What Happens

You can have coronary artery disease and not know it. Sometimes the disease is found during an electrocardiogram or stress test. Often a heart attack is the first sign of heart disease.

When you do know that you have heart disease, you may wonder how it spreads over time and what you can do to slow its progress. It's important to take care of yourself. Making healthy lifestyle changes can reduce your chances of heart attack and stroke. Take your medicines as your doctor prescribes. To learn more, see the Treatment and Prevention sections of this topic.

If your heart disease gets worse, your arteries will narrow, and less blood will flow to your heart. You may start to have chest pain or discomfort (angina) when you exercise or feel stressed. This is called stable angina. Most people are able to control stable angina by resting or taking nitroglycerin.

In some cases, sudden and serious problems can happen. New blockages that form in the arteries of the heart can become unstable. They can suddenly tear and cause blood clots to form. These clots block blood flow to your heart, causing a heart attack or unstable angina.

If your heart disease is severe, or if your chest pain and other symptoms can't be controlled with medicines, you may need to think about other treatment, such as:

• Angioplasty.
• Stenting.
• Coronary artery bypass surgery.

These treatments, along with making changes like eating right and not smoking, can help you live a longer, healthier life. If your disease becomes much worse, it can lead to serious medical problems. Many important end-of-life decisions can be made while you are active and able to communicate your wishes. For more information, see the End-of-Life Decisions section of this topic.

Complications of heart disease

Over time, you may have other health problems caused by coronary artery disease. Low blood flow can make it harder for your heart to pump. This can lead to heart failure or atrial fibrillation. Atrial fibrillation increases the risk of stroke. For more information, see the topics Atrial Fibrillation, Heart Failure, and Stroke.

Narrow coronary arteries don't just cause problems for your heart. They can also affect blood vessels in other parts of your body. See a picture of the cardiovascular system.

Most often, problems occur in arteries that bring blood to your heart, brain, and arms and legs (peripheral arterial disease). For more information, see the topic Peripheral Arterial Disease of the Legs.