What Is Coronary Artery Disease?

Coronary artery disease (CAD) is the most common form of heart disease that results from damage to the large arteries, called the coronary arteries, that supply blood to the heart. Coronary artery damage occurs when plaque builds up within the walls of the arteries (atherosclerosis), leading to narrowing and weakening of the artery walls.

Over time, plaque buildup (deposits of cholesterol, a waxy, fatty substance) can get worse and restrict the amount of blood that is delivered to the heart, which can lead to a heart attack. Sometimes, symptoms are present before this occurs. This article will review symptoms, causes, and treatment of CAD as well as tips for managing the condition. 

Coronary Artery Disease Symptoms

The most common symptom of CAD is angina, or chest pain. Clogged coronary arteries block blood flow to the muscle of the heart. This causes the heart to have to pump harder, especially during increased activity, to send blood throughout the body. This increased workload can result in pain, pressure, and a squeezing sensation in the chest, which is often the only early sign of CAD. 

If angina is not present, having a heart attack can sometimes be the first sign of having CAD. A heart attack occurs when lack of blood and oxygen to the heart causes damage to the heart muscle, which can interfere with its ability to beat properly.

Other symptoms of coronary artery disease may include:

• Chest tightness
• Generalized body weakness
• Light-headedness
• Nausea
• Pain or discomfort in the arms or shoulders
• Shortness of breath

Over time, lack of proper blood supply to the heart from coronary artery disease can weaken the ability of the heart to pump blood throughout the body and can lead to heart failure. 

What Causes Coronary Artery Disease?

CAD is caused by the formation of plaque that builds up within the large arteries of the heart called the coronary arteries. Plaque builds up within arteries when excess cholesterol in the blood gets deposited within the walls of arteries. This plaque buildup narrows arteries, leading to atherosclerosis.

Risk factors, many of which you can control, increase the risk of plaque buildup within the coronary arteries. These include several conditions including:

• High blood pressure
• High cholesterol 
• Diabetes
• Obesity 

Other risk factors for CAD include lifestyle habits that increase inflammation throughout the body and weaken the health of your heart and blood vessels. These include lack of physical activity, unhealthy eating, drinking too much alcohol, and smoking tobacco.

Testing to Diagnose CAD

Certain tests that examine your heart function can help diagnose CAD. These include:

• Electrocardiogram (ECG or EKG): A test that measures the electrical activity of your heart to assess your heart rate and regularity of your heartbeat
• Echocardiogram (echo): A test that uses ultrasound waves to examine the structure of your heart
• Exercise stress test: A test that measures your heart rate while walking on a treadmill to examine how your heart is working when it has to pump more blood throughout your body
• Chest X-ray: An X-ray image produced by radiation to examine the structure of your heart and lungs
• Cardiac catheterization: A test in which a thin tube called a catheter is inserted into your arteries to check for blockage
• Coronary angiogram: A test that examines the flow of blood through the coronary arteries
• Coronary artery calcium scan: A computed tomography (CT) scan that examines the coronary arteries for plaque and calcium buildup 

Coronary Artery Disease Treatment 

Treatment for CAD aims to prevent worsening of clogged arteries (atherosclerosis), reduce symptoms like angina, and improve blood flow and heart function. Treatment methods include healthy lifestyle habits like regular exercise and medical treatments like medication and surgery.

Exercise

Exercise and regular physical activity can help improve heart function and blood flow throughout the body. It is important for both the treatment and prevention of CAD. The American Heart Association recommends at least a total of 150 minutes of moderate intensity exercise per week or 75 minutes of vigorous intensity exercise over tree to five days.

Medication

Medication is one of the most important treatments for CAD. Depending on condition severity and any other conditions you have, your healthcare provider may prescribe one or more of the following medications:

• Beta-blockers (blood pressure–lowering medications)
• Calcium channel blockers (blood pressure–lowering medications)
• Nitrates (medications for angina)
• Acetylsalicylic acid (aspirin) (reduces risk of atherothrombosis, a blood clot forming in an artery)
• Statins (cholesterol medications)
• Renin-angiotensin-aldosterone system (RAAS) inhibitors (blood pressure regulators)

Surgery

For severe CAD that continues to negatively impact heart function even with medication, surgery may be needed to improve the function of the coronary arteries. Surgery can include:

• Cardiac catheterization: A procedure in which a small tube is inserted into a clogged, narrowed artery to expand it in size and improve blood flow to the heart 
• Coronary artery bypass graft (CABG): A procedure in which an artery or vein is removed from one part of the body, often the leg, and inserted near the heart to allow an alternate pathway around a narrowed artery to improve blood flow to the heart

Can CAD Be Reversed?

CAD causes permanent damage to the heart and its blood vessels, so it cannot be reversed. That’s why prevention is especially important to prevent the development of the condition and lifelong side effects. 

Daily Life With CAD

Living with CAD can affect your daily activities. Maintaining good overall health and making sure certain health markers stay within good ranges can help control your condition. This includes maintaining low cholesterol, low blood sugar, and low blood pressure. 

High blood pressure can increase pressure within already damaged coronary arteries, which can further cause more damage. High cholesterol can worsen plaque buildup through greater levels of cholesterol in the blood. High blood sugar worsens inflammation throughout the body, which can accelerate damage to the coronary arteries. 

Outlook for CAD

Heart disease is the number one killer of both men and women, so early diagnosis and treatment of CAD is important for lifelong management. Without treatment, CAD can progressively get worse and further restrict blood flow to the heart, which can lead to a dangerous heart attack.

Taking your medication as prescribed and practicing healthy lifestyle habits, including getting regular exercise, eating a healthy diet, and stopping smoking, can help decrease symptoms and prevent coronary artery disease from worsening.