Coronary Artery Disease

In this factsheet:
• The Facts on Coronary Artery Disease
• Causes of Coronary Artery Disease
• Symptoms and Complications of Coronary Artery Disease
• Diagnosing Coronary Artery Disease
• Treating and Preventing Coronary Artery Disease

The Facts on Coronary Artery Disease

Coronary artery disease (CAD) refers to the narrowing of heart arteries due to atherosclerosis (see below). The heart muscle does not get enough oxygen when heart arteries are narrowed. If the heart is starved of oxygen, chest pain (angina) occurs. If an artery is completely blocked, a heart attack results. A heart attack is medically referred to as a myocardial infarction (MI). CAD is the most common form of heart disease and heart attack is a leading killer of both men and women.

Many of these deaths can be prevented because some risk factors for CAD are controllable. Some of these controllable risk factors include high blood pressure, high blood cholesterol, and diabetes. There are other controllable risk factors more related to lifestyle, such as not smoking, maintaining a health weight, and getting physically active.

Although medical treatments for heart disease have come a long way, controlling risk factors remains the key to preventing illness and death from CAD.

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Causes of Coronary Artery Disease

A low supply of oxygen in the heart is most often caused by atherosclerosis, also called "hardening of the arteries." In this condition, fatty deposits called plaques form in the linings of the blood vessels. The plaques make the arteries narrower as they build up, and less blood is able to get through to the heart, depriving it of oxygen. Atherosclerosis is often the result of too much "bad" cholesterol (low density lipoproteins, or LDL) and triglycerides circulating in the bloodstream.

You are at risk for developing atherosclerosis and CAD if you:

• have high levels of "bad" cholesterol (either from a high-fat diet, or produced naturally by the liver)
• have high blood pressure
• are a smoker
• have diabetes
• lead a sedentary lifestyle
• are overweight (particularly if you are a man who is obese in the torso)

Occasionally, a genetic condition can cause atherosclerosis, leading to heart disease.

Men run a higher risk of developing the disease than premenopausal women. After menopause, the incidence of CAD in women increases, and can be equal to men.

Symptoms and Complications of Coronary Artery Disease

Some people with CAD might have no symptoms until the disease is severe enough to cause chest pains, or angina pectoris (angina comes from the Greek word for "strangling").

Stable angina is often the first sign that a person has CAD. Chest pain or discomfort occurs with activity and is relieved by rest. With unstable angina, symptoms become less predictable and can occur when you are at rest. This indicates rapid progression of CAD and higher risk of a heart attack and requires that you see a doctor immediately.

Some symptoms of angina include:

• tightness or a squeezing sensation across the chest
• burning or pressure beneath the breast bone
• pain or ache radiating to the shoulders, jaw, arms, throat, neck, or upper abdomen
• fatigue
• nausea or vomiting
• sweating
• weakness
• shortness of breath
• lightheadness

If a plaque lining a blood vessel ruptures, it may completely block an area of the heart from receiving the oxygen-rich blood supply it needs. The starved cells in that area will then die, resulting in a heart attack (or myocardial infarction, MI).

The symptoms of a heart attack are similar to those of angina, but much stronger.

Men will often feel:

• constant pain in the middle of the chest that may radiate to the neck, jaw, left shoulder, or arm
• tightness or squeezing in the chest
• a sensation of "heaviness" or heavy indigestion
• sweating, nausea, and vomiting
• shortness of breath

In women, the main symptoms can be similar to men but may also include:

• shoulder, neck, or back pain
• feeling a sharp pain on breathing in cold air
• fatigue

It's very important to get medical help as quickly as possible if you feel you have the symptoms of a heart attack.

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