About Coronary Artery Disease
A form of heart disease, coronary artery disease (CAD) is a condition where one or more of the larger arteries supplying blood to the heart become narrowed, limiting the amount of blood to the heart muscle. It often develops slowly over several years, and can lead to a heart attack, abnormal heart rhythm (arrhythmia), and heart failure. CAD is the most common form of heart disease and is a leading cause of death in the United States for both men and women.
Types of CAD
-
Acute Coronary Syndrome (ACS)
-
Chronic Total Occlusion (CTO)
-
Obstructive CAD
-
Non-Obstructive CAD
-
Spontaneous Coronary Artery Dissection (SCAD)
- Chest discomfort or pain (angina), often brought on by activity that subsides with rest
- Shortness of breath with exertion (activity)
- A squeezing or pinching sensation in the chest
- Fatigue
- Sluggishness
- Shortness of breath
- A heart attack
If you experience chest pain along with pain in the arm, jaw, or below the breastbone, accompanied by sweating, nausea, or severe shortness of breath, you might be having a heart attack. Call 911 immediately.
Causes and Risk Factors
The causes of CAD can vary by the type diagnosed, but generally CAD is caused by:
- Blockages in the arteries or blood vessels caused by the buildup of fat and cholesterol (plaque) within blood vessels
- Damage to the inner lining of a blood vessel around the heart
- Tightening or constriction of blood vessel around the heart
- Microvascular dysfunction of the smaller blood vessels connected to the larger coronary arteries around the heart
- Pressure affecting the blood vessel from close or adjacent heart muscle
SCAD can be caused by extreme physical or emotional stress, childbirth, high blood pressure, and certain genetic conditions.
The most common risk factors for developing CAD are:
- A family history of heart disease
- Having high LDL cholesterol or low HDL cholesterol
- Being overweight or obese
- Being over the age of 45 for men and the age of 55 for women
- Living a sedentary lifestyle
- High blood pressure
- Unhealthy diet
- Smoking tobacco or using nicotine products
- Drinking alcohol in excess
CAD can be caused by various factors, including environmental and socioeconomic elements, but genetics also play a role. Recent studies suggest that 40-60% of CAD risk may be inherited. Researchers have found roughly 60 gene variants linked to the risk of developing CAD, though more research is needed to understand the role of genetics in CAD.
Diagnosing Coronary Artery Disease
To determine if you might be at risk for coronary artery disease, talk to your primary care doctor about your family and personal health history. They will do a physical exam and may order blood tests. If you are at risk or have symptoms, your doctor might refer you to a cardiologist.
For diagnosing CAD, your primary care doctor or cardiologist may suggest additional diagnostic tests, including:
-
Diagnostic Cardiac Catheterization
-
Cardiac CT Scan
-
Echocardiogram
-
Electrocardiogram
-
Exercise Stress Test
-
Nuclear Stress Test
-
Pharmacologic Stress Test
-
Lifestyle Changes
-
Medications
-
Percutaneous Coronary Intervention
-
Intravascular Brachytherapy
-
Coronary Intravascular Lithotripsy
-
Atherectomy
-
Coronary Artery Bypass Grafting
Your doctor may suggest changes to your lifestyle that can help you manage CAD, such as:
- Eating a heart-healthy diet. Your doctor may give you more information about what foods to eat and what to avoid, such as those high in fats, cholesterol or salt (sodium).
- Becoming more physically active and having an exercise routine. Always talk with your doctor before you start a new exercise.
- Quit smoking. Smoking is a major cause of CAD and other forms of heart disease.
- Losing weight or maintaining a healthy weight.
- Avoiding alcohol.
- Getting enough rest and sleep.
Different medications can be used to treat CAD symptoms, and they are usually prescribed or managed by a cardiologist:
- Aspirin: This common medication helps thin the blood and prevent blood clots. It can be used alone or in combination with other medications.
- Angiotensin-Converting Enzyme (ACE) Inhibitors: Drugs that prevent your body from changing the angiotensin hormone to angiotensin II and work by blocking the renin-angiotensin-aldosterone system (RAAS) to create a “widening” or dilating effect on blood vessels. ARC inhibitors may be used if CAD patients have additional conditions such as heart failure, diabetes or kidney disease.
- Angiotensin II Receptor Blockers (ARBs): For someone with CAD whose blood vessels already have narrowing, this medication works to prevent narrowing the blood vessels as well as keeping salt and fluid from building up in the body. These are often used as an alternative to ACE inhibitors.
- Beta Blockers: Drugs that can help widen the blood vessels and help the heart beat slower.
- Calcium Channel Blockers: Medications that block calcium to relax the muscles in the blood vessels.
- Cholesterol lowering medications: These drugs are used to lower LDL cholesterol, preventing it from building up and forming plaque in the blood vessels.
- Nitroglycerin: This medication relaxes and widens blood vessels. It’s often prescribed to help relieve or prevent chest pain for non-obstructive CAD.
- Mease Countryside Hospital
- Morton Plant Hospital
- Morton Plant North Bay Hospital
- South Florida Baptist Hospital
- St. Anthony's Hospital
- St. Joseph's Hospital
- St. Joseph's Hospital-North
- St. Joseph's Hospital-South
- Winter Haven Hospital
PCI for Chronic Coronary Total Occlusion (CTO): BayCare has specialists skilled in performing PCI for CTOs. This treatment is available at the following BayCare locations:
For people who have previously undergone PCI to clear a blocked blood vessel, a small percentage may experience "restenosis," where the vessel or stent begins to narrow again. This additional narrowing is often due to the formation of scar tissue. In such cases, IVBT may be considered as an additional treatment option. IVBT is a specialized procedure in which an interventional cardiologist, a radiation oncologist, and a radiation physicist collaborate to deliver targeted radiation through a catheter to the area of restenosis (re-narrowing). This radiation helps to inhibit the growth of scar tissue. IVBT is performed at the below BayCare location:
Atherectomy is a catheter-based procedure used to open blocked or narrowed blood vessels by removing the plaque buildup with special cutting devices or lasers. This minimally invasive procedure is available at the following BayCare Locations:
Coronary artery bypass grafting (CABG) is a type of open-heart surgery that improves blood flow to the heart by redirecting blood flow around the blocked or narrowed coronary arteries that supply blood to the heart. CABG is the most common form of open-heart surgery. BayCare has three top-rated, high quality open-heart surgery programs at the following locations:
Living With CAD
CAD is the most common type of heart disease, with an estimated 18 million Americans living with it. If you're diagnosed with CAD, it’s important to take an active role in your heart health. Talk with your primary care doctor or cardiologist about things you can do to make living with CAD easier, such as:
- Watch your cholesterol levels: Talk with your doctor about routine cholesterol blood testing and taking lifestyle or medication steps to lower your cholesterol if needed.
- Check your blood pressure often: High blood pressure (hypertension) can cause damage to your blood vessels and increase risks for a heart attack or stroke for those with CAD.
- Take your medications as prescribed: Follow your doctor's instructions for any medications, including over-the-counter ones like aspirin. If you have questions, talk to your doctor regularly.
- Track your symptoms: If you have symptoms, keep a record of when your symptoms appear and share them with your doctor. This can help you and your doctor design a better treatment plan for you.
What You Need to Know About Coronary Artery Disease (CAD)
Coronary artery disease (CAD), a narrowing of one or more arteries that supply blood to the heart, is a leading cause of death for men and women in the United States. In this podcast, interventional cardiologist Dr. Laura Mosher explains the risk factors and symptoms for CAD, how it is diagnosed and treatment options.Learn more about BayCare's heart and vascular services
Coronary Artery Disease (CAD) Testing
Dr. Piyush Sovani explains coronary artery disease (CAD), including symptoms and who is at risk, preventative testing and understanding what the test results mean.
Need a cardiac specialist?
Call us at (855) 233-0888 or fill out the form to request a referral to a cardiac specialist.