Coronary artery disease, also called CAD, coronary or atherosclerotic heart disease, is a serious condition caused by a buildup of plaque in your coronary arteries, the blood vessels that bring oxygen-rich blood to your heart. It affects millions of Americans.
Your arteries are smooth and elastic. But when plaque builds up on their inner walls, it can make them stiff and narrow. This slows blood flow to your heart muscle, so it doesn’t get the oxygen it needs.
The plaque could also break off, leading to a heart attack or sudden cardiac death.
The most common symptom is angina, or chest pain.
People describe angina as:
You might mistake it for indigestion or heartburn.
You usually feel angina in your chest, but you might feel it in your:
Symptoms are often subtler in women. Nausea, sweating, fatigue, or shortness of breath can join the typical pressure-like chest pain.
Other symptoms of coronary artery disease include:
Experts think CAD starts with damage or injury to the inner layer of a coronary artery. This damage can even happen when you’re a child. Plaque can start to collect along your blood vessel walls when you’re young and build up as you get older. That buildup inflames those walls and raises your risk of blood clots and heart attacks.
The plaque makes the inner walls of your blood vessels sticky. Things like inflammatory cells, lipoproteins, and calcium attach to the plaque as they travel through your bloodstream.
More of these materials build up, along with cholesterol. That pushes your artery walls out while making them narrower.
Over time, a narrowed coronary artery may develop new blood vessels that go around the blockage to get blood to your heart muscle. But if you’re pushing yourself or stressed out, the new arteries may not be able to bring enough oxygen-rich blood to your heart.
In some cases, when plaque breaks, a blood clot may block the supply to your heart muscle. This causes a heart attack.
If a blood vessel to your brain is blocked, usually by a clot, you can have an ischemic stroke.
If a blood vessel in your brain bursts, you might have a hemorrhagic stroke. These are usually brought on by high blood pressure.
Studies have found that taking low-dose aspirin each day could help prevent heart attacks and strokes in some people who are 50 or older and at risk for heart disease. Talk with your doctor about whether you should take low-dose aspirin.
Many things can make you more likely to have coronary artery disease. Some you can change, and some you can’t. They include:
Cardiac ischemia is when plaque and fatty matter narrow the inside of your artery so much that it can’t supply enough oxygen-rich blood to your heart. This can cause heart attacks, with or without chest pain and other symptoms.
Ischemia happens most during:
Coronary artery disease can get to a point where ischemia happens even when you’re resting. This is a medical emergency and may lead to a heart attack. If this happens to you, call your doctor or go to the emergency room. Ischemia can happen without warning in anyone with heart disease, although it’s more common in people with diabetes.
Your doctor can tell if you have coronary artery disease after:
You might also get diagnostic tests so your doctor can find the extent of your coronary artery disease and its effect on your heart. This helps them choose the best treatment for you. These tests include:
Your treatment may involve:
Lifestyle changes. If you smoke, quit. Eat less processed food, and change to a diet low in trans fats, salt, and sugar. Keep your blood sugar in control if you have diabetes. Exercise regularly (but talk to your doctor before starting an exercise program).
Medications. If lifestyle changes aren’t enough, you might need medication. The drugs you’ll take depend on your situation. If you’ve been diagnosed with coronary artery disease, you could take:
Surgery and other procedures. Common ones to treat coronary artery disease include:
All of these treatments boost blood supply to your heart, but they can’t cure coronary artery disease.
Doctors are also studying new ways to treat heart disease, including:
Home remedies for coronary artery disease
Lifestyle changes can prevent or slow CAD:
Complications of coronary artery disease include:
An important part of recovering from CAD or other heart problems is cardiac rehabilitation (rehab). Research shows that it can lower your chance of death from heart disease and future heart problems. You’ll work with a team of people who will help you with:
It’s important to know your heart disease symptoms and what causes them.
Call your doctor if you feel new symptoms or if the ones you’re used to become more frequent or severe. Call 911 if you or someone you’re with has chest pain, especially when it comes with things like shortness of breath, heart palpitations, dizziness, a fast heartbeat, nausea, or sweating.
If you’re taking nitroglycerin for chest pain, call 911 if you’re still feeling pain after two doses (at 5-minute intervals) or after 15 minutes.
Emergency workers may tell you to chew an aspirin to help keep a blood clot from forming or getting larger.
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