What is coronary artery disease?

Coronary artery disease (CAD) is the most common form of heart disease. It occurs when arteries in the heart are blocked, leading to complications including:

• Angina (chest pain) if the heart does not have enough oxygen; or
• Heart attack if the heart does not get any oxygen at all. During a heart attack, some of the heart muscle can die from a lack of oxygen.

Symptoms
Diagnosis
Treatment

Causes
Over many years, plaque builds up on artery walls. Plaque is a sticky, yellow substance made of fatty substances like cholesterol, as well as calcium and waste products from your cells. It narrows and clogs the arteries, slowing the flow of blood. This condition is called atherosclerosis, which may begin as early as childhood.  It can occur anywhere in the body, but it usually affects large and medium-sized arteries.

Sometimes plaque in an artery can rupture. The body's repair system in turn creates a blood clot to heal the wound. The clot, however, can block the artery, leading to either a heart attack or stroke.

Symptoms

Early warning signs may include: fatigue, pain and dizziness. They can also include the symptoms associated with angina: a squeezing, suffocating or burning feeling in your chest that tends to start in the centre of your chest but may move to your arm, neck, back, throat or jaw. Women are more likely to experience atypical symptoms such as vague chest discomfort. If left untreated, CAD can lead to other serious problems such as heart attack, stroke or even death.

Diagnosis

Your doctor will start by taking a medical history, doing a physical exam and ordering some chest X-rays. Your doctor may also want to do some of these other tests:

Angiography
Echocardiogram
Electrocardiogram (ECG/EKG)

Treatment

There is no cure for CAD, but there are many treatments, including medications, surgery and lifestyle changes, that can slow down its progress.

Medications

Anti-platelets
ACE inhibitors
Beta-blockers
Calcium channel blockers
Nitrates (Nitroglycerin)

Surgical and non-surgical procedures

Percutaneous coronary intervention (PCI or angioplasty with stent) 
Coronary artery bypass surgery

Lifestyle

You can lower your risk of coronary artery disease by knowing and controlling your blood pressure, diabetes and blood cholesterol. It is also important to lead a healthy lifestyle by being smoke-free and physically active, eating a healthy diet that is lower in fat, especially saturated and trans fat, achieving and maintaining a healthy weight, limiting alcohol use and reducing your stress.

 Last reviewed August 2009.