Coronary artery disease
The most common cardiovascular disease, caused by plaque buildup in heart arteries.
Coronary artery disease (CAD), also referred to as coronary heart disease or ischemic heart disease, is a condition in which the heart muscle receives insufficient blood flow because atheromatous plaques have built up inside the coronary arteries. It represents the most prevalent form of cardiovascular disease. The primary symptom is angina, a chest discomfort or pain that can radiate to the shoulder, arm, back, neck, or jaw and may sometimes be mistaken for heartburn. When this pain occurs predictably with exertion or emotional stress, lasts only a few minutes, and resolves with rest, it is termed stable angina and indicates a fixed narrowing of the arteries. If the angina changes in intensity, frequency, or character, it is considered unstable and may signal an impending heart attack. Shortness of breath is another common symptom, and some individuals experience no symptoms at all until a heart attack occurs. In many cases, the first manifestation of the disease is a myocardial infarction, which can also involve sweating, nausea, vomiting, and lightheadedness. Symptoms can differ between sexes: females most often report shortness of breath, along with extreme fatigue, sleep disturbances, indigestion, and anxiety, while chest pain is less commonly reported by them than by males. Females typically develop symptoms about a decade later than males and are less likely to recognize them or seek treatment. Advanced disease reduces oxygen-rich blood supply to the heart, especially during strenuous activities when the heart demands more oxygen. Complications include heart failure and abnormal heart rhythms. The underlying cause is atherosclerosis, a chronic inflammatory process that hardens the arteries and deposits cholesterol-laden plaques on the arterial walls. Well-established risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, depression, family history, psychological stress, and excessive alcohol consumption. Smoking just one cigarette daily roughly doubles the risk, and smoking is linked to about 36% of cases, while obesity is associated with roughly 20%. Lack of exercise contributes to an estimated 7–12% of cases. About half of all cases have a genetic component.
Quick Facts
- Field
- Cardiology, cardiothoracic surgery
- Symptoms
- Chest pain, shortness of breath
- Complications
- Heart failure
- abnormal heart rhythms
- heart attack
- cardiogenic shock
- cardiac arrest
- Causes
- Atherosclerosis of the arteries of the heart
- Risks
- High blood pressure
- smoking
- diabetes
- lack of exercise
- obesity
- high blood cholesterol
- Diagnosis
- Electrocardiogram
- cardiac stress test
- coronary computed tomographic angiography
- coronary angiogram
- Prevention
- Healthy diet
- regular exercise
- maintaining a healthy weight
- not smoking
- Treatment
- Percutaneous coronary intervention (PCI), coronary artery bypass surgery (CABG)
Facts from the source article.
Lore & Background
Coronary artery disease is a condition in which the heart muscle receives an inadequate supply of blood because the coronary arteries have become narrowed or blocked by the buildup of atheromatous plaques. This reduction in blood flow can lead to several serious complications, including stable angina, unstable angina, myocardial ischemia, and myocardial infarction. The most common symptom is angina, a sensation of chest pain, tightness, pressure, or squeezing that may radiate to the shoulder, arm, back, neck, or jaw and can sometimes be mistaken for heartburn. In stable angina, these episodes are typically triggered by physical exertion or emotional stress, last less than a few minutes, and are relieved by rest. Unstable angina is characterized by a change in the pattern of symptoms—becoming more frequent, severe, or occurring at rest—and may signal an impending heart attack. Other symptoms include shortness of breath, sweating, nausea, vomiting, and lightheadedness, especially during a heart attack. Notably, some individuals experience no symptoms at all until a heart attack occurs. The disease is driven by atherosclerosis, a chronic inflammatory process that hardens the arteries and deposits cholesterol-rich plaques on the arterial walls. Key risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, depression, and excessive alcohol consumption; smoking just one cigarette per day roughly doubles the risk. Diagnosis may involve tests such as an electrocardiogram, cardiac stress testing, coronary computed tomographic angiography, or coronary angiogram. Treatment mirrors prevention and includes lifestyle changes, medications like antiplatelets, beta blockers, or nitroglycerin, and in severe cases, procedures such as percutaneous coronary intervention or coronary artery bypass surgery.
Reader's Guide
Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, depression, family history, psychological stress, excessive alcohol consumption, and air pollution. Air pollution, both indoor and outdoor, is responsible for roughly 28% of deaths from CAD. Ways to reduce risk include eating a healthy diet, regularly exercising, maintaining a healthy weight, and not smoking. Treatment involves the same measures as prevention; additional medications such as antiplatelets (including aspirin), beta blockers, or nitroglycerin may be recommended. Procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) may be used in severe disease. In those with stable CAD, it is unclear if PCI or CABG in addition to other treatments improves life expectancy or decreases heart attack risk.
Frequently Asked Questions
What is Coronary artery disease known for?
Its signature moves include producing stable angina, unstable angina, and myocardial ischemia, with its most devastating attack being a full myocardial infarction. It works by steadily narrowing the coronary arteries until the cardiac muscle can no longer receive adequate blood flow.
What are Coronary artery disease's known allies (risk factors)?
Its most frequent co-conspirators include high blood pressure, cigarette smoking, diabetes, physical inactivity, and obesity, all of which accelerate the plaque accumulation it depends on. These factors essentially feed and empower CAD, making their control a key strategy in keeping it in check.
More in Common Diseases & Disorders
Spotted an error? Know more?
Reader corrections go straight into our review queue. Suggest an edit · How this site is sourced