What Is Coronary Artery Disease? Causes, Symptoms, Treatment, and More (original) (raw)

Coronary artery disease (CAD) is the most common type of heart disease. Although it’s the top cause of death in the U.S., there is a lot you can do to prevent or treat it.

The trouble starts when a waxy substance called plaque builds up inside the arteries that supply blood to the heart muscle. It can take decades to block the blood flow, but it can eventually cause a heart attack or failure.

How common is coronary artery disease?

An estimated 18.2 million Americans have coronary artery disease, or about one in 20 adults, making it the most common form of heart disease in the country.

The condition is also the leading cause of death in the U.S. In 2021 alone, 375,476 people died of coronary artery disease, and 20% were younger than 65.

Coronary artery disease vs. heart attack

Coronary artery disease is a form of heart disease, and most heart attacks are caused by coronary artery disease. Some people only discover they have coronary artery disease after they've had a heart attack.

Coronary artery disease isn’t just one disease, but several different conditions.

Starting as early as childhood, plaque – a combination of cholesterol, fat, and other substances – starts to stick to the walls lining your blood vessels.

It builds up over time. That makes arteries harder and narrower, which doctors call “atherosclerosis.“

In some cases, plaque can break or rupture. As a result, blood cells called platelets will try to repair the artery, forming a blood clot.

Like gunk in a clogged drainpipe, this buildup prevents a free flow of blood through the arteries. Blood carries oxygen and nutrients to the heart. Myocardial ischemia is when your heart muscle doesn’t get enough blood, and it can lead to shortness of breath and chest pain (angina).

Without enough oxygen, the heart can become weaker. This can lead to an irregular heartbeat (arrhythmia). It can also cause heart failure, which means the heart can’t pump enough blood throughout the body to meet the body's needs. If you have limited blood flow to your arms or legs, this condition is called peripheral artery disease.

If a plaque grows so large that it stops blood flow to the heart muscle, you could have a heart attack. But most of the time, heart attacks happen from the smaller plaques that rupture.

In the early stages, you may not have any symptoms. But as the plaque continues to build up and curbs blood flow to the heart muscle, you may notice that you’re short of breath or fatigued, especially during exercise.

The most common symptom of CAD is angina, or chest pain. Some people mistake it for heartburn or indigestion.

With angina, your chest feels uncomfortable. You may also have that feeling in the shoulders, arms, back, or jaw. You may feel:

Symptoms of CAD for women

Women and those assigned female at birth often have different heart attack symptoms than men or those assigned male at birth. While the most common red flag is still chest pain, women are more likely to have other symptoms, such as shortness of breath, extreme fatigue, nausea, vomiting, and back or jaw pain.

When to call 911

If you have any of the following symptoms, call 911 right away:

Coronary artery disease becomes more likely as you get older or if it runs in your family. Other risk factors include

Men, and people assigned male gender at birth, have a higher risk for CAD after age 45. For women and people who were assigned female gender at birth, the risk goes up after 55.

Some risk factors that affect women (and those assigned female at birth) in particular are:

You’re more likely to have coronary artery disease, sometimes called coronary heart disease, if you’re over 35 or male.

Black, Hispanic, and Southeast Asian people are more likely to get sick from CAD and to die from it than other ethnic groups. American Indians are 1.5 times more likely to be diagnosed with CAD than White people.

In fact, minorities are at higher risk of all types of heart disease. Among Black people, 47% are diagnosed with some type of cardiovascular (heart and blood vessel) disease. For White people, the rate is 36%. Overall, Black people are more than twice as likely as White people to die from heart disease.

Black, Hispanic, and American Indian people are also more likely to have conditions that contribute to heart disease, like high blood pressure, obesity, and diabetes.

There are many possible reasons for these disparities. They include:

Your doctor will give you a checkup and talk with you about your symptoms, risks, and family history. You may also get tests such as:

How to check for heart blockage at home

There’s no home test that can determine whether you have coronary artery disease. But if you’re concerned about your heart health in general, there are steps you can take to keep tabs on it:

Heart rate measurement. Check your pulse to figure out how fast your heartbeat is:

A healthy rate is between 60 and 100 beats per minute. If yours is much higher or lower than that, tell your doctor.

Blood pressure cuff. Because high blood pressure raises your risk for heart disease, it’s important to keep blood pressure in a healthy range. For most people, that’s less than 120/80. But ask your doctor what your numbers should be. Some monitors let you upload your readings into an app or website for easy tracking. You can also print them out to share with your doctor.

The stair test. If you can’t climb four flights of stairs within 90 seconds, that may be a sign that your heart isn’t as healthy as it should be. Talk to your doctor about your concerns.

Your doctor can order many tests to get a better sense of your heart health. That can include:

Coronary artery disease can lead to other serious – and sometimes life-threatening – conditions, such as:

Depending on your case, your treatment plan may include one or a combination of the following treatments:

Medications

You may need to take medicines to help your heart be healthier. They can include blood thinners (anticoagulants), aspirin and other anti-clotting medicines, ACE inhibitors, beta-blockers, nitroglycerin, calcium channel blockers, certain immunosuppressants,statins, or PCSK9s.

Invasive procedures

Part of your treatment plan may involve surgery. Some of the most commonly performed procedures for coronary artery disease include:

Cardiac rehabilitation and recovery

If you've had a heart attack or cardiac surgery, your doctor will likely recommend that you complete a cardiac rehab program to help you recover. Cardiac rehab will start while you're in the hospital, then you can attend outpatient appointments once you go home. Most insurance companies will cover 12 weeks of cardiac rehab. Typically, these programs include the following:

Studies have shown that cardiac rehab can help lower your future risk of stroke, heart attack, depression, and cardiac-related death.

Lifestyle changes

These time-tested methods sound familiar for a reason -- they work!

Fortunately, there are a number of things you can do to reduce your chances of getting CAD.

Get wise to your risk. Speak to your doctor about getting your cholesterol, blood pressure, and blood sugar checked. If you have high cholesterol, high blood pressure, or diabetes, it’s important to manage those conditions.

Aim for a healthy weight. If you’re not sure what your target weight should be, ask your doctor. And if you have a lot of weight to lose, remember that even a modest amount of weight loss helps.

Avoid cigarette smoke. If you smoke, quit. Steer clear of secondhand smoke.

Limit your alcohol. One or two drinks may have some heart benefits, but too much is risky. Men should have no more than two alcoholic drinks a day, and women should have no more than one per day.

Eat smart. Eat whole foods and avoid trans fats, which can be found in many baked goods and deep-fried and processed foods. Get plenty of fiber-rich foods, such as fruits and veggies, whole grains, and beans. Limit salt and aim to have two servings of fatty fish, such as salmon, tuna, or mackerel, a week. They’re high in heart-healthy omega-3 fats.

Exercise regularly. You’ll want to get at least 30 minutes of moderate-intensity exercise (like hiking or going for a bike ride that makes your heart beat faster but not race) on 5 or more days a week. Speak with your doctor before you begin a new exercise routine.

Manage your stress level. Use strategies such as exercise, meditation, and other healthy activities that relax you.

There is no cure for coronary artery disease. Your prognosis will depend on your age, symptoms, and other health conditions and risk factors you have.

But you may be able to improve your prognosis or slow the progression of the disease by changing your lifestyle and following your doctor’s treatment plan. Take any medications your doctor prescribes to treat your coronary artery disease as consistently as possible.

If you have coronary artery disease, you will have regular check-ups with your doctor and any specialists they refer you to, like a cardiologist.

But if you notice any changes in your symptoms or if you have side effects related to your medications between those visits, reach out to your doctor. They can also discuss any questions or concerns you have about your treatment plan.

If you are having symptoms of a heart attack or stroke, call 911 right away. Both are medical emergencies that require medical attention as quickly as possible.

Coronary artery disease is the most common form of heart disease in the U.S. If you've been diagnosed with the condition, your doctor will help you find the treatment plan that's right for you. Coronary artery disease can lead to serious complications, including heart attack and arrhythmia, but quitting smoking, eating a low-sodium diet, and maintaining a healthy weight are steps you can take right away to help lower your risk. Always talk with your doctor if your symptoms change, and ask them before making any major changes to your exercise routine.