Coronary Artery Disease

An illustration of a heart procedure.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. Patients with CAD may experience a variety of symptoms when the demand for blood to the heart is more than the heart’s ability to supply blood due to blockages in the vessels that supply blood to the heart. Often referred to as angina, symptoms may include feelings of chest discomfort, a squeezing or pinching feeling in the chest, fatigue, sluggishness, and shortness of breath. Though angina symptoms usually go away with rest, it’s important not to ignore these symptoms and talk to a doctor quickly. If you are experiencing pain in the chest, arm, jaw or below the breastbone in combination with sweating, nausea, or extreme shortness of breath, you may be having a heart attack. Please call 911 immediately.

Listen as Dr. Laura Mosher talks more about Coronary Artery Disease. 

Diagnosing CAD

To help find out if you may be at risk for CAD, talk to your primary care doctor about your family medical history as well as your own personal medical history. Your doctor will also perform a physical exam and may order some blood work (lab work).  If you’re at risk or having some symptoms, your primary care physician may refer you to a cardiologist, a doctor who specializes in the prevention, diagnosis, treatment and management of CAD (heart disease).

To help diagnosis CAD, your primary care doctor or cardiologist may also order some diagnostic testing. Listen as cardiologist Dr. Piyush Sovani talks about the different testing options to diagnose CAD. Different tests your doctor may order include:

  • Cardiac CT scan
    Also referred to as coronary calcium scan, this non-invasive test uses x-rays from a CT scanner to show calcium and plaque buildup in your coronary arteries, that can narrow the arteries. 
  • Echocardiogram
    This non-invasive test/imaging study uses sound waves to produce images of the heart's chambers, valves and wall. It helps to show the heart’s overall function and structure.
  • Electrocardiogram (ECG or EKG)
    This non-invasive test measures the heart's electrical activity and helps to show any heart rhythm (arrhythmias) issues and/or heart muscle damage. 
  • Exercise stress test
    This test involves exercising on a treadmill, while being closely monitored, to see how well the heart is working. This test measures the heart's response to stress or exercise and can detect any coronary blockages.
  • Nuclear stress test
    In this imaging study/test, a small amount of radioactive material (also known as a tracer) is injected into the bloodstream to help identify the areas of the heart that are receiving less blood flow.
  • Pharmacologic stress test
    In this test instead of using exercise to test your heart, medication is given to increase your heart rate.

Request a Heart Specialist Referral

Treating CAD

With CAD, blockages in the blood vessels are usually caused by the buildup of fat and cholesterol inside the vessel. Treatment options for CAD vary, but may include medications, lifestyle changes, percutaneous coronary intervention (PCI), and open-heart surgery.

PCI, also referred to as angioplasty, is a non-surgical procedure used to open blocked or narrowed arteries in the heart and restore blood flow to the heart muscle. A PCI procedure is designed to open blocked vessels using a small flexible tube called a catheter. With the catheter, an interventional cardiologist typically uses a balloon or intracoronary stent to open up the blocked vessel. Many of our BayCare Hospitals perform PCI procedures:

Additional Specialized Treatments

PCI for Chronic Coronary Total Occlusion

When blockage by plaque occurs in arteries for an extended period of time (90 days or more), it may be considered chronic coronary total occlusion (CTO). Though treatment for this condition was historically limited, BayCare can now treat it using PCI. BayCare’s three cardiovascular flagship facilities have experts trained in treating CTO:

Intravascular Brachytherapy

For those who’ve had a previous PCI treatment to open a blocked blood vessel, a small percentage of people may experience “restenosis” where the blood vessel or stent used to open a blocked blood vessel starts to become narrowed again. This additional narrowing is often due to scar tissue that can develop. For some, intravascular brachytherapy (IVBT) may be an additional treatment option.

IVBT is a specialized procedure where an interventional cardiologist, a radiation oncologist, and radiation physicist work together to direct radiation through a catheter to the area of restenosis (re-narrowing) in a blood vessel. Radiation treatment to the area helps to prevent the growth of scar tissue. At BayCare, this specialized treatment is currently offered at:

Getting Help for for Heart Disease Today

A primary care physician can help determine your risk for coronary artery disease, and let you know if you may need the care of a heart specialist, like a cardiologist.  Cardiologists can order the tests to help diagnosis heart disease as well as develop a treatment plan based on your needs if needed. To request a physician referral to a primary care physician or heart specialist, please call (855) 233-0888 or complete a physician referral form.