Coronary Artery Disease: At a Glance
In coronary artery disease, the blood supply to the heart muscle is partially or completely blocked. In atherosclerosis (literally “hardening of the arteries”), fatty deposits accumulate in artery walls and eventually narrow the artery and may even block blood flow in the artery. Atherosclerosis can affect the arteries supplying blood to the heart, causing coronary artery disease.
Blockage of blood flow can cause
Angina: Temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen
Acute coronary syndromes: Sudden blockage in a coronary artery that causes unstable angina or a heart attack (myocardial infarction), depending on the location and amount of blockage
For a full discussion, see Overview of Coronary Artery Disease.
Some factors that affect whether a person develops coronary artery disease cannot be modified. They include
Other risk factors for coronary artery disease can be modified or treated. These factors include
People who are having a heart attack have symptoms such as
For unknown reasons, women often have different, less identifiable symptoms.
About one third of people who have a heart attack do not have chest pain—usually women and people who are not white, are older than 75, have heart failure or diabetes, or have had a stroke.
Acute coronary syndromes are medical emergencies. The sooner treatment begins, the better the chances of survival.
Treatment and diagnosis occur simultaneously. Doctors monitor the heart with electrocardiography (ECG) to watch for signs of complications such as heart rhythm abnormalities.
Drugs are given to reduce the risk of blood clots, to relieve pain, and often to reduce anxiety.
Stress testing (electrocardiography done during exercise or using a drug) is usually done before or shortly after discharge to determine how well the person is doing after the heart attack and whether the blood supply to the heart is still reduced.
People also need to change their lifestyle to reduce their risk of future heart problems. Such changes include
Eating a healthy diet (for example, limiting the amount of fat)
Carefully increasing the amount of exercise they get (as recommended by their doctor or physical therapist)
If they smoke, quitting
Cardiac rehabilitation is useful for some people who
The goal is to maintain or regain independence or, at the least, to do basic activities of daily living, within the constraints of abnormal heart function.