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Coronary artery disease, or heart disease, is a heart problem that happens when fatty deposits called plaque (say "plak") build up inside coronary arteries of your heart. Those are the blood vessels that supply blood and oxygen to your heart muscle. This process of plaque buildup is called hardening of the arteries, or atherosclerosis.
Plaque buildup may reduce blood flow to the heart muscle. Like any muscle, the heart needs blood to work well. Poor blood flow can cause angina symptoms, such as chest pain or pressure. If the plaque breaks apart, it can cause a heart attack.
Coronary artery disease is caused by a process called hardening of the arteries, or atherosclerosis. Fatty deposits called plaque build up inside coronary arteries. These arteries supply blood to the heart muscle. Over time, the plaque buildup may narrow the arteries and reduce blood flow to the heart muscle.
The symptoms of coronary artery disease are angina and shortness of breath. Angina can feel like chest pain or pressure. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms. Symptoms typically happen when the heart works hard.
Your doctor will ask about your medical history and do a physical exam. You may have tests to check how well your heart is working and to see if your arteries are narrowed. Examples of tests include an electrocardiogram, an echocardiogram, stress tests, and a CT angiogram.
Coronary artery disease is treated with healthy lifestyle changes and medicine. Treatment focuses on lowering your risk for heart attack and stroke and managing your symptoms. Sometimes angioplasty or bypass surgery is done to improve blood flow to the heart.
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Coronary artery disease is caused by a process called hardening of the arteries, or atherosclerosis.
Atherosclerosis occurs when fatty deposits called plaque build up inside arteries. Arteries are the blood vessels that carry oxygen-rich blood throughout your body. When plaque builds up in the arteries that supply blood to the heart muscle (the coronary arteries), it is called coronary artery disease. Over time, the plaque may narrow the arteries and reduce blood flow to the heart muscle.
Things that put you at risk for coronary artery disease are the things that lead to a problem called atherosclerosis, or hardening of the arteries. These things include:
Your age, sex, and race can also raise your risk. For example, your risk increases as you get older.
You can help prevent coronary artery disease by taking steps toward a heart-healthy lifestyle. A heart-healthy lifestyle can also help you reduce risk factors such as high cholesterol and high blood pressure.
This is one of the best things you can do for your heart and your overall health.
This means eating plenty of fruits and vegetables, fish, and high-fibre grains and breads. Eat foods low in sodium (salt), saturated fat, and trans fat. Limit alcohol and sugar.
Being overweight makes you more likely to have high blood pressure, heart problems, and diabetes. These conditions make a heart attack more likely.
Health problems such as diabetes, high blood pressure, and high cholesterol can make having heart problems more likely. If you manage these conditions, you can lower your risk for heart problems. Lifestyle changes can help you manage these other health problems.
If you think you may have a problem with alcohol or drug use, talk to your doctor.
The symptoms of coronary artery disease are angina (say "ANN-juh-nuh" or "ann-JY-nuh") and shortness of breath. Symptoms can happen when the heart is working hard and does not get enough oxygen, such as during exercise. Some people don't have any symptoms.
People feel angina symptoms in different ways. Symptoms include chest pain or pressure, or a strange feeling in the chest. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms. Other symptoms of angina include shortness of breath, nausea or vomiting, light-headedness or sudden weakness, and a fast or irregular heartbeat.
Some people describe their angina as pressure, heaviness, weight, tightness, squeezing, discomfort, or dull aching in the chest. People may put a fist to the chest when describing their pain. Some people may feel tingling or numbness in the arm, hand, or jaw.
Most people feel angina symptoms in the chest. Women are somewhat more likely than men to have other symptoms like shortness of breath, nausea, and back or jaw pain. Some women describe their symptoms as mild. Others feel tired when they have angina.
Angina can be stable or unstable.
Some people don't have any symptoms. This is called "silent ischemia." Ischemia is the medical term for what happens when your heart muscle doesn't get enough oxygen.
A heart attack is sometimes the first sign of coronary artery disease.
Coronary artery disease is a lifelong (chronic) disease. It can get worse over time and can lead to a heart attack or other heart problems. But treatment can help slow the disease, relieve symptoms, and prevent a heart attack.
Coronary artery disease most often begins when the inside walls of the coronary arteries are damaged because of another health problem, such as high cholesterol, high blood pressure, diabetes, or smoking. This damage can lead to atherosclerosis, or hardening of the arteries. This means that plaque, made of fats and other substances, builds up in the coronary arteries.
Atherosclerosis can get worse over time. As plaque builds up in the arteries, they may become narrow. This can reduce blood flow to the heart muscle. This is called ischemia (say "is-KEE-mee-uh"). Ischemia can cause angina symptoms, such as chest pain or pressure.
Some people with coronary artery disease never feel angina symptoms, such as chest pain or pressure. But others may feel angina symptoms when their hearts have to work harder, such as during exercise. Angina is a signal that your heart is not getting enough oxygen.
If you've had angina for a while, you may be able to predict what activities or stress will cause your symptoms. This is called stable angina.
If coronary artery disease gets worse, your stable angina symptoms may change. For example, you can still predict when symptoms will happen, but they may come on sooner, feel worse, or last longer.
If blood flow to the heart muscle is suddenly slowed, unstable angina happens. Unstable angina is an emergency. It may mean that you are having a heart attack.
Unstable angina is a change in your usual pattern of stable angina. Your symptoms do not happen at a predictable time. For example, you may feel angina when you are resting. Your symptoms may be more frequent, severe, or longer-lasting than your usual pattern of stable angina. Your symptoms may not go away when you try your typical ways of relieving them, such as rest or nitroglycerin.
If the plaque in a coronary artery breaks apart, it can cause a heart attack. A tear or rupture in the plaque tells the body to repair the injured artery lining, much as the body might heal a cut on the skin. A blood clot forms to seal the area. The blood clot can completely block blood flow to the heart muscle and cause a heart attack.
Over time, low blood flow to the heart muscle can weaken or damage the heart. This can lead to heart failure or atrial fibrillation.
Heart attacks that damage critical or large areas of the heart tend to cause more problems (complications) later. These may include:
Do not wait if you think you are having a heart attack. Some people aren't sure whether they're having one, or they don't want to bother others, so they wait. But getting help fast can save your life.
Call 911 or other emergency services immediately if you have symptoms of a heart attack or are with someone who has symptoms. Symptoms may include:
After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself. By taking an ambulance, you may be able to start treatment before you arrive at the hospital.
Nitroglycerin. If you typically use nitroglycerin to relieve angina and if one dose of nitroglycerin has not relieved your symptoms within 5 minutes, call 911. Do not wait to call for help.
Call your doctor if:
Your doctor will do a physical exam, a medical history, and possibly some tests to find out if you have coronary artery disease or are at risk for having it.
A medical history and physical exam are always a part of evaluating a person who has symptoms or risk factors for coronary artery disease. The history and physical exam help to guide further decisions about testing and treatment.
During the medical history, your doctor will ask questions about your symptoms, your personal health history, and your family medical history.
A complete physical exam will also be done. This includes checking your blood pressure and listening to your heart and lungs.
If your doctor thinks you may have coronary artery disease, you will have some tests. They include:
You might have one or more imaging tests to look at your arteries and your heart. You might have these tests if your doctor needs more information for diagnosis or to help guide treatment.
These tests include:
Coronary artery disease is treated with healthy lifestyle changes and medicine. Sometimes a procedure or surgery is done.
Treatment focuses on lowering your risk for heart attack and stroke and managing your symptoms. It can slow the disease and improve the quality and length of your life.
There are many things you can do to feel better, prevent problems, and stay healthy longer. These steps are an important part of treatment.
You can lower your risk for heart attack and stroke by making lifestyle changes and taking medicine. A heart-healthy lifestyle can also improve the quality and length of your life.
Taking medicine correctly can lower your risk of having a heart attack or dying from coronary artery disease.
Lifestyle changes are the first step for anyone with coronary artery disease. Even though you take medicine, lifestyle changes can also keep your heart and your body healthy.
Healthy habits can slow the disease. They can improve the quality and length of your life. And they can help lower your risk of a heart attack and stroke.
Ask your doctor if a cardiac rehabilitation (rehab) program is right for you. In cardiac rehab, you will get support to help you build new, healthy habits.
To be heart-healthy:
Call your doctor if your stable angina symptoms seem worse but still follow your typical pattern. You can predict when symptoms will happen, but they may come on sooner, feel worse, or last longer.
Get help right away if you have angina symptoms that do not follow your typical pattern. For example, your symptoms may happen at rest or not go away with nitroglycerin. It may mean you are having a heart attack.
Medicines are an important part of your treatment for coronary artery disease. A few medicines work in different ways to help lower your risk of having a heart attack or dying from coronary artery disease. These medicines help lower blood pressure, lower cholesterol, lower the heart's workload, and prevent blood clots.
Medicines are also used to help relieve your symptoms.
These medicines include:
Aspirin and other blood thinners can help prevent blood clots from forming that could cause a heart attack.
Aspirin, ibuprofen, and naproxen are all non-steroidal anti-inflammatory drugs (NSAIDs). They can relieve pain and inflammation. But only aspirin will reduce your risk for heart attack or stroke. Don't substitute ibuprofen or naproxen for aspirin.
Statins help lower cholesterol. Other cholesterol medicines, such as ezetimibe, may be used along with a statin.
Stable angina can often be controlled with medicine such as:
Coronary artery bypass surgery is a surgery to treat coronary artery disease. The surgery helps blood make a detour, or bypass, around one or more narrowed or blocked coronary arteries. Coronary arteries are the blood vessels that bring blood to the heart. The surgery is also called bypass surgery or coronary artery bypass graft (CABG).
Your doctor will make a bypass using a piece of blood vessel from another part of your body. Your doctor will attach, or graft, this blood vessel above and below the blocked section of your artery.
Coronary angioplasty is a procedure that uses a thin tube called a catheter to open a blocked or narrowed coronary artery. Coronary arteries are the blood vessels that bring oxygen to the heart muscle. Angioplasty also may be called percutaneous coronary intervention (PCI).
Angioplasty can widen an artery that has been narrowed by fatty buildup (plaque) or blocked by a blood clot. The procedure helps blood flow more normally to the heart muscle.
Current as of: September 7, 2022
Author: Healthwise StaffClinical Review Board: Kathleen Romito MD - Family MedicineMartin J. Gabica MD - Family MedicineAdam Husney MD - Family MedicineStephen Fort MD, MRCP, FRCPC - Interventional Cardiology
Current as of: September 7, 2022
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Adam Husney MD - Family Medicine & Stephen Fort MD, MRCP, FRCPC - Interventional Cardiology
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