coronary artery disease

What is coronary artery disease?

Coronary arteries are the blood vessels that carry blood to the heart muscle. Coronary artery disease (also called CAD or coronary heart disease) is caused by a thickening of the inside walls of the coronary arteries. This thickening is called atherosclerosis (say: "ath-uh-roe-skluh-roe-suhs"). A fatty substance called plaque builds up inside the thickened walls of the arteries, blocking or slowing the flow of blood. If your heart muscle doesn\'t get enough blood to work properly, you may have angina or a heart attack.

Symptoms

What are the symptoms of CAD?

Coronary artery disease may take years to develop. You may not notice any symptoms of coronary artery disease until the disease progresses. As your arteries become blocked you may experience:

• Angina (a squeezing pain or pressing feeling in your chest)
• Shortness of breath
• Heart attack

Causes & Risk Factors

What causes CAD?

Both men and women can get CAD. It can be hereditary (run in your family). It might also develop as you get older and plaque builds up in your arteries over the years.

Know your risk factors

In the United States, heart disease is the leading cause of death for women and men. Risk factors for heart disease include:

• Age
• Family history
• High blood pressure
• High cholesterol
• Smoking
• Poor diet
• Overweight or obesity
• Inactivity (sedentary lifestyle)
• Other health problems (such as diabetes)

Treatment

How is CAD treated?

Most people who have CAD take medicine to help control their condition. Medicines called beta-blockers, calcium channel blockers and nitrates can help relieve angina. Taking low-dose aspirin every day can reduce the chance of a second heart attack in people who have already had one. Your doctor will tell you whether you should take any of these medicines.

What about surgery?

Angioplasty is a surgical treatment for CAD. Angioplasty uses a tiny balloon to push open blocked arteries around the heart. The balloon is ed in an artery in the arm or leg. A small metal rod called a stent might be put into the artery the blockage was to hold the artery open.

Another surgical treatment for CAD is bypass surgery. Pieces of veins or arteries are taken the legs and sewn into the arteries of the heart to bring blood past a blockage and increase the blood flow to the heart. Bypass surgery is usually done when angioplasty isn\'t possible or when your doctor feels it\'s a better choice for you.

Are there side effects and other risks to the treatment of CAD?

All medicines may have side effects. Aspirin may cause upset stomach. Nitrates may cause a flush (redness in the face) and headaches. Beta-blockers cause tiredness and sexual problems in some patients. Calcium channel blockers may cause constipation and leg swelling. Fortunately, most patients don\'t have side effects these medicines. If you have side effects after taking a medicine, tell your doctor.

Surgery, such as angioplasty or bypass surgery, also has potential risks. The major risks can include heart attack, stroke or even death. These are rare and most patients do well. After angioplasty, you can usually expect to return to your previous activity level, or even a better activity level, within a few days. It takes longer (a few weeks or months) to recover bypass surgery.

How do I know which treatment is right for me?

Your doctor will help you decide which treatment is best for you.

Does CAD ever go away?

CAD doesn\'t go away, but by working with your doctor, you can live longer and feel better.

Prevention

What can I do to lower my risk of CAD?

• Don\'t smoke.Nicotine raises your blood pressure because it causes your body to release adrenaline, which makes your blood vessels constrict and your heart beat faster. If you smoke, ask your doctor to help you make a plan to quit.
• Control your blood pressure.If you have high blood pressure, your doctor can suggest ways to lower it. If you\'re taking medicine for high blood pressure, be sure to take it just the way your doctor tells you to.
• Exercise.Regular exercise can make your heart stronger and reduce your risk of heart disease. Exercise can also help if you have high blood pressure. Before you start any new exercise program, talk to your doctor about the right kind of exercise for you.
• Ask your doctor about taking a low dose of aspirin each day.Aspirin helps prevent CAD, but taking it also has some risks.
• Ask your doctor about taking vitamin supplements.While foods that are rich in vitamin E and beta-carotene are very healthy and help reduce cardiovascular risk, the U.S. Preventive Services Task Force and the American Academy of Family Physicians recommend against taking vitamin E or beta-carotene supplements for the prevention of cardiovascular disease. Even though a diet rich in healthy foods reduces cardiovascular risk, there is no clear evidence that taking multivitamins does the same thing.
• Eat a healthy diet.Choose fruits, vegetables, meats, fish, and whole grains. Try to avoid processed foods, white flour, sugars, and high fructose corn syrup. The Mediterranean Diet  is also very good for heart health. If you have questions, talk to your doctor about how to make heart-healthy changes to your diet.

How do I know lifestyle changes are helping?

Rest assured that these lifestyle changes will lower your CAD risk, even if you don\'t feel any different. Your body will also need time to respond to the changes you\'ve made. Your doctor will watch your progress. For example, if your cholesterol level hasn\'t improved after you\'ve made changes for a few months, your doctor may prescribe medicine to lower your cholesterol. However, you will still need to keep up the healthy lifestyle changes you\'ve started to help the medicine work.

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Questions to Ask Your Doctor

• Am I at risk for coronary artery disease (CAD)?
• What lifestyle changes should I make to decrease my risk of CAD?
• Do I need any tests?
• How many blockages do I have in my arteries? How severe are the blockages?
• What\'s my best treatment option? Do I need medicine? Surgery?
• Will the medicine(s) you prescribed interact with the medicine(s) I currently take?
• What are some signs that I need to go to a hospital or seek treatment right away?