Coronary Artery Disease
Coronary artery disease (CAD) develops when plaque narrows the arteries that supply blood to the heart muscle. It is the most common form of heart disease and a leading cause of heart attacks.
Table of Contents
Quick Facts
- Type: Cardiovascular disease
- ICD-10: I25
- Most common cause: Atherosclerosis
- Leading cause of: Heart attacks
Overview
The coronary arteries deliver oxygen-rich blood to the heart. Over years, fatty deposits (plaque) build up on the artery walls and narrow them — a process called atherosclerosis. Reduced blood flow can cause angina; sudden plaque rupture with clot formation causes a heart attack.
Symptoms
- Angina — chest pressure, squeezing, or discomfort, often brought on by exertion and relieved by rest
- Shortness of breath, especially with exertion
- Pain radiating to the arm, jaw, neck, or back
- Nausea or sweating with chest discomfort
- Fatigue
Some people have no symptoms until a heart attack occurs.
Risk Factors
- High blood pressure
- High cholesterol
- Diabetes
- Smoking
- Obesity and physical inactivity
- Family history of early heart disease
- Age, male sex, and postmenopausal status
- Chronic kidney disease
Diagnosis
- ECG (resting and stress)
- Stress testing (exercise or pharmacologic, with or without imaging)
- Coronary calcium score (CT)
- Coronary CT angiography
- Invasive coronary angiography (cardiac catheterization)
- Blood tests for lipids, glucose, kidney function, and troponin
Treatment
Lifestyle
- Quit smoking
- Heart-healthy diet (Mediterranean or DASH)
- Regular exercise
- Healthy weight
- Manage stress; treat sleep apnea
Medications
- Statins (and other lipid-lowering agents)
- Antiplatelet agents (aspirin, sometimes others)
- Blood-pressure medications
- Beta-blockers and nitrates for angina control
- SGLT2 inhibitors / GLP-1 agonists for selected patients with diabetes
Procedures
- Percutaneous coronary intervention (angioplasty with stents)
- Coronary artery bypass grafting (CABG) for advanced multi-vessel disease
When to See a Doctor
Schedule an appointment for chest discomfort with exertion, shortness of breath, or a strong family history. Call 911 for chest pain at rest, severe symptoms, or any features that suggest a heart attack.
Frequently Asked Questions
CAD is the underlying disease — plaque-narrowed arteries. A heart attack is an acute event that often occurs when a plaque ruptures and clots off the artery.
Aggressive risk-factor control and high-intensity cholesterol lowering can stabilize and modestly regress plaque. Severe narrowings may still need procedures.
Aspirin is usually recommended after a heart attack or stent. For primary prevention (no prior event), routine aspirin is no longer recommended for most adults — discuss with your doctor.
It depends on the pattern of disease, your overall health, and other factors. For complex multi-vessel disease, bypass often provides better long-term outcomes; for focal blockages, stenting is often preferred.
References
- American Heart Association/American College of Cardiology. Coronary Artery Disease Guidelines.