Center for Coronary Artery Disease

Coronary artery disease (CAD) happens when the coronary arteries that supply blood to the heart become narrowed or blocked by plaque buildup (atherosclerosis).

This reduces blood flow and oxygen to the heart muscle, which can lead to chest pain (angina), heart attack or other complications.

Coronary artery disease is primarily caused by atherosclerosis, a buildup of cholesterol, fats and other substances on artery walls.

Over time, plaque hardens and narrows the arteries, reducing blood flow and oxygen to the heart. It usually develops over many years, although early changes may begin earlier in life.

You can reduce your risk and slow the progression of coronary artery disease by addressing contributing factors.

Helpful steps may include:

• Following a heart-healthy diet that includes fruits, vegetables, whole grains, lean proteins and healthy fats such as olive oil, nuts and seeds
• Limiting trans fats, saturated fats and foods high in salt and sugar
• Getting regular physical activity, aiming for at least 150 minutes of moderate exercise each week
• Maintaining a healthy weight
• Getting regular, good quality sleep
• Controlling cholesterol and blood pressure
• Avoiding tobacco
• Managing stress

Medications are often used as well. For people with established coronary artery disease, including a prior heart attack, cholesterol-lowering medications may help reduce progression and lower the risk of future heart attacks.

Coronary artery disease can be evaluated with tests that assess the heart’s rhythm, structure and blood flow.

Depending on your symptoms and risk, your physician may recommend one or more of the following:

• Physical exam and medical history
• Blood tests such as a lipid cholesterol profile and lipoprotein (a)
• Electrocardiogram (EKG)
• Coronary calcium scoring (CAC)
• Exercise treadmill test
• CT coronary angiography
• Stress imaging
• Cardiac catheterization

Many people may not notice symptoms until coronary artery disease becomes more advanced.

Common symptoms can include:

• Chest pain or discomfort (angina), including pressure, tightness or squeezing in the chest, back or neck
• Fatigue
• Shortness of breath

A completely blocked artery can cause a heart attack, which is a medical emergency.

Treatment focuses on improving blood flow, reducing symptoms and lowering the risk of heart attack.

Treatment may include:

• Lifestyle changes such as diet, exercise and quitting smoking
• Medications, including cholesterol-lowering medicines, blood pressure medicines and blood thinners
• Procedures when needed, such as angioplasty and stenting or bypass surgery

Your care plan is individualized based on your symptoms, test results and overall risk.

You should seek medical care if you experience symptoms such as chest discomfort, shortness of breath, fatigue or a racing or irregular heartbeat.

Seek emergency care right away if you have severe chest pain, pressure or symptoms that may indicate a heart attack.