#HeartHealthDay: Coronary artery disease symptoms, causes, and treatment

Coronary artery disease symptoms often include pain in the chest, shoulder or back.
Coronary artery disease symptoms often include pain in the chest, shoulder or back.
Photo credit: Shutterstock

What you need to know:

  • Coronary artery disease is preventable if you live a healthy lifestyle.
  • Chest, back, shoulder and jaw pain are often symptoms of CAD.
  • Treatments include surgery and/or medication.

Coronary artery disease happens when the coronary arteries (the arteries that supply blood to the heart muscle) become narrowed by plaque build-up. Plaque is made up of cholesterol and other substances found in the blood. Over time, plaque hardens and narrows the coronary arteries. This limits the flow of oxygen-rich blood to the heart muscle.

Coronary artery disease is the most common type of heart disease. It is also the leading cause of death around the world.

There are two forms of coronary artery disease:

1. Acute coronary syndrome (ACS), which is divided into unstable angina (chest pain at rest with increasing intensity over time), NSTEMI (a type of heart attack that involves part of the innermost layers of tissue of the heart, and the second layer of tissues of the heart), and STEMI (where the entire heart wall is involved in the heart attack).

ACS describes a range of conditions associated with the sudden, reduced blood flow to the heart. ACS happens when the plaque in your coronary arteries rupture or tear open. This can cause a blood clot to form. The blood clot can then block the flow of blood to your heart muscles.

2. Chronic coronary artery disease (CAD) which includes stable angina (chest pain on exertion)

This is a more gradual form of coronary artery disease. CAD happens when the plaque in your coronary arteries slowly builds up over time (which could take years). This can lead to narrowing of the arteries, which can eventually restrict blood flow to your heart.

Coronary artery disease has many causes:

  • Atherosclerosis: This is the most common cause of coronary artery disease. Atherosclerosis happens when plaque builds up in your arteries. Over time, this plaque can harden and narrow your arteries.
  • Smoking increases the risks of coronary artery disease development although it is not a cause in itself.
  • Coronaryvasospasm
  • Coronaryemboli (rare)
  • Arterioscrerosis (an inflammation of the walls of the coronary vessels)

Coronary artery disease symptoms

Angina is chest pain or discomfort when your heart muscle doesn't get enough oxygen-rich blood. It's a common symptom of coronary artery disease (CAD). It feels like a pressing or squeezing pain, usually in your chest under your breastbone. Angina pain also can occur in your shoulders, arms, neck, jaw, or back. 

The other significant sign of coronary artery disease is a heart attack, also known as myocardial infarction. When plaque build-up becomes severe, it can restrict blood flow and cause a heart attack.

Symptoms associated with a heart attack include chest pain, discomfort in the arms or shoulders, shortness of breath, and nausea. A heart attack can cause permanent damage to your heart or even be fatal.

What increases the risk of coronary artery disease?

Coronary artery disease is a complex condition with many different risk factors. Some of the most common risk factors include:

  • Physically inactive lifestyle.
  • Family history: If you have a family history of heart disease, you are more likely to develop CAD.
  • Smoking: Smoking is one of the most important risk factors for CAD. Cigarette smoke damages the lining of your arteries and makes plaque more likely to form.
  • High blood pressure: High blood pressure puts extra stress on your heart and can damage your arteries.
  • High cholesterol: High cholesterol can narrow your arteries and increase your risk for heart disease.
  • Diabetes: Diabetes can damage your blood vessels and increase your risk for CAD.
  • Obesity: Obesity increases your risk for CAD, high blood pressure, and diabetes.
  • Stress: Stress can contribute to the development of CAD.
  • Eating junk/ unhealthy foods.

What are the complications of coronary artery disease?

Coronary artery disease can lead to a number of complications, including:

  • Heart attack: A heart attack occurs when the blood flow to your heart is blocked. This can cause permanent damage to your heart or even be fatal.
  • Angina: Angina is chest pain or discomfort when your heart muscle doesn't get enough oxygen-rich blood.
  • Arrhythmias: Arrhythmias are abnormal heart rhythms that can be dangerous.
  • Heart failure: Heart failure occurs when your heart cannot pump enough blood to meet your body's needs.
  • Sudden cardiac death: This is an abrupt, unexpected death from a heart problem.

How is coronary artery disease diagnosed?

Coronary artery disease is usually diagnosed with a combination of tests, including:

  • Medical history and physical exam: Your doctor will ask about your medical history and symptoms and perform a physical exam.
  • Blood tests can help diagnose CAD by checking for high cholesterol or diabetes.
  • Stress test: A stress test is a type of exercise test that can help diagnose CAD.
  • Electrocardiogram and echocardiogram
  • Chest X-ray
  • Coronary angiography and MRI scan

How is coronary artery disease treated?

Treatment for coronary artery disease usually starts with lifestyle changes, such as quitting smoking, exercising, and eating a healthy diet. Medications and, in some cases, surgery may be needed to treat CAD.

What can you do to prevent coronary artery disease?

Prevention is always better than cure. This is especially true regarding coronary heart disease, as this condition can be debilitating and even life-threatening.

One can prevent coronary heart disease through life changes such as exercising regularly, eating a healthy diet, and avoiding smoking.

Exercise helps to keep your heart and blood vessels healthy, and a healthy diet will help to lower your cholesterol levels.

If you smoke, quitting is one of the best things you can do for your heart health. In addition to these lifestyle changes, you should also see your doctor regularly for check-ups.