Coronary Artery Disease: Causes, Symptoms, and Treatments

How we reviewed this article: · Healthline

Key takeaways

Coronary artery disease (CAD), the most common type of heart disease, occurs when a buildup of plaque narrows or blocks the arteries that supply blood to the heart, potentially leading to a heart attack.

CAD symptoms include chest pain, shortness of breath, and dizziness. Other symptoms that are more common in women and older adults include nausea, vomiting, and back or jaw pain.

Managing CAD may involve lifestyle changes like quitting smoking, exercising regularly, and eating a healthy diet. Medications (like cholesterol-lowering medications, blood pressure medications and blood thinners) or procedures, such as angioplasty or bypass surgery, may also be needed.

Coronary artery disease (CAD) causes impaired blood flow in the arteries that supply blood to the heart. Also called coronary heart disease (CHD), CAD is the most common form of

heart disease

and affects approximately

20.5 million

Americans over the age of 20.

It’s also the

leading cause of death

for both men and women in the United States. It’s estimated that every

40 seconds

, someone in the United States has a heart attack.

When your heart doesn’t get enough arterial blood, you may experience a variety of symptoms.

Angina

(chest pressure) is the most common symptom of CAD. Some people describe this discomfort as:

chest pressure

pressure that radiates to neck, upper arm or back

heaviness

tightness

burning

squeezing

These symptoms can also be mistaken for heartburn or indigestion.

Other symptoms of CAD include:

pain in the arms or shoulders

shortness of breath

sweating

dizziness

nausea

vomiting

fatigue

palpitations

You may experience

more symptoms

when your blood flow is more restricted. If a blockage cuts off blood flow completely or almost completely, your heart muscle will start to die if not restored. This is a heart attack.

Don’t ignore any of these symptoms, especially if they are excruciating or last longer than five minutes. Immediate medical treatment is necessary.

Symptoms of CAD for women

The most common symptom of a heart attack in women, as in men, is chest discomfort. However, women are

more likely to also experience

the following:

nausea

fatigue

vomiting

back pain

jaw pain

shortness of breath without feeling chest pain

Due to decreased blood flow, both men and women’s hearts may also:

become weak

develop abnormal heart rhythms (

arrhythmia

) or rates

fail to pump as much blood as your body needs

Your doctor will detect these heart abnormalities during diagnosis.

The most common cause of CAD is a vascular injury with cholesterol plaque buildup in the arteries, known as

atherosclerosis

. Reduced blood flow occurs when one or more of these arteries becomes partially or completely blocked.

Other rare causes

of damage or blockage to a coronary artery, such as a tear in the artery or a blood clot (embolus) traveling from the heart, also limit blood flow to the heart.

Understanding therisk factors for CAD can help with your plan to prevent or decrease the likelihood of developing the disease.

Risk factors include:

high blood pressure

high blood cholesterol levels

tobacco

smoking

insulin resistance/hyperglycemia/

diabetes

mellitus

obesity

inactivity

unhealthy eating habits

obstructive sleep apnea

emotional stress

excessive alcohol consumption

history of

preeclampsia

during pregnancy

The risk for CAD also increases with age. Based on age alone as a risk factor, men have a greater risk for the disease beginning at

age 45

, and risk in women increases at

age 55

. The risk for coronary artery disease is also higher if you have a family history of the disease.

Diagnosing CAD

requires a review of your medical history, a physical examination, and other medical testing. These tests include:

Electrocardiogram

: This test monitors electrical signals that travel through your heart. It may help your doctor determine whether you’ve had a heart attack.

Echocardiogram

: This imaging test uses ultrasound waves to create a picture of your heart. The results of this test reveal how well the heart’s muscle and valves are functioning.

Stress test

: This particular test measures the stress on your heart during physical activity and while at rest. The test monitors your heart’s electrical activity while you walk on a treadmill or ride a stationary bike. Nuclear imaging or echocardiographic imaging may also be performed for a portion of this test. For those unable to perform physical exercise, certain medications can be used instead for stress testing.

Cardiac catheterization (left heart catheterization)

: During this procedure, your doctor injects a special dye into your coronary arteries through a catheter inserted through an artery in your groin or wrist. The dye helps enhance the radiographic image of your coronary arteries to identify any blockages.

Coronary CT scan

: This can show calcium deposits and narrowing in the arteries due to

atherosclerosis

.

The four primary coronary arteries are located on the surface of the heart:

right main coronary artery

left main coronary artery

left circumflex artery

left anterior descending artery

The left anterior descending artery and left circumflex artery are branches off the left main artery, like a tree trunk

These arteries bring oxygen and nutrient-rich blood to your heart. Your heart is a muscle that’s responsible for pumping blood throughout your body and needs oxygen all the time. A

healthy heart

moves approximately 2,000 gallons of blood through your body every day.

Like any other organ or muscle, your heart must receive an adequate, dependable supply of blood in order to carry out its work. Reduced blood flow to your heart can cause symptoms of CAD.

It’s important to reduce or control your risk factors and seek treatment to lower the chance of a heart attack or stroke if you’re diagnosed with CAD.

Treatment

also depends on your current health condition, risk factors, and overall well-being. For example, your doctor may prescribe medication therapy to treat high cholesterol or high blood pressure, or you may receive medication to control blood sugar if you have diabetes. You may also be directed to take blood thinners like aspirin. Cardiac rehab may also be recommended.

Lifestyle changes can also reduce your risk of heart disease and stroke. For example:

quit smoking tobacco

reduce or stop your consumption of alcohol

exercise regularly

lose weight to a healthy level

eat a

healthy diet

(low in saturated fat, sodium, and added sugar)

For those with high-risk coronary artery disease and those with angina that does not improve with lifestyle changes and medication, your doctor may recommend a procedure to increase blood flow to your heart. These procedures may be:

balloon angioplasty

: to widen blocked arteries and smoosh down the plaque buildup, usually performed with the insertion of a stent to help keep the lumen open after the procedure

coronary artery bypass graft surgery

: to restore blood flow to the heart in open chest surgery

Everyone’s outlook for CAD is different. You have better chances of preventing

extensive damage

to your heart the earlier you can start your treatment or implement lifestyle changes.

It is important to follow your doctor’s instructions. Take medications as directed and make the recommended lifestyle changes. If you have a higher risk for CAD, you can help to

prevent

the disease by reducing your risk factors.