Coronary Artery Disease (CAD)

Coronary Artery Disease, also known as ischemic heart disease or ischemia, is the leading cause of death for both men and women in the United States. 

CAD occurs when the arteries that lead to your heart become hardened and narrowed due to the buildup of plaque in your arteries. If left untreated, CAD can lead to a heart attack, heart failure, or stroke.

If you have CAD in one part of your body, disease likely exists in the other arteries in your body. Both carotid artery disease and peripheral artery disease exist as a result of plaque buildup in the body. 

What Causes Coronary Artery Disease?

Coronary artery disease occurs when your coronary arteries narrow and harden due to a buildup of plaque. This buildup of plaque is known as atherosclerosis. The plaque is comprised of numerous fatty deposits. Substances like cholesterol, fat, calcium, cellular waste products, and fibrin make up the majority of plaque buildup in your arteries. This plaque develops along the walls of your arteries, thickening the wall and narrowing the channel in which your blood flows through. With the channel narrowed, blood flow is reduced, lessening the amount of oxygen and nutrients that supplement the body. 

Narrowing of the arteries due to plaque build up
Plaque narrowing the arteries

In certain cases, the plaque itself can cause health issues. Most plaque deposits that exist in your arteries are soft on the inside and hard on the outside. If the hard outer surface breaks apart or cracks, platelets rush the area and blood clots form around the soft inside, further narrowing the artery. Plaque may also break off and get stuck in a different part of the artery, after being carried there by your bloodstream. This may result in your artery being blocked completely, and lead to a heart attack.

Coronary artery disease begins in childhood. When you are born your arteries are clean and open. As you age, substances like fat naturally build up in your arteries and become plaque. Thus causing blockage of the artery. 

A simple way to visualize coronary artery disease is to think of the drain pipe in your shower. When you first use your shower, the pipe is clean and liquids flow through it normally. However, after continued usage, the drain pipe becomes clogged with an array of substances, like hair. The hair that is stuck in the drain pipe clogs it. In return, water flow is reduced and blockage occurs. The same thing occurs in your arteries, except instead of hair blocking the passageway, plaque does.

Although aging is a main cause of coronary artery disease, other things can aid in the buildup of plaque in your arteries. Damage of an inner layer of a coronary artery is considered a main cause of the disease. The damage can come from various factors, such as:

  • Smoking
  • High cholesterol
  • Emotional Stress
  • Alcohol abuse
  • Diabetes
  • Insulin resistance
  • Unhealthy lifestyle & diet

Symptoms of Coronary Artery Disease

You may not notice any symptoms related to CAD until it’s too late. However, many people who are afflicted with CAD suffer from angina, a medical term for chest pain or discomfort. Angina is often described as a tight, heavy, burning, or squeezing sensation in your chest that passes in time and may be triggered by physical or emotional stress. Shortness of breath while exerting energy is also a common indicator of CAD. 

A heart attack is also a major indicator of coronary artery disease. It can occur at any time without warning. Heart attacks are caused by a completely blocked coronary artery. Symptoms of a heart attack include:

  • Pain, pressure, tightness, squeezing, or aching in your chest and arms. These sensations may spread to your jaw, neck, and/or back.
  • Nausea
  • Shortness of breath
  • Cold sweat
  • Fatigue
  • Dizziness
  • Lightheadedness
  • Indigestion or heartburn
  • Abdominal pain

If you believe that you are having a heart attack. Call 911 or your local emergency number immediately.

Am I At Risk?

Even the healthiest people on the planet may be at risk of coronary artery disease. There are several risk factors for CAD that cannot be controlled. These uncontrollable risk factors include: 

  • Sex: Before the age of 70, men have a higher risk of CAD & heart attack than women. By age 70, postmenopausal women share the same risk as their male counterparts. 
  • Family History: If your family has a history of heart disease, especially before the age of 50, you may be at a higher risk of CAD.
  • Age: Because CAD develops gradually as you age, your risk factor becomes higher the older you get. 

Risk factors that can be controlled through lifestyle changes also exist. These include:

  • Smoking tobacco and/or cigarettes
  • High blood cholesterol
  • High blood pressure
  • Living a sedentary lifestyle
  • Obesity
  • Unhealthy diet
  • Alcohol abuse

If you are unsure if you are at risk for coronary artery disease, call us to schedule an appointment.

How is Coronary Artery Disease Diagnosed?

There are several ways to diagnose coronary artery disease. When you come in for an appointment, our physicians will ask you questions about your medical history, family medical history, order a physical exam, and run routine blood tests. A diagnostic imaging test may be ordered as well. These diagnostic imaging tests include: 

  • Electrocardiogram: Also known as an EKG or ECG. This test records the electrical signals in your heart in real time to help doctors visualize what’s going on.
  • Echocardiogram: This test utilizes sound waves to help visualize the heart. 
  • Stress Test: This test involves stressing the heart, usually by way of a treadmill or medication, in order to test its functionality while active.
  • Cardiac catheterization/angiogram: This test involves injecting a special dye into your blood flow by way of a long flexible tube called a catheter. The dye outlines spots where plaque buildup may have occurred.
  • CT heart scan: This test lets doctors see areas in your arteries where calcium deposits may have formed.

How is Coronary Artery Disease Treated?

Treatment for CAD depends on how far along the disease is. If caught early enough, treatment may be kept to lifestyle changes. If the progression of the disease is far along and severe, medical procedures will most likely be necessary.

Regardless of the severity of the disease, lifestyle changes will always be prescribed by your doctor. Here are several things you can do right now in order to have healthier arteries, and to prevent further development of CAD.

  • Eat healthier. Look for foods or meals that are low in saturated fat, sodium, and cholesterol to best increase your chances of healthy living.
  • Exercise more often. Even exercise in small amounts may keep CAD under control. Try going on a walk for at least 30 minutes a day, 5 times a week.
  • Quit smoking
  • Maintain a healthy weight for your body type. 

Besides lifestyle changes, your physician may prescribe various drugs in order to treat your CAD. Ask your doctor what kind of medication might be prescribed upon discovery of coronary artery disease. Remember to have your prescription medication history, and current prescriptions you are taking, on hand when you schedule an appointment with your doctor.

If the disease is severe an invasive medical procedure, such as a cardiac catheterization, may be done in order to relieve you of your CAD symptoms.

How Will This Affect My Life?

Now that you know you have this disease you need to make some lifestyle changes to control risk factors. Controlling risk factors will help retard the disease process so that you can continue to live life with the quality you are accustomed. There is no cure for this disease but it can be controlled.

Activity

We encourage all our patients to be active and to live life as normally as possible.

  1. Gradually resume your usual routine. If angina occurs with daily activity let your doctor know.
  2. Begin an exercise program 3-5 times a week for 20-30 minutes (walking, cycling, swimming, low-impact aerobic routines). Start slowly and increase every few days as tolerated.
  3. You may return to work anytime.
  4. Don’t smoke!
  5. Treat high blood pressure.
  6. Eat a diet low in fat, cholesterol, and salt. Eat lots of fresh fruits and vegetables and more fish and poultry. Limit red meat, eggs, and dairy products.
  7. Control blood sugars if you are diabetic.
  8. See your doctors as advised and at least yearly.

If you have any questions or concerns regarding coronary artery disease, or would like to schedule an appointment with us, contact us here.