Coronary Artery Disease

What is coronary artery disease?

Your heart muscle is fed by its own set of arteries, called the coronary arteries. Coronary artery disease develops when cholesterol-rich deposits called plaque build up inside those arteries over years, making them narrower and stiffer. As the opening narrows, less blood reaches the heart muscle — especially when the heart is working harder.

It is the most common form of heart disease, and it develops gradually. Many people have no idea it is present until symptoms appear or it is found during testing.

What are the symptoms?

The classic symptom is angina — chest pressure, tightness, or heaviness that appears with physical exertion or stress and improves with rest. Other symptoms include shortness of breath, unusual fatigue with activity, and discomfort in the arm, jaw, neck, or back.

Some people have no symptoms at all until they have a heart attack, which is why risk-factor screening matters even when you feel well.

What raises the risk of coronary artery disease?

• High blood pressure and high cholesterol
• Diabetes and insulin resistance
• Smoking or tobacco use
• Family history of early heart disease
• Obesity and physical inactivity
• Age, and chronic kidney disease

Several of these are treatable, which is why a cardiologist's evaluation focuses as much on risk factors as on symptoms.

How is it diagnosed?

Diagnosis usually combines your symptom pattern and risk profile with testing. That may include an EKG, an echocardiogram to assess heart function, and a stress test to see whether the heart shows signs of reduced blood flow under exertion. If those results suggest significant narrowing, a cardiac catheterization can show the arteries directly and measure how much a narrowing actually limits blood flow.

How is coronary artery disease treated?

Treatment has three parts, and most patients need all three:

• Risk-factor treatment — controlling blood pressure, cholesterol, and diabetes, and stopping tobacco
• Medication — to protect the heart, reduce symptoms, and lower the chance of a heart attack
• Procedures when needed — for significant blockages, an interventional cardiologist can open the artery from the inside using a catheter, usually placing a stent to hold it open. Some patients are better served by bypass surgery, which is performed by a cardiac surgeon

Our practice includes an interventional cardiologist, Dr. Afaq Motiwala, so patients who need catheter-based treatment can move from evaluation to procedure to follow-up within the same team.

This page is general health information, not medical advice. It cannot replace an evaluation by a physician who knows your history. Talk with your cardiologist or primary care physician about what applies to you.