Coronary Artery Disease

The term "heart disease," also known as cardiovascular disease, covers a lot of ground. It's used for a variety of problems with the circulatory system, from high blood pressure to abnormal heart rhythms. Most of the time, though, when people speak of heart disease what they really mean is coronary artery disease—a narrowing of the coronary arteries. No wider than a strand of spaghetti, each coronary artery deliver bloods to hard-working heart muscle cells.

The cause of coronary artery disease is almost always atherosclerotic plaque—gooey cholesterol-filled deposits that form inside artery walls. Plaque is usually the result of an unhealthy diet, too little exercise, high cholesterol, high blood pressure, smoking, and other "insults" that damage the lining of artery walls.

When a coronary artery becomes clogged with plaque, it can't always deliver enough blood to the heart muscle cells it is supposed to supply. Sometimes this doesn't cause any noticeable symptoms. Sometimes it causes angina — chest pain that occurs with physical exertion or stress. Coronary artery disease can also be the root cause of a heart attack, or lead to the chronic condition known as heart failure.

Coronary artery disease affects millions of Americans. Once limited almost entirely to older people, it is now beginning to appear in younger folks, a change driven by the rising tides of obesity and type 2 diabetes.

Coronary artery disease isn't an inevitable part of growing older. A healthy lifestyle that includes exercise, a healthy diet, and not smoking goes a long way to preventing it, especially when started at a young age. Lifestyle changes and medications can also reverse coronary artery disease, or at least prevent it from getting worse.

Coronary Artery Disease Articles

How atrial fibrillation may affect your brain

People with atrial fibrillation—a heart rhythm disorder that causes a rapid, irregular heart rate—may face an increase risk of thinking and memory problems. Atrial fibrillation causes blood to pool in the heart’s upper left chamber, which may form clots that can travel to the brain, causing a stroke. But tiny clots can cause silent, unnoticed strokes. Over time, these stroke gradually injure part of the brain involved with thinking and memory. (Locked) More »

Artery disease below the belt

In peripheral artery disease (PAD), the arteries below the heart become clogged with fatty deposits. The main symptom (pain in the calf, thigh, or buttocks with walking that goes away with rest) doesn’t always occur or is mistaken for something else, so PAD often goes unrecognized. But people with PAD likely have narrowed heart and brain arteries as well, putting them at risk for a heart attack or stroke. Treatments include regular walking, medications, and for severe cases, a procedure to open a blocked artery in the leg. (Locked) More »

High-tech heart scans: Who might need one?

Computed tomography angiography (CTA) is one of several techniques used to evaluate people with chest pain that’s thought to result from coronary artery disease. It provides detailed views of the heart’s arteries. Compared with other tests, such as exercise stress tests with nuclear imaging, CTA takes less time and is easier to endure. But it requires radiation exposure and provides no clear long-term advantages in terms of preventing heart attacks or similar problems. (Locked) More »

For "bad" cholesterol, lower is better; dual drug therapy may help

High cholesterol, in particular high low-density lipoprotein (LDL), the so-called bad cholesterol, is a key cause of heart disease. A large clinical trial called IMPROVE-IT set out in 2005 to answer two key questions about LDL: The results of IMPROVE-IT were recently published in The New England Journal of Medicine. Dr. Deepak L. Bhatt, Editor in Chief of the Harvard Heart Letter, talked about the significance of the IMPROVE-IT findings with Dr. Christopher P. Cannon, the trial's lead investigator, and Dr. John A. Jarcho, an editor of The New England Journal of Medicine. More »

Battling breathlessness

Shortness of breath is one of the most common problems people bring to their doctors. The most obvious causes such as asthma, chronic obstructive pulmonary disease, and coronary artery disease are relatively easy to uncover with a battery of standard tests. For some people, however, the source of the problem remains frustratingly elusive. Advanced cardiopulmonary testing that measures heart and lung function during exercise can often provide answers. (Locked) More »