Coronary arteries are the blood vessels that carry blood to the heart muscle. Coronary artery disease (also called CAD or coronary heart disease) is caused by a thickening of the inside walls of the coronary arteries. This thickening is called atherosclerosis (say: “ath-uh-roe-skluh-roe-suhs”). A fatty substance called plaque builds up inside the thickened walls of the arteries, blocking or slowing the flow of blood. If your heart muscle doesn't get enough blood to work properly, you may have angina or a heart attack.
Coronary artery disease may take years to develop. You may not notice any symptoms of coronary artery disease until the disease progresses. As your arteries become blocked you may experience:
Both men and women can get CAD. It can be hereditary (run in your family). It might also develop as you get older and plaque builds up in your arteries over the years.
In the United States, heart disease is the leading cause of death for women and men. Risk factors for heart disease include:
Most people who have CAD take medicine to help control their condition. Medicines called beta-blockers, calcium channel blockers and nitrates can help relieve angina. Taking low-dose aspirin every day can reduce the chance of a second heart attack in people who have already had one. Your doctor will tell you whether you should take any of these medicines.
Angioplasty is a surgical treatment for CAD. Angioplasty uses a tiny balloon to push open blocked arteries around the heart. The balloon is inserted in an artery in the arm or leg. A small metal rod called a stent might be put into the artery where the blockage was to hold the artery open.
Another surgical treatment for CAD is bypass surgery. Pieces of veins or arteries are taken from the legs and sewn into the arteries of the heart to bring blood past a blockage and increase the blood flow to the heart. Bypass surgery is usually done when angioplasty isn't possible or when your doctor feels it's a better choice for you.
All medicines may have side effects. Aspirin may cause upset stomach. Nitrates may cause a flush (redness in the face) and headaches. Beta-blockers cause tiredness and sexual problems in some patients. Calcium channel blockers may cause constipation and leg swelling. Fortunately, most patients don't have side effects from these medicines. If you have side effects after taking a medicine, tell your doctor.
Surgery, such as angioplasty or bypass surgery, also has potential risks. The major risks can include heart attack, stroke or even death. These are rare and most patients do well. After angioplasty, you can usually expect to return to your previous activity level, or even a better activity level, within a few days. It takes longer (a few weeks or months) to recover from bypass surgery.
Your doctor will help you decide which treatment is best for you.
CAD doesn't go away, but by working with your doctor, you can live longer and feel better.
Your body will need time to respond to the changes you've made. Your doctor will watch your progress. If your cholesterol level hasn't improved after 6 months to 1 year, your doctor may prescribe medicine to lower your cholesterol. However, you will still need to keep up the healthy lifestyle changes you've started to help the medicine work.
Written by familydoctor.org editorial staff