Know the warning signs of this common heart condition often caused by clogged, narrowed arteries and how lifestyle changes can lower your risk.
Coronary artery disease is a common heart condition. The major blood vessels that supply the heart (coronary arteries) struggle to send enough blood, oxygen and nutrients to the heart muscle. Cholesterol deposits (plaques) in the heart arteries and inflammation are usually the cause of coronary artery disease.
Signs and symptoms of coronary artery disease occur when the heart doesn't get enough oxygen-rich blood. If you have coronary artery disease, reduced blood flow to the heart can cause chest pain (angina) and shortness of breath. A complete blockage of blood flow can cause a heart attack.
Coronary artery disease often develops over decades. Symptoms may go unnoticed until a significant blockage causes problems or a heart attack occurs. Following a heart-healthy lifestyle can help prevent coronary artery disease.
Coronary artery disease may also be called coronary heart disease.
Symptoms may go unrecognized at first, or they may only occur when the heart is beating hard like during exercise. As the coronary arteries continue to narrow, less and less blood gets to the heart and symptoms can become more severe or frequent.
Coronary artery disease signs and symptoms can include:
If you think you're having a heart attack, immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last option.
Smoking or having high blood pressure, high cholesterol, diabetes, obesity or a strong family history of heart disease makes you more likely to get coronary artery disease. If you're at high risk of coronary artery disease, talk to your health care provider. You may need tests to check for narrowed arteries and coronary artery disease.
Coronary artery disease starts when fats, cholesterols and other substances collect on the inner walls of the heart arteries. This condition is called atherosclerosis. The buildup is called plaque. Plaque can cause the arteries to narrow, blocking blood flow. The plaque can also burst, leading to a blood clot.
Besides high cholesterol, damage to the coronary arteries may be caused by:
If there's too much cholesterol in the blood, the cholesterol and other substances may form deposits (plaques) that collect on artery walls. Plaques can cause an artery to become narrowed or blocked. If a plaque ruptures, a blood clot can form. Plaques and blood clots can reduce blood flow through an artery.
Coronary artery disease is common. Age, genetics, other health conditions and lifestyle choices can affect the health of the heart arteries.
Coronary artery disease risk factors include:
Risk factors often occur together. One risk factor may trigger another.
When grouped together, certain risk factors make you even more likely to develop coronary artery disease. For example, metabolic syndrome — a cluster of conditions that includes high blood pressure, high blood sugar, excess body fat around the waist and high triglyceride levels — increases the risk of coronary artery disease.
Sometimes coronary artery disease develops without any classic risk factors. Other possible risk factors for coronary artery disease may include:
Coronary artery disease can lead to:
The same lifestyle habits used to help treat coronary artery disease can also help prevent it. A healthy lifestyle can help keep the arteries strong and clear of plaque. To improve heart health, follow these tips:
To diagnose coronary artery disease, a health care provider will examine you. You'll likely be asked questions about your medical history and any symptoms. Blood tests are usually done to check your overall health.
Test to help diagnose or monitor coronary artery disease include:
Echocardiogram. This test uses sound waves to create pictures of the beating heart. An echocardiogram can show how blood moves through the heart and heart valves.
Parts of the heart that move weakly may be caused by a lack of oxygen or a heart attack. This may be a sign of coronary artery disease or other conditions.
Heart (cardiac) CT scan. A CT scan of the heart can show calcium deposits and blockages in the heart arteries. Calcium deposits can narrow the arteries.
Sometimes dye is given by IV during this test. The dye helps create detailed pictures of the heart arteries. If dye is used, the test is called a CT coronary angiogram.
Cardiac catheterization and angiogram. During cardiac catheterization, a heart doctor (cardiologist) gently inserts a flexible tube (catheter) into a blood vessel, usually in the wrist or groin. The catheter is gently guided to the heart. X-rays help guide it. Dye flows through the catheter. The dye helps blood vessels show up better on the images and outlines any blockages.
If you have an artery blockage that needs treatment, a balloon on the tip of the catheter can be inflated to open the artery. A mesh tube (stent) is typically used to keep the artery open.
Treatment for coronary artery disease usually involves lifestyle changes such as not smoking, eating healthy and exercising more. Sometimes, medications and procedures are needed.
There are many drugs available to treat coronary artery disease, including:
Aspirin. Aspirin helps thin the blood and prevent blood clots. Daily low-dose aspirin therapy may be recommended for the primary prevention of heart attack or stroke in some people.
Daily use of aspirin can have serious side effects, including bleeding in the stomach and intestines. Don't start taking a daily aspirin without talking to your health care provider.
Sometimes, surgery is needed to fix a blocked artery. Some options are:
Coronary angioplasty and stent placement. This procedure is done to open clogged heart arteries. It may also be called percutaneous coronary intervention (PCI). The heart doctor (cardiologist) guides a thin, flexible tube (catheter) to the narrowed part of the heart artery. A tiny balloon is inflated to help widen the blocked artery and improve blood flow.
A small wire mesh tube (stent) may be placed in the artery during angioplasty. The stent helps keep the artery open. It lowers the risk of the artery narrowing again. Some stents slowly release medication to help keep the arteries open.
When placing a coronary artery stent, a health care provider will find the blocked heart artery (A). A balloon on the tip of a flexible tube (catheter) is inflated. It widens the blocked artery. Then a metal mesh stent is placed (B). The stent holds the artery open so blood moves through (C).
Making certain lifestyle changes can help keep the arteries healthy and can prevent or slow coronary artery disease. Try these heart-healthy tips:
Regular medical checkups are important. Some of the main risk factors for coronary artery disease — high cholesterol, high blood pressure and diabetes — have no symptoms in the early stages. Early detection and treatment can help you maintain better heart health.
Omega-3 fatty acids are a type of unsaturated fatty acid. It's thought that they can lower inflammation throughout the body. Inflammation has been linked to coronary artery disease. However, the pros and cons of omega-3 fatty acids for heart disease continue to be studied.
Sources of omega-3 fatty acids include:
Other supplements may help lower blood pressure or cholesterol — two risk factors for coronary artery disease. Some that may be effective are:
Always talk to a health care provider before taking herbs, supplements or medications bought without a prescription. Some drugs and supplements can interfere with other drugs.
If you have symptoms of coronary artery disease or any risk factors, make an appointment with your health care provider. You may be referred to a heart specialist (cardiologist).
Here's some information to help you get ready for your appointment and to know what to expect from your doctor.
Questions to ask your health care provider at your first appointment include:
If you're referred to a heart doctor (cardiologist) for coronary artery disease, you may want to ask these questions:
Don't hesitate to ask additional questions about your condition.
A health care provider who sees you for coronary artery disease may ask:
It's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and getting more exercise. These habits protect against coronary artery disease and its complications, including heart attack and stroke.