical Activity and Your Heart" for more information.
Maintain a Healthy Weight
Maintaining a healthy weight can decrease risk
factors for CAD. If you're overweight, aim to reduce your weight by 7 to 10
percent during your first year of treatment. This amount of weight loss can
lower your risk for CAD and other health problems.
After the first year, you may have to continue to
lose weight so you can lower your body mass index (BMI) to less than 25.
BMI measures your weight in relation to your height
and gives an estimate of your total body fat. A BMI between 25 and 29 is
considered overweight. A BMI of 30 or more is considered obese. A BMI of less
than 25 is the goal for preventing and treating CAD.
You can calculate your BMI using the NHLBI's
online calculator, or your
health care provider can calculate your BMI.
For more information on losing weight and
maintaining your weight, see the Diseases and Conditions Index
Overweight
and Obesity article.
Quit Smoking
If you smoke or use tobacco, quit. Smoking can
damage and tighten blood vessels and raise your risk for CAD. Talk to your
doctor about programs and products that can help you quit. The U.S. Department
of Health and Human Services also has information on how to
quit smoking.
You also should avoid exposure to secondhand smoke.
Reduce Stress
Research shows that the most commonly reported
"trigger" for a heart attack is an emotionally upsetting
eventparticularly one involving anger. Also, some of the ways people cope
with stress, such as drinking, smoking, or overeating, aren't heart healthy.
Physical activity can help relieve stress and reduce
other CAD risk factors. Many people also find that meditation or relaxation
therapy helps them reduce stress.
Medicines
You may need medicines to treat CAD if lifestyle
changes aren't enough. Medicines can:
- Decrease the workload on your heart and relieve
CAD symptoms
- Decrease your chance of having a heart attack or
dying suddenly
- Lower your cholesterol and blood pressure
- Prevent blood clots
- Prevent or delay the need for a special procedure
(for example,
angioplasty
or coronary
artery bypass grafting (CABG))
Medicines used to treat CAD include anticoagulants
(AN-te-ko-AG-u-lants), aspirin and other antiplatelet (an-ty-PLAYT-lit)
medicines, ACE inhibitors, beta blockers, calcium channel blockers,
nitroglycerin, glycoprotein IIb-IIIa, statins, and fish oil and other
supplements high in omega-3 fatty acids.
Medical Procedures
You may need a medical procedure to treat CAD. Both
angioplasty and CABG are used as treatments.
Angioplasty opens blocked or narrowed coronary
arteries. During angioplasty, a thin tube with a balloon or other device on the
end is threaded through a blood vessel to the narrowed or blocked coronary
artery. Once in place, the balloon is inflated to push the plaque outward
against the wall of the artery. This widens the artery and restores the flow of
blood.
Angioplasty can improve blood flow to your heart,
relieve chest pain, and possibly prevent a heart attack. Sometimes a small mesh
tube called a
stent
is placed in the artery to keep it open after the procedure.
In CABG, arteries or veins from other areas in your
body are used to bypass (that is, go around) your narrowed coronary arteries.
CABG can improve blood flow to your heart, relieve chest pain, and possibly
prevent a heart attack.
You and your doctor can discuss which treatment is
right for you.
Cardiac Rehabilitation
Your doctor may prescribe cardiac rehabilitation
(rehab) for angina or after CABG, angioplasty, or a heart attack. Cardiac
rehab, when combined with medicine and surgical treatments, can help you
recover faster, feel better, and develop a healthier lifestyle. Almost everyone
with CAD can benefit from cardiac rehab.
The cardiac rehab team may include doctors, nurses,
exercise specialists, physical and occupational therapists, dietitians, and
psychologists or other behavioral therapists.
Rehab has two parts:
- Exercise training. This part helps you learn how
to exercise safely, strengthen your muscles, and improve your stamina. Your
exercise plan will be based on your individual abilities, needs, and interests.
- Education, counseling, and training. This part of
rehab helps you understand your heart condition and find ways to reduce your
risk for future heart problems. The cardiac rehab team will help you learn how
to cope with the stress of adjusting to a new lifestyle and with your fears
about the future.
For more information on cardiac rehab, see the
Diseases and Conditions Index
Cardiac
Rehabilitation article.
How Can Coronary Artery Disease Be Prevented or
Delayed?
Taking action to control your
risk factors can help prevent or delay
coronary artery disease (CAD). Your chance of developing CAD goes up with the
number of risk factors you have.
Making lifestyle changes and taking prescribed
medicines are important steps. See "How Is
Coronary Artery Disease Treated?" for information on heart healthy eating
plans, physical activity, maintaining a healthy weight, and medicines.
Know your family history of health problems related
to CAD. If you or someone in your family has CAD, be sure to tell your doctor.
Also, let your doctor know if you smoke.
Living With Coronary Artery Disease
Coronary artery disease (CAD) can cause serious
complications. However, if you follow your doctor's advice and change your
habits, you can prevent or reduce the chances of:
- Dying suddenly from heart problems
- Having a
heart
attack and permanently damaging your heart muscle
- Damaging your heart because of reduced oxygen
supply
- Having
arrhythmias
(irregular heartbeats)
Ongoing Health Care Needs
Doing physical activity regularly, taking prescribed
medicines, following a heart healthy eating plan, and watching your weight can
help control CAD. (See "How Is Coronary Artery
Disease Treated?" for more information).
See your doctor regularly to keep track of your
blood pressure and blood cholesterol and blood sugar levels. A cholesterol
blood test will show your levels of LDL ("bad") cholesterol, HDL ("good")
cholesterol, and triglycerides. A fasting blood glucose test will check your
blood sugar level and show if you're at risk for or have
diabetes. These tests will show whether you need more
treatments for your CAD.
Talk to your doctor about how often you should
schedule office visits or blood tests. Between those visits, call your doctor
if you develop any new symptoms or if your symptoms worsen.
CAD raises your risk for heart attack. Learn
the symptoms of
heart
attack and
arrhythmia.
Call 911 if you have any of these symptoms for more
than 5 minutes:
- Chest discomfort or painuncomfortable
pressure, squeezing, fullness, or pain in the center of the chest that can be
mild or strong. This discomfort or pain lasts more than a few minutes or goes
away and comes back.
- Upper body discomfort in one or both arms, the
back, neck, jaw, or stomach.
- Shortness of breath, which may occur with or
before chest discomfort.
It's important to know the difference between
angina
and a heart attack. During a heart attack, the pain is usually more severe than
angina, and it doesn't go away when you rest or take medicine. If you don't
know whether your chest pain is angina or a heart attack, call
911.
Let the people you see regularly know you're at risk
for a heart attack. They can seek emergency care if you suddenly faint,
collapse, or develop other severe symptoms.
You may feel depressed or anxious if you've been
diagnosed with CAD and/or had a heart attack. You may worry about heart
problems or making lifestyle changes that are necessary for your health. Your
doctor may recommend medicine, professional counseling, or relaxation therapy
if you have depression or anxiety.
Physical activity can improve mental well-being, but
you should talk to your doctor before starting any fitness activities. It's
important to treat any anxiety or depression that develops because it raises
your risk of having a heart attack.
Key Points
- Coronary artery disease (CAD) is a condition in
which plaque builds up inside the coronary arteries. These arteries supply your
heart muscle with oxygen-rich blood.
- Plaque narrows the coronary arteries and reduces
blood flow to your heart muscle. It also makes it more likely that blood clots
will form in your arteries. Blood clots can partially or completely block blood
flow.
- CAD can lead to
angina,
heart
attack,
heart
failure, and
arrhythmias
(irregular heartbeats).
- CAD is the most common type of heart disease.
It's the leading cause of death in the United States for both men and women.
- Research suggests that CAD starts when certain
factors damage the inner layers of the coronary arteries. When damage occurs,
your body starts a healing process. This healing causes plaque to build up
where the artery is damaged. Over time, the plaque may crack and causes blood
clots to form in the arteries. This can worsen angina or cause a heart attack.
- Many factors raise the risk of developing
CAD. Major risk factors include
unhealthy
blood cholesterol levels,
high
blood pressure, smoking, insulin resistance,
diabetes,
overweight
or obesity,
metabolic
syndrome, lack of physical activity, age, and a family history of early
heart disease.
- Common symptoms of CAD are angina and shortness
of breath. However, some people have no signs or symptoms. This is called
silent CAD. It may not be diagnosed until a person shows signs and symptoms of
a heart attack, heart failure, or an arrhythmia.
- Your doctor will diagnose CAD based on your
medical and family histories, your risk factors, and the results of diagnostic
tests.
- Treatment for CAD may include lifestyle changes,
medicines, and medical procedures. Lifestyle changes include following a heart
healthy eating plan, increasing physical activity, maintaining a healthy
weight, quitting smoking, and reducing stress.
- Taking action to control your risk factors can
help prevent or delay CAD. You can take action by making lifestyle changes
and/or taking medicines as prescribed by your doctor.
- If you've been diagnosed with CAD, you can
control the disease with lifestyle changes and medicines. See your doctor
regularly, and call him or her if you develop any new symptoms or your symptoms
become more severe.
Links to Other Information About Coronary Artery
Disease
NHLBI Resources
Non-NHLBI Resources
Clinical Trials
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