Coronary artery disease (CAD) is the most common type of heart disease. It occurs when a waxy substance called plaque builds up inside your coronary arteries, the blood vessels that supply oxygen-rich blood to the heart. The plaque build-up narrows the coronary arteries, a condition known as atherosclerosis, decreasing and potentially stopping blood flow to your heart.

Symptoms of coronary artery disease

CAD can cause:

  • Angina – chest pain, often described as a feeling of squeezing, tightness or pressure in the chest
  • Shortness of breath or extreme fatigue with exertion
  • Heart failure (sometimes called congestive heart failure, or CHF) – occurs when the heart doesn’t pump blood as well as it should. While heart failure is a serious condition—and usually there is no cure—many people with heart failure lead a full, enjoyable life when the condition is managed with heart failure medications and accompanied by healthy lifestyle changes.
  • Heart attack (also known as myocardial infarction, or MI) – occurs when a loss of blood flow has caused severe damage to the heart muscle, called ischemia. A STEMI (ST-elevation myocardial infarction) is a full-blown heart attack caused by the complete (100 percent) blockage of a coronary artery. An NSTEMI (non-ST-elevation myocardial infarction) is usually caused by a severely, but not completely, blocked coronary artery. Both types of heart attack are considered medical emergencies.

Causes of coronary artery disease

Atherosclerosis—narrowing of the blood vessels caused by a build-up of plaque on the blood vessel walls—is the most common cause of CAD. Plaque begins because of injury to the blood vessel walls. After an injury, tissue collects or is deposited at the site, helping the blood vessel heal. But that tissue can also make it easier for substances in the blood to stick to the area, which can remain even after the injury has healed. Over time, more substances can get trapped and form plaque. The plaque irritates the blood vessel walls, causing more injury and creating a new cycle that develops more plaque. The blood vessel opening gets narrower with each layer of plaque.

Risk factors for coronary artery disease

Damage to blood vessels can occur from multiple factors such as:

  • High blood pressure – causes rough blood flow that can injure the walls of blood vessels
  • High LDL “bad” cholesterol – can stick to and irritate the walls of the blood vessels
  • Diabetes – excess glucose in the blood can add to plaque build-up in blood vessels
  • Smoking – chemicals from cigarette smoke can irritate blood vessel walls and form deposits in blood vessel walls

Additional risk factors for CAD include:

  • Being post-menopausal for women
  • Being older than 45 for men
  • Obesity

Are you at risk for heart disease? Take our online Heart Risk Assessment.

Diagnosing coronary artery disease

To determine if you have CAD, your physician will perform a physical exam and ask about your symptoms, your health history and your family health history. To confirm the presence of CAD, your physician may order one or more of the following tests:

To detect heart damage or other health conditions, your physician may order:

  • Cardiac CT scan
  • Exercise stress test
  • Chest X-ray
  • Electrocardiogram (ECG or EKG)
  • Blood tests, to check cholesterol and glucose levels

Treatments for coronary artery disease

The goals of treatment for CAD are to ease immediate angina symptoms, improve heart function and prevent permanent heart damage in the future. Treatments are meant to slow or reverse plaque build-up, dilate arteries to improve blood flow and prevent other complications.

Treatment generally includes a combination of:

  • Lifestyle changes – good nutrition, weight management, smoking cessation, exercise
  • Medications
  • Surgery – in certain cases
  • Management of underlying conditions, such as high blood pressure or diabetes

Managing risk factors for coronary artery disease

While a variety of issues can increase the risk of CAD, many risk factors can be avoided or managed by:

  • Reaching and maintaining a healthy weight
  • Quitting smoking
  • Eating a healthful diet
  • Exercising regularly
  • Managing other health conditions, such as diabetes and high blood pressure
  • Coronary artery disease specialists

The experienced heart specialists at Houston Heart are experts at diagnosing and treating CAD.

To learn more, schedule an appointment.