Coronary Artery Disease (CAD)

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.

Coronary artery disease occurs when a substance called plaque builds up in the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol deposits, which can accumulate in your arteries. When this happens, your arteries can narrow over time. This process is called atherosclerosis.

Plaque buildup can cause angina, the most common symptom of CAD. This condition causes chest pain or discomfort because the heart muscle doesn't get enough blood. Over time, CAD can weaken the heart muscle. This may lead to heart failure, a serious condition where the heart can't pump blood the way that it should. An irregular heartbeat, or arrhythmia, can also develop.

For some people, the first sign of CAD is a heart attack. A heart attack occurs when plaque totally blocks an artery carrying blood to the heart. It also can happen if a plaque deposit breaks off and clots a coronary artery.

Many things increase your risk for heart disease:

• Men in their 40s have a higher risk of CHD than women. But as women get older (especially after they reach menopause), their risk increases to almost equal that of a man's risk.
• Bad genes (heredity) can increase your risk. You are more likely to develop the condition if someone in your family has a history of heart disease -- especially if they had it before age 50. Your risk for CHD goes up the older you get.
• Diabetes is a strong risk factor for heart disease.
• High blood pressure increases your risks of coronary artery disease and heart failure.
• Abnormal cholesterol levels: your LDL ("bad") cholesterol should be as low as possible, and your HDL ("good") cholesterol should be as high as possible to reduce your risk of CHD.
• Smokers have a much higher risk of heart disease than nonsmokers.
• Chronic kidney disease can increase your risk.
• Already having atherosclerosis or hardening of the arteries in another part of your body (examples are stroke and abdominal aortic aneurysm) increases your risk of having coronary heart disease.
• Other risk factors include alcohol abuse, not getting enough exercise, and having excessive amounts of stress.

Prevention
See your health care provider regularly.
Tips for preventing CHD or lowering your risk of the disease:

• Avoid or reduce stress as best as you can.
• Don't smoke.
• Eat well-balanced meals that are low in fat and cholesterol and include several daily servings of fruits and vegetables.
• Get regular exercise. If your weight is considered normal, get at least 30 minutes of exercise every day. If you are overweight or obese, experts say you should get 60 - 90 minutes of exercise every day.
• Keep your blood pressure below 130/80 mmHg if you have diabetes or chronic kidney disease, and below 140/90 otherwise
• Keep your cholesterol and blood sugar under control.

Symptoms

Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms.
Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.

• It may feel heavy or like someone is squeezing your heart. You feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back.
• The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
• Other symptoms include shortness of breath and fatigue with activity (exertion).

Women, elderly people, and people with diabetes are more likely to have symptoms other than chest pain, such as:

• Fatigue
• Shortness of breath
• Weakness

Get Tested

Doctors can determine your risk for CAD by checking your blood pressure, cholesterol, and blood glucose, and by finding out more about your family's history of heart disease. If you're at high risk or already have symptoms, your doctor can perform several tests to diagnose CAD including—