Coronary Artery Disease

Coronary artery disease develops when the major blood vessels that supply your heart become damaged or diseased.
Cholesterol-containing deposits (plaques) in your coronary arteries and inflammation are usually to blame for coronary artery disease.
The coronary arteries supply blood, oxygen, and nutrients to your heart.
A buildup of plaque can narrow these arteries, decreasing blood flow to your heart.
Eventually, the reduced blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms.
A complete blockage can cause a heart attack.
Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack.
But you can take steps to prevent and treat coronary artery disease.
A healthy lifestyle can make a big impact.

Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood.
The damage may be caused by various factors, including
Smoking
High blood pressure
High cholesterol
Diabetes or insulin resistance
Not being active (sedentary lifestyle)
Once the inner wall of an artery is damaged, fatty deposits (plaque) made of cholesterol and other cellular waste products tend to collect at the site of injury.
This process is called atherosclerosis.
If the plaque surface breaks or ruptures, blood cells called platelets clump together at the site to try to repair the artery.
This clump can block the artery, leading to a heart attack.
Other risk factors for CAD are:
Sex
Age
Obesity
Family stress
High stress
Unhealthy diet
Sometimes coronary artery disease develops without any classic risk factors.
Researchers are studying other possible risk factors, including:
High triglycerides
Sleep apnea
High-sensitivity C-reactive protein (hs-CRP)
Homocysteine
Alcohol use
Preeclampsia
Autoimmune diseases

If your coronary arteries narrow, they can’t supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise.
At first, the decreased blood flow may not cause any symptoms.
As plaque continues to build up in your coronary arteries you may develop the following coronary artery disease signs and symptoms:
Chest pain or discomfort (angina)
Weakness, light-headedness, nausea (feeling sick to your stomach), or a cold sweat
Pain or discomfort in the arms or shoulder
Shortness of breath
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.

Measures the electrical activity, rate, and regularity of your heartbeat.

Uses ultrasound (special sound wave) to create a picture of the heart.

Measures your heart rate while you walk on a treadmill.

This helps to determine how well your heart is working when it has to pump more blood.

Uses x-rays to create a picture of the heart, lungs, and other organs in the chest.

Checks the inside of your arteries for blockage by inserting a thin, flexible tube through an artery in the groin, arm, or neck to reach the heart.

Monitors blockage and flow of blood through the coronary arteries.

Uses X-rays to detect dye injected via cardiac catheterization.

A computed tomography (CT) scan that looks in the coronary arteries for calcium buildup and plaque.

Treatment for coronary artery disease usually involves lifestyle changes and, if necessary, drugs and certain medical procedures.

Lifestyle

Making a commitment to the following healthy lifestyle changes can go a long way toward promoting healthier arteries:
Quit smoking
Eat healthy foods
Exercise regularly
Lose excess weight
Reduce stress

Medication

Various drugs can be used to treat coronary artery disease, including:
Aspirin
Cholesterol-modifying medications
Calcium channel blockers
Beta blockers
Ranolazine
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)
Nitroglycerin

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