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Coronary Artery Disease: At a Glance

By The Manual's Editorial Staff,

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.

Who Is at Risk of Coronary Artery Disease?

Some factors that affect whether a person develops coronary artery disease cannot be modified. They include

  • Advancing age

  • Male sex

  • Family history of early coronary artery disease (that is, having a close relative who developed the disease before age 50 to 55)

Other risk factors for coronary artery disease can be modified or treated. These factors include

How to Know Whether You Are Having a Heart Attack

People who are having a heart attack have symptoms such as

  • Chest discomfort or pain that may spread to the back, jaw, left arm, right arm, shoulders, or abdomen

  • Shortness of breath

  • Nausea or vomiting

  • Anxiety and/or restlessness

  • A feeling of faintness or actually fainting

  • Sudden, heavy sweating

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.

Did You Know...

  • Half of deaths due to a heart attack occur in the first 3 or 4 hours after symptoms begin.

Acute coronary syndromes are medical emergencies. The sooner treatment begins, the better the chances of survival.

How Is a Heart Attack Treated?

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.

Procedures such as percutaneous coronary intervention (angioplasty and placement of a stent) and coronary artery bypass grafting (surgery) may be done to open narrowed or blocked arteries.

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 have high blood pressure or diabetes, trying to keep those disorders under control

  • If they smoke, quitting

Cardiac rehabilitation is useful for some people who

  • Have had a recent heart attack

  • Have heart failure or coronary artery disease that has recently developed or suddenly worsened

  • Have had heart surgery

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.

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