Key takeaways

  • Coronary artery disease (CAD), the most common type of heart disease, occurs when a buildup of plaque narrows or blocks the arteries that supply blood to the heart, potentially leading to a heart attack.
  • CAD symptoms include chest pain, shortness of breath, and dizziness. Other symptoms that are more common in women and older adults include nausea, vomiting, and back or jaw pain.
  • Managing CAD may involve lifestyle changes like quitting smoking, exercising regularly, and eating a healthy diet. Medications (like cholesterol-lowering medications, blood pressure medications and blood thinners) or procedures, such as angioplasty or bypass surgery, may also be needed.

Coronary artery disease (CAD) causes impaired blood flow in the arteries that supply blood to the heart. Also called coronary heart disease (CHD), CAD is the most common form of heart disease and affects approximately 20.5 million Americans over the age of 20.

It’s also the leading cause of death for both men and women in the United States. It’s estimated that every 40 seconds, someone in the United States has a heart attack.

Most heart attacks are due to CAD.

When your heart doesn’t get enough arterial blood, you may experience a variety of symptoms. Angina (chest pressure) is the most common symptom of CAD. Some people describe this discomfort as:

  • chest pressure
  • pressure that radiates to neck, upper arm or back
  • heaviness
  • tightness
  • burning
  • squeezing

These symptoms can also be mistaken for heartburn or indigestion.

Other symptoms of CAD include:

  • pain in the arms or shoulders
  • shortness of breath
  • sweating
  • dizziness
  • nausea
  • vomiting
  • fatigue
  • palpitations

You may experience more symptoms when your blood flow is more restricted. If a blockage cuts off blood flow completely or almost completely, your heart muscle will start to die if not restored. This is a heart attack.

Don’t ignore any of these symptoms, especially if they are excruciating or last longer than five minutes. Immediate medical treatment is necessary.

Symptoms of CAD for women

The most common symptom of a heart attack in women, as in men, is chest discomfort. However, women are more likely to also experience the following:

Due to decreased blood flow, both men and women’s hearts may also:

  • become weak
  • develop abnormal heart rhythms (arrhythmia) or rates
  • fail to pump as much blood as your body needs

Your doctor will detect these heart abnormalities during diagnosis.

The most common cause of CAD is a vascular injury with cholesterol plaque buildup in the arteries, known as atherosclerosis. Reduced blood flow occurs when one or more of these arteries becomes partially or completely blocked.

Other rare causes of damage or blockage to a coronary artery, such as a tear in the artery or a blood clot (embolus) traveling from the heart, also limit blood flow to the heart.

Understanding therisk factors for CAD can help with your plan to prevent or decrease the likelihood of developing the disease.

Risk factors include:

The risk for CAD also increases with age. Based on age alone as a risk factor, men have a greater risk for the disease beginning at age 45, and risk in women increases at age 55. The risk for coronary artery disease is also higher if you have a family history of the disease.

Diagnosing CAD requires a review of your medical history, a physical examination, and other medical testing. These tests include:

  • Electrocardiogram: This test monitors electrical signals that travel through your heart. It may help your doctor determine whether you’ve had a heart attack.
  • Echocardiogram: This imaging test uses ultrasound waves to create a picture of your heart. The results of this test reveal how well the heart’s muscle and valves are functioning.
  • Stress test: This particular test measures the stress on your heart during physical activity and while at rest. The test monitors your heart’s electrical activity while you walk on a treadmill or ride a stationary bike. Nuclear imaging or echocardiographic imaging may also be performed for a portion of this test. For those unable to perform physical exercise, certain medications can be used instead for stress testing.
  • Cardiac catheterization (left heart catheterization): During this procedure, your doctor injects a special dye into your coronary arteries through a catheter inserted through an artery in your groin or wrist. The dye helps enhance the radiographic image of your coronary arteries to identify any blockages.
  • Coronary CT scan: This can show calcium deposits and narrowing in the arteries due to atherosclerosis.

The four primary coronary arteries are located on the surface of the heart:

  • right main coronary artery
  • left main coronary artery
  • left circumflex artery
  • left anterior descending artery

The left anterior descending artery and left circumflex artery are branches off the left main artery, like a tree trunk

These arteries bring oxygen and nutrient-rich blood to your heart. Your heart is a muscle that’s responsible for pumping blood throughout your body and needs oxygen all the time. A healthy heart moves approximately 2,000 gallons of blood through your body every day.

Like any other organ or muscle, your heart must receive an adequate, dependable supply of blood in order to carry out its work. Reduced blood flow to your heart can cause symptoms of CAD.

It’s important to reduce or control your risk factors and seek treatment to lower the chance of a heart attack or stroke if you’re diagnosed with CAD.

Treatment also depends on your current health condition, risk factors, and overall well-being. For example, your doctor may prescribe medication therapy to treat high cholesterol or high blood pressure, or you may receive medication to control blood sugar if you have diabetes. You may also be directed to take blood thinners like aspirin. Cardiac rehab may also be recommended.

Lifestyle changes can also reduce your risk of heart disease and stroke. For example:

For those with high-risk coronary artery disease and those with angina that does not improve with lifestyle changes and medication, your doctor may recommend a procedure to increase blood flow to your heart. These procedures may be:

Everyone’s outlook for CAD is different. You have better chances of preventing extensive damage to your heart the earlier you can start your treatment or implement lifestyle changes.

It is important to follow your doctor’s instructions. Take medications as directed and make the recommended lifestyle changes. If you have a higher risk for CAD, you can help to prevent the disease by reducing your risk factors.