Patient education: Coronary artery disease (The Basics)

What is coronary artery disease? — Coronary artery disease is a condition that puts you at risk for heart attack and other forms of heart disease. In people who have coronary artery disease, the arteries that supply blood to the heart get clogged with fatty deposits (figure 1). Other names for this disease are "coronary heart disease" or just "heart disease."

What are the symptoms of coronary artery disease? — Many people with coronary artery disease have no symptoms. For those who do, the most common symptoms usually happen with exercise. They can include:

●Pain, pressure, or discomfort in the center of the chest

●Pain, tingling, or discomfort in other parts of the upper body – This might include the arms, back, neck, jaw, or stomach.

●Feeling short of breath

What are the symptoms of a heart attack? — The first symptom of coronary artery disease can be a heart attack (figure 2). That's why it is so important to know how to spot a heart attack.

The symptoms of a heart attack can include:

●Pain, pressure, or discomfort in the center of the chest

●Pain, tingling, or discomfort in other parts of the upper body, including the arms, back, neck, jaw, or stomach

●Shortness of breath

●Nausea, vomiting, burping, or heartburn

●Sweating or having cold, clammy skin

●A racing or uneven heartbeat

●Feeling dizzy or lightheaded

If these symptoms last more than 10 minutes or they keep coming and going, call for an ambulance (in the US and Canada, dial 9-1-1) right away. Do not try to get to the hospital on your own.

As mentioned above, some people with coronary artery disease have chest pain even when they are not having a heart attack. This is most likely to happen when they are walking, going up stairs, or moving around. But if you have chest pain that is new or different than pain you have had before, you should see a doctor right away.

Is there a test for coronary artery disease? — Yes. If your doctor or nurse thinks you might have coronary artery disease, they might order blood tests and one or more of these tests:

●An electrocardiogram ("ECG") – This test measures the electrical activity in your heart.

●A stress test – During a stress test, which is also called an exercise test, you might be asked to run or walk on a treadmill while you also have an ECG. Physical activity increases the heart's need for blood. This test helps doctors see if the heart is getting enough blood. If you cannot walk or run, your doctor might do this test by giving you a medicine to make your heart pump faster.

●An echocardiogram – This test uses sound waves to create an image of your heart as it beats.

●Cardiac catheterization (also called "cardiac cath") – During this test, the doctor puts a thin tube into a blood vessel in your leg or arm. Then they move the tube up to your heart. Next, the doctor puts a dye that shows up on X-ray into the tube. This part of the test is called "coronary angiography." It can show whether any of the arteries in your heart are clogged.

How is coronary artery disease treated? — The main treatments for coronary artery disease are:

●Lifestyle changes – Here are some things you can do to reduce your risk of heart attack and death:

•Quit smoking, if you smoke.

•Eat lots of fruits, vegetables, and foods with a lot of fiber. Avoid foods that have a lot of sugar.

•Walk or do some form of physically activity on most days of the week.

•Lose weight, if you are overweight.

●Medicines – The medicines to treat heart disease are very important. Some medicines lower your risk of heart attacks and can help you live longer. But you must take them every day, as directed. Medicines your doctor might prescribe include:

•Medicines called statins, which lower cholesterol

•Medicines to lower blood pressure

•Aspirin or other medicines that help prevent blood clots

•Medicines to treat diabetes

People who have chest pain caused by coronary artery disease (called "angina") can also get medicines to relive their pain. These medicines might include "nitrates," "beta blockers," and others.

Some people with coronary artery disease can also have:

●A stent procedure – During this procedure, the doctor puts a thin plastic tube into the blocked artery, and uses a tiny balloon to open the blockage. Then the doctor leaves a tiny mesh tube called a "stent" inside the artery to hold it open.

●Bypass surgery (also known as "coronary artery bypass grafting" or CABG) – During bypass surgery, the doctor removes a piece of blood vessel from another part of the body. Then they reattach the blood vessel above and below the area that is clogged. This re-routes blood around the clog and allows it to get to the part of the heart that was not getting blood (figure 3).

If your doctor recommends stenting or bypass surgery, ask these questions:

●What are the benefits of this procedure for me? Will the procedure help me live longer? Will it reduce my chance of having a heart attack? Will I feel better if I have this procedure?

●What are the risks of the procedure?

●What happens if I don't have this procedure?

More on this topic

Patient education: Medicines after a heart attack (The Basics)
Patient education: Heart attack (The Basics)
Patient education: Heart attack recovery (The Basics)
Patient education: Chest pain (The Basics)
Patient education: High blood pressure in adults (The Basics)
Patient education: High cholesterol (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: ECG and stress test (The Basics)
Patient education: Nuclear heart testing (The Basics)
Patient education: Cardiac catheterization (The Basics)
Patient education: Coronary artery disease in women (The Basics)
Patient education: Stenting for the heart (The Basics)
Patient education: Treatment choices for angina (chest pain) (The Basics)
Patient education: Can foods or supplements lower cholesterol? (The Basics)
Patient education: Coronary artery bypass graft surgery (The Basics)

Patient education: High cholesterol and lipids (Beyond the Basics)
Patient education: Heart attack (Beyond the Basics)
Patient education: Aspirin in the primary prevention of cardiovascular disease and cancer (Beyond the Basics)
Patient education: Chest pain (Beyond the Basics)
Patient education: Medications for angina (Beyond the Basics)
Patient education: Angina treatment — medical versus interventional therapy (Beyond the Basics)
Patient education: Stenting for the heart (Beyond the Basics)
Patient education: Coronary artery bypass graft surgery (Beyond the Basics)
Patient education: Recovery after coronary artery bypass graft surgery (CABG) (Beyond the Basics)