Coronary artery disease (CAD)

Chest | Cardiology | Coronary artery disease (CAD) (Disease)


The coronary arteries are the blood vessels that supply the heart. Coronary artery disease (CAD) is the narrowing of these arteries by fat and calcium build up called plaques. This is also called coronary atherosclerosis.

The following characteristics give a bigger chance of having CAD: smoking, obesity, family history of CAD, high blood pressure, elevated cholesterol, diabetes, sedentary lifestyle, and kidney disease. Sometimes a blood clot can develop in these plaques and suddenly block the blood supply to the heart causing a heart attack. Symptoms of coronary artery disease can vary widely and in some patients like the elderly, diabetics and women there is no chest pain.

If the arteries become too narrow, the blood supply to the heart muscle is reduced. This may led to symptoms such as angina. If a blood clot forms in the narrowed artery and completely blocks the blood supply to part of your heart, it can cause a heart attack.

Causes and Risk factors

CAD is the leading cause of death worldwide. While the symptoms and signs of coronary artery disease are noted in the advanced state of disease, most individuals with coronary artery disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a sudden heart attack, finally arises.

After decades of progression, some of these atheromatous plaques may rupture and (along with the activation of the blood clotting system) start limiting blood flow to the heart muscle. The disease is the most common cause of sudden death, and is also the most common reason for death of men and women over 20 years of age.

Risk factors that you can’t change include increasing age, being male and having a family history of heart disease. Aboriginal and Torres Strait Islander people are also at increased risk of coronary heart disease.

Diagnosis and Treatment

Many tests help diagnose CAD. Usually, the doctor will order more than one test before making a diagnosis. Tests may include: coronary angiography/arteriography - an invasive test that evaluates the heart arteries under x-ray, CT angiography - a noninvasive way to perform coronary angiography, Echocardiogram, Electrocardiogram (ECG), Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries -- the more calcium, the higher your chance for CAD.

Treatment for coronary artery disease focuses on taking steps to manage symptoms and reduce the risk of heart attack and stroke. ...

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