Coronary Artery Disease
Coronary artery disease (CAD) is one of the most common types of heart disease. It develops when the arteries that supply blood to the heart muscle become narrowed or blocked, usually because of the buildup of fatty deposits called plaque. Reduced blood flow to the heart can cause chest discomfort, shortness of breath and other symptoms, and in severe cases may lead to a heart attack.
At DHEE Hospitals Cardiology, comprehensive evaluation and management of coronary artery disease can help identify the extent of the condition, manage cardiovascular risk factors and determine the appropriate treatment approach for each patient.
What Is Coronary Artery Disease?
The coronary arteries supply oxygen-rich blood to the heart muscle. Over time, cholesterol and other substances can accumulate within the artery walls, forming plaque. This process is known as atherosclerosis.
As plaque builds up, the arteries may become narrower, reducing blood flow to the heart. A blood clot can sometimes form over a ruptured plaque and suddenly block blood flow, potentially causing a heart attack.
What Causes Coronary Artery Disease?
Coronary artery disease usually develops gradually over many years. Several factors can contribute to the development and progression of atherosclerosis.
- High LDL cholesterol
- High blood pressure
- Diabetes
- Smoking and tobacco use
- Being overweight or obese
- Physical inactivity
- Unhealthy dietary patterns
- Increasing age
- Family history of cardiovascular disease
Having multiple risk factors can increase the likelihood of developing coronary artery disease.
Symptoms of Coronary Artery Disease
Some people with coronary artery disease have no noticeable symptoms, particularly during the early stages. When blood flow to the heart becomes insufficient, symptoms may develop, especially during physical activity or emotional stress.
Common symptoms include:
- Chest pain or discomfort: Often described as pressure, tightness, heaviness or squeezing.
- Shortness of breath: Particularly during physical activity.
- Fatigue: Unusual tiredness or reduced exercise tolerance.
- Discomfort in the arm, shoulder, back, neck or jaw: This may occur with or without chest discomfort.
- Dizziness or light-headedness: Particularly when associated with other cardiac symptoms.
What Is Angina?
Angina is chest discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. It can be a symptom of coronary artery disease.
Angina may occur during physical activity or emotional stress and may improve with rest. However, new, worsening or persistent chest discomfort requires prompt medical evaluation because it may indicate a more serious problem.
Can Coronary Artery Disease Occur Without Symptoms?
Yes. Coronary artery disease can sometimes remain unnoticed until it causes a significant reduction in blood flow or an acute cardiovascular event. Some people may have few or no typical symptoms.
People with risk factors such as diabetes, high blood pressure, high cholesterol, smoking history or a strong family history of heart disease should discuss their cardiovascular risk with a healthcare professional.
How Is Coronary Artery Disease Diagnosed?
Your cardiologist will consider your symptoms, medical history, cardiovascular risk factors and physical examination before deciding which investigations are appropriate.
Depending on your individual situation, evaluation may include:
- Electrocardiogram (ECG): Records the electrical activity of the heart.
- Echocardiogram: Evaluates the structure and pumping function of the heart.
- Exercise stress testing: Assesses the heart’s response to physical activity in appropriate patients.
- Blood tests: May assess cholesterol, blood sugar and other cardiovascular risk factors.
- CT coronary angiography: Uses CT imaging to evaluate the coronary arteries in selected patients.
- Coronary angiography: Provides detailed images of the coronary arteries and may be recommended when significant coronary artery disease is suspected or when intervention is being considered.
How Is Coronary Artery Disease Treated?
Treatment depends on the severity of the disease, symptoms, affected arteries and the patient’s overall cardiovascular risk. Management may involve lifestyle changes, medications or procedures.
Lifestyle Changes
Heart-healthy lifestyle measures are an important part of managing coronary artery disease. Your healthcare team may recommend:
- Following a balanced, heart-healthy diet
- Maintaining a healthy body weight
- Engaging in appropriate regular physical activity
- Stopping smoking and avoiding tobacco
- Managing stress
- Controlling blood pressure, cholesterol and blood sugar
Medications
Depending on your condition, your doctor may prescribe medications to control cardiovascular risk factors, reduce symptoms or lower the risk of complications. These may include cholesterol-lowering medicines, blood pressure medicines, antiplatelet medicines or other cardiac medications.
Take prescribed medication as directed and do not stop or change treatment without consulting your doctor.
Angioplasty and Stent Placement
In selected patients with significant coronary artery narrowing, angioplasty may be used to improve blood flow through the affected artery. A balloon is used to widen the narrowed area, and a stent may be placed to help keep the artery open.
The need for angioplasty and stenting depends on the patient’s symptoms, coronary anatomy and overall clinical condition.
Coronary Artery Bypass Surgery
For some patients with extensive or complex coronary artery disease, coronary artery bypass grafting (CABG) may be considered. The procedure creates new pathways for blood to flow around significantly narrowed or blocked coronary arteries.
Your cardiology team will determine the most appropriate treatment based on the location and extent of coronary artery disease and other individual factors.
How Can Coronary Artery Disease Be Prevented?
Some risk factors, such as age and family history, cannot be changed. However, many important cardiovascular risk factors can be managed.
Steps that can support heart health include:
- Keeping blood pressure under control
- Managing cholesterol levels
- Maintaining healthy blood sugar levels
- Avoiding smoking and tobacco
- Maintaining a healthy weight
- Following a balanced diet
- Staying physically active
- Attending recommended health and cardiac check-ups
When Should You Seek Emergency Care?
Sudden or persistent chest pressure, squeezing or discomfort can be a warning sign of a heart attack, particularly when accompanied by shortness of breath, sweating, nausea, dizziness or pain spreading to the arm, back, neck or jaw.
Do not wait for these symptoms to disappear. Seek emergency medical care immediately if you suspect a heart attack.
Living With Coronary Artery Disease
Coronary artery disease is often a long-term condition that requires ongoing management. Following your treatment plan, taking prescribed medications, attending follow-up appointments and controlling cardiovascular risk factors can help support long-term heart health.
Your cardiologist can also advise you about appropriate physical activity, diet, medications and monitoring based on the severity of your condition.
Coronary Artery Disease Care at DHEE Hospitals Cardiology
DHEE Hospitals Cardiology provides evaluation and management for patients with coronary artery disease and other cardiovascular conditions. From assessing symptoms and cardiovascular risk factors to performing appropriate diagnostic investigations and planning treatment, care is tailored to the individual patient’s needs.
If you experience symptoms suggestive of coronary artery disease or have multiple cardiovascular risk factors, consult a cardiologist for an appropriate evaluation.
Frequently Asked Questions About Coronary Artery Disease
Is coronary artery disease curable?
Coronary artery disease is a chronic condition, but its progression and associated cardiovascular risk can often be managed through lifestyle changes, medications and appropriate medical or interventional treatment.
Can coronary artery disease cause a heart attack?
Yes. A significant blockage or sudden formation of a blood clot within a coronary artery can reduce or completely stop blood flow to part of the heart muscle, resulting in a heart attack.
Can coronary artery disease be present without chest pain?
Yes. Some people may have coronary artery disease without typical chest pain. This can occur particularly in people with certain risk factors, including diabetes. Regular cardiovascular risk assessment can help identify potential concerns.
Does everyone with coronary artery disease need a stent?
No. Treatment depends on the severity and location of the disease, symptoms and other clinical factors. Some patients can be managed with medication and lifestyle changes, while others may require angioplasty, stenting or bypass surgery.
