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

A different type of heart attack

A small percentage of heart attacks result from a tear in the inner wall of one of the heart’s arteries. Called spontaneous coronary artery dissection or SCAD, it’s the most common reason for acute coronary syndrome in women under 50. Expanded awareness of heart disease in women and improved diagnostic tools have increased recognition of SCAD. The typical person with SCAD is a middle-aged, healthy woman with few or none of the classic risk factors for heart disease, such as diabetes and high cholesterol. While the exact cause isn’t entirely clear, most people with SCAD have some sort of abnormality in the blood vessels outside the heart, including a rare condition called fibromuscular dysplasia. More »

What is a myocardial bridge?

A myocardial bridge refers to a coronary artery that dives into the heart’s muscle and comes back out again. The condition is usually harmless but can cause angina when the heart’s contractions squeeze the segment of the vessel. More »

Fish oil drug helps shrink plaque in heart arteries

A drug made from a highly purified form of EPA (an omega-3 fatty acid found in fish) appears to help reduce plaque in the heart’s arteries. This may explain why the drug, icosapent ethyl (Vascepa), helps lower the risk of heart attack and stroke. More »

Our evolving understanding of the problem with plaque

New imaging techniques that use light or sound waves to create images of the inside of coronary arteries have helped researchers better understand the fat-laden plaque that builds up inside artery walls (atherosclerosis). Most heart attacks happen when small, inflamed areas of fatty plaque rupture suddenly, causing a clot that blocks blood flow. This may explain why treating large, obstructive plaques with stents or bypass surgery does not seem to prevent heart attacks or help people live longer. More »

Air pollution: An invisible threat to your heart

Exposure to microscopic particles called PM2.5 in air pollution may increase a person’s risk of heart attack, stroke, and heart rhythm disorders. The tiny particles pass from the lungs into the bloodstream, triggering inflammation and other cell-damaging processes. Air pollution comes mainly from coal-fired power plants, industrial factories, and motor vehicles. To limit exposure, people should try to avoid exercising outdoors near busy roads or industrial areas. More »

Calcium scan concerns

Coronary artery calcium scans tend to be quite accurate. Unlike some other imaging tests, the results are unlikely to be either falsely negative or falsely positive because the results are literally black and white (the calcium shows up as white on the scan). More »

Sex differences in heart disease: A closer look

Heart attack symptoms tend to be pretty similar among both sexes. However, chest pain and sweating are slightly more common in men, while nausea and vomiting and shortness of breath tend to be more likely to occur in women. Heart attacks that show no evidence of a blockage in a major heart artery (known as myocardial infarction with nonobstructive coronary arteries, or MINOCA) tend to occur more often in women, but about 40% of these unusual heart attacks occur in men. More »