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 closer look at your coronary arteries

The blood vessels that supply the heart may narrow with age, known as coronary artery disease. But people have misconceptions about this condition, which is responsible for the heart attacks that strike somewhere in this country roughly every 40 seconds. For example, people don’t usually experience angina (the classic symptom of coronary artery disease) until an artery is 70% to 90% blocked. Angioplasty plus a stent to reopen a blocked coronary artery can be lifesaving when done during a heart attack. For people with stable angina, a stent can relieve symptoms but has not been proved to prevent a future heart attack or extend a person’s life. (Locked) More »

What can at-home genetic tests tell you about heart-related risks?

At-home genetic tests such as 23andMe and Ancestry Health are unlikely to help predict a person’s odds of heart disease. The results reveal only limited information about a person’s risk for abnormally high cholesterol (a condition known as familial hypercholesterolemia) or harmful blood clots (known as hereditary thrombophilia). Most cases of coronary artery disease, the most common form of heart disease, are polygenic, meaning they result from changes in multiple genes. (Locked) More »

Understanding sudden cardiac arrest

Coronary artery disease is the underlying cause of most cases of sudden cardiac arrest, which means the heart abruptly and unexpectedly stops beating. Most heart attacks do not lead to cardiac arrest. But sometimes, the heart’s ventricles quiver rapidly and irregularly during a heart attack, and this lethal rhythm causes most sudden cardiac arrests. Heart attack survivors who experienced significant muscle damage are also at risk for cardiac arrest. Other possible causes of cardiac arrest include inherited abnormalities of the heart’s electrical pathways or structural changes in the heart, such as those caused by heart muscle disease (cardiomyopathy). (Locked) More »

Checking for an abdominal aortic aneurysm: Who, when, and why?

Guidelines recommend that men ages 65 to 75 who have ever smoked cigarettes be screened for an abdominal aortic aneurysm (AAA). But other people at high risk might also consider this one-time test. These include older men and women with a family history of AAA and those with chronic obstructive pulmonary disease or atherosclerotic heart disease. The screening test is simple and painless, and it costs roughly $50, which is fully covered by Medicare for men who meet the guideline criteria, as well as for people ages 65 to 75 with a family history of AAA. (Locked) More »

What is pulmonary hypertension?

Pulmonary hypertension affects the pulmonary arteries, which carry blood from the right side of the heart to the lungs. The vessels tighten, become stiff and thick, or develop blood clots. These changes reduce or block blood flow, raising pressure in the pulmonary arteries. (Locked) More »

Omega-3 supplements may improve heart health

A review of existing data suggests daily omega-3 supplements may protect against heart attack and death from coronary artery disease. This suggests that supplements might be an alternative for people who have trouble getting enough omega-3s from fish in their diet. More »

Cardiac Catheterization

Cardiac catheterization is a procedure in which a heart specialist inserts a small tube (catheter) through a large blood vessel in the arm or leg, and then passes the tube into the heart. Once inside the heart, doctors use the catheter to evaluate how the heart is working by measuring pressure and oxygen levels within the heart's chambers. Through the catheter, doctors inject a special dye that provides an X-ray image of the heart's internal structure and blood flow patterns. The procedure is often done to look for narrowed and blocked coronary arteries. The X-ray dye also is injected into each of the three largest coronary arteries. This is called coronary angiography. (Locked) More »

Holter Monitor and Event Monitor

A Holter monitor is a portable EKG device that records your heart rhythm over time, outside the hospital or doctor's office. Whereas a regular EKG examines your heart's electrical activity for a few seconds, the Holter monitor examines changes over a sustained period of time-usually a 24- to 48-hour period-while you go about your daily activities and even while you sleep. One type of Holter monitor, called an "event monitor," can be used to record rhythms over a longer time, such as a 30-day period. Doctors use Holter monitor or event monitor tests to evaluate symptoms that come and go and that might be related to heart-rhythm changes or coronary artery disease. Men with a lot of hair on their chest will probably have to shave it. Otherwise, there's no special preparation. A technician in your doctor's office or a diagnostic lab fits you with a Holter monitor and explains how to use it. Five stickers are attached to your chest. Wires snap onto each of these stickers and connect them to the monitor. The wires detect your heart's electrical pattern throughout the day, while the monitor records and stores the data for doctors to interpret later. You can fit the monitor into a purse or jacket pocket or wear it over your shoulder by its strap. (Locked) More »

Dealing with the discomfort of angina

Angina pectoris is often defined as chest pain due to an inadequate supply of oxygen to the heart muscle. But most people describe the feeling as a sense of heaviness or pressure. It can also cause discomfort in the neck, jaw, and shoulders. Anything that increases blood flow to the heart, including exercise or periods of intense emotion, can trigger angina. Unstable angina (which is a medical emergency) occurs during rest or slight exertion. A number of medications can help ease angina. (Locked) More »