Coronary Artery Disease

Coronary artery disease is known by many names, including atherosclerosis, hardening of the arteries, arteriosclerosis, or coronary artery disease (CAD).

Coronary artery disease is a condition characterized by atherosclerosis which is plaque building up in the arteries, causing them to narrow and decrease or block blood flow to the heart.

Plaque is made up of cholesterol and several other substances. A variety of risk factors, including genetic and lifestyle factors, can cause plaque buildup to start at an early age.

The Flow of Blood in the Heart

The heart muscles pumps blood throughout the body using a network of blood vessels, including arteries and veins. Oxygen-rich blood is deposited into the left side of the heart, which then pumps blood through the largest artery of the heart, the aorta. Smaller arteries branch off the aorta and cover the outside of the heart in order to supply oxygen to the muscle. Arteries carry blood throughout the body, where cells take oxygen from the blood. Veins carry the oxygen-poor blood to the right side of the heart, where the blood is carried to the lungs in order to oxygenate to repeat the cycle.

Coronary arteries

Arteries supply the entire body with oxygen-rich blood, including the heart. The aorta branches into multiple arteries that spread across the surface of the heart and supply it with oxygen.

The bottom of the heart is supplied by the right coronary artery (RCA). The short left main (LM) artery has two branches: the circumflex (Cx) artery that supplies the back of the heart and the left anterior descending (LAD) that supplies the front of the heart.

Risk Factors for Coronary Heart Disease

There are genetic and lifestyle risk factors for CAD. While genetics are not controllable, other risk factors can be modified in order to improve outcomes. Lifestyle factors, such as a high-fat or high-cholesterol diet, can increase your risk for CAD.


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As CAD is a progressive disease, symptoms may not be noticeable until the disease is more severe.

Symptoms of coronary heart disease will vary depending on the severity of the disease and can include:

  • shortness of breath;
  • weakness;
  • fatigue;
  • pain spreading to the arms shoulders, back, neck, or jaw, and pain, pressure, tightness;
  • heaviness behind the breastbone.
While some individuals may have no symptoms, some may have episodes of mild to severe chest pain or angina.

Angina is chest pain cause by insufficient oxygenated blood reaching the heart. Bloods clots are more likely to occur in arteries with reduced blood flow, which can further block the artery and decrease the flow of blood even further.

When the heart’s blood supply is completely cut off, flow of oxygen and nutrients are reduced to the heart, which can cause unstable angina and eventually cause a heart attack.

Diagnosis and Treatment

A cardiac stress test or an electrocardiogram (ECG) can be used to diagnoses coronary heart disease. Treatment includes positive lifestyle changes, medications, and, in severe cases, cardiac surgery or procedures.

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