Coronary Artery Disease
What is coronary artery disease?
Coronary artery disease occurs when fatty deposits called plaque (say "plak") build up inside the coronary arteries. The coronary arteries wrap around the heart and supply it with blood and oxygen. When plaque builds up, it narrows the arteries and reduces the amount of blood that gets to your heart. This can lead to serious problems, including heart attack.
Coronary artery disease (also called CAD) is the most common type of heart disease. It is also the number one killer of both men and women in the United States.
It can be a shock to find out that you have coronary artery disease. Many people only find out when they have a heart attack. Whether or not you have had a heart attack, there are many things you can do to slow coronary artery disease and reduce your risk of future problems.
What causes coronary artery disease?
Coronary artery disease is caused by hardening of the arteries, or atherosclerosis. Atherosclerosis occurs when plaque builds up inside the arteries. (Arteries are the blood vessels that carry oxygen-rich blood throughout your body.) Atherosclerosis can affect any arteries in the body. When it occurs in the arteries that supply blood to the heart, it is called coronary artery disease.
Plaque is a fatty material made up of cholesterol, calcium, and other substances in the blood. To understand why plaque is a problem, compare a healthy artery with an artery with atherosclerosis:
See a picture of a normal artery and an artery narrowed by plaque.
When plaque builds up in the coronary arteries, the heart doesn't get the blood it needs to work well. Over time, this can weaken or damage the heart. If a plaque tears, the body tries to fix the tear by forming a blood clot around it. The clot can block blood flow to the heart and cause a heart attack. See a picture of how plaque causes a heart attack.
What are the symptoms?
Usually people with coronary artery disease don't have symptoms until after age 50. Then they may start to have symptoms at times when the heart is working harder and needs more oxygen, such as during exercise. Typical first symptoms include:
Less common symptoms include a fast heartbeat, feeling sick to your stomach, and increased sweating. Some people don't have any symptoms. In rare cases, a person can have a "silent" heart attack, without symptoms.
To find out your risk for a heart attack in the next 10 years, use this Interactive Tool: Are You at Risk for a Heart Attack?
How is coronary artery disease diagnosed?
To diagnose coronary artery disease, doctors start by doing a physical exam and asking questions about your past health and your risk factors. Risk factors are things that increase the chance that you will have coronary artery disease.
Some common risk factors are being older than 65; smoking; having high cholesterol, high blood pressure, or diabetes; and having heart disease in your family. The more risk factors you have, the more likely it is that you have coronary artery disease.
If your doctor thinks that you have coronary artery disease, you may have tests, such as:
Your doctor may order other tests to look at blood flow to your heart. You may have a coronary angiogram if your doctor is considering a procedure to remove blockages, such as angioplasty or bypass surgery.
How is it treated?
Treatment focuses on taking steps to manage your symptoms and reduce your risk for heart attack and stroke. Some risk factors you can't control, such as your age and family history. Other risk factors you can control, such as high blood pressure, high cholesterol, and smoking. Lifestyle changes can help lower your risks. You may also need to take medicines or have a procedure to open your arteries.
Lifestyle changes are the first step for anyone with coronary artery disease. These changes may stop or even reverse coronary artery disease. To improve your heart health:
Changing old habits may not be easy, but it is very important to help you live a healthier and longer life. Having a plan can help. Start with small steps. For example, commit to eating five servings of fruits and vegetables a day. Instead of having dessert, take a short walk. When you feel stressed, stop and take some deep breaths.
Medicines may be needed in addition to lifestyle changes. Medicines that are often prescribed for people with coronary artery disease include:
Procedures may be done to improve blood flow to the heart.
What else can you do?
To stay as healthy as possible, it is important to:
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