Coronary Artery Disease

Patient Conditions

Coronary Artery Disease (CAD)

What is Coronary Artery Disease?

The coronary arteries supply blood to the heart muscle itself.

Coronary Artery Disease (CAD), the most common form of heart disease, is the leading cause of death among both men and women in America today.

According to American Heart Association, over 12 million Americans suffer from CAD and each year, more than 500,000 Americans die of heart attacks caused by this disease.

Also known as ischemic heart disease, CAD occurs when obstructions of the coronary arteries (the small blood vessels that supply blood and oxygen to the heart) reduce or stop the flow of blood to the heart, depriving the heart muscle of oxygen.

CAD usually results from the buildup of fatty material and plaque in the arteries.

CAD can cause chest pain, shortness of breath, and other symptoms. If the blood supply is cut off completely, a heart attack will result.

Chest pain can be a warning of an impending heart attack or even death. Unfortunately, less than half of all patients have any warning symptoms.

Causes and Risk Factors

According to the American Heart Association, the lifetime risk of having coronary heart disease after age 40 is 49 percent for men and 32 percent for women.

As women get older, the risk increases almost to that of men. 

There are many factors that increase the risk for CAD, some of which can be controlled.

CAD risk factors include the following:

  • Family history of coronary heart disease, stroke or peripheral arterial disease. (especially before age 50 in men; or before age 60 in women)
  • Family history of stroke or peripheral artery disease
  • Male gender
  • Age (65 and older)
  • Tobacco smoking 
  • High blood pressure
  • Diabetes
  • High cholesterol levels (specifically, high LDL cholesterol and low HDL cholesterol and high triglycerides)
  • Lack of physical activity or exercise
  • Obesity
  • Menopause in women

Since CAD is related to certain aspects of lifestyle, many risk factors such as high blood pressure, high blood cholesterol, smoking, obesity, and physical inactivity can be controlled. Although medical treatments for heart disease have advanced greatly, controlling risk factors remains the key to preventing illness and death from CAD.

Signs and Symptoms Medical illustration of chest and restricted coronary artery

Angina is a specific type of pain in the chest caused by inadequate blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).

The symptoms associated with CAD may be pronounced, but the disease can also occur without any noticeable symptoms.

Some common symptoms include:

Chest pain (angina) -- This is the most common symptom, and it results from the heart not getting enough blood or oxygen.

The intensity of the pain varies from person-to-person. Chest pain may be typical or atypical.

Typical chest pain is felt under the sternum and is characterized by a heavy or squeezing feeling, it is precipitated by exertion or emotion, and it is relieved by rest or nitroglycerin.

Atypical chest pain can be located in the left chest, abdomen, back, or arm and is fleeting or sharp. Atypical chest pain is unrelated to exercise and is not relieved by rest or nitroglycerin. Atypical chest pain is more common in women.

Shortness of breath -- This is usually a symptom of congestive heart failure. The heart at this point is weak because of the long-term lack of blood and oxygen, or sometimes from a recent or past heart attack. If the heart is not pumping enough blood to circulate in the body, shortness of breath may be accompanied by swollen feet and ankles.

Heart attack -- In some cases, the first sign of CAD is a heart attack. This occurs when atherosclerotic plaque or a blood clot blocks the blood flow of the coronary artery to the heart. The coronary artery was likely already narrowed from CAD. The pain associated with a heart attack is usually severe, lasts longer than the chest pain described above, and is not relieved by resting or nitroglycerin.

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This page was last updated: September 12, 2014

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