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Coronary Artery Disease

What is coronary artery disease?

Coronary artery disease (CAD) is narrowing of the arteries to your heart caused by a buildup of plaque. Plaque is made up of cholesterol and other substances. The narrowing in your arteries decreases the amount of blood that can flow to your heart. This causes your heart to get less oxygen.


What increases my risk for CAD?

  • Age 40 years or older

  • Family history of CAD

  • Smoking or regular exposure to secondhand smoke

  • Medical conditions, such as high blood pressure, high cholesterol, and diabetes

  • Obesity or lack of exercise

What are the signs and symptoms of CAD?

You may not have any symptoms of CAD. The most common symptom is chest pain, also called angina, caused by decreased blood flow to your heart. Angina may feel like burning, squeezing, or crushing tightness in your chest. The pain may spread to your neck, jaw, or shoulder blade. You may have other symptoms along with chest pain. These include nausea, vomiting, sweating, fainting, and hands and feet that are cold to the touch.

How is CAD diagnosed?

Your caregiver will ask you if you have a family history of CAD. He will also ask about your symptoms and about the medicines you are taking.

  • Blood tests will check for high cholesterol or other medical conditions that may have led to CAD.

  • An EKG records the electrical activity of your heart. It is used to check your heart rhythm and it may show if there is damage to your heart.

  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.

  • An exercise stress test helps caregivers see the changes that take place in your heart during exercise. An EKG is done while you ride an exercise bike or walk on a treadmill. Caregivers will ask if you have chest pain or trouble breathing during the test. An exercise test may be combined with an echocardiogram or nuclear isotope imaging. Nuclear isotopes are very small amounts of radioactive material that are injected into your bloodstream. Images show areas of your heart that have decreased blood flow.

  • A stress test with medicine may be done if you cannot do the exercise stress test. You are given medicine that causes your heart to work harder. You will be connected to a stress test machine. This test is combined with the echocardiogram or nuclear isotope imaging.

  • An angiography, CT scan, or MRI may be done to take pictures of your blood vessels and arteries. The pictures may show narrowing or a blockage. You may be given a dye to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

Which medicines are used to treat CAD?

  • Blood pressure medicines are given to lower your blood pressure. These medicines may include ACE inhibitors and beta-blockers. ACE inhibitors help keep your blood vessels relaxed and open. This helps keep blood flowing into your heart. Beta-blockers keep your heart pumping strongly and regularly. This helps keep your heart from working too hard to get oxygen.

  • Cholesterol medicines help lower high blood cholesterol levels.

  • Nitrates , such as nitroglycerin, relax the arteries of your heart so it gets more oxygen. They help to relieve your chest pain.

  • Antiplatelet medicines , such as aspirin, keep platelets from sticking to a damaged part of your artery. Platelets are a part of your blood that stick together to help heal injuries. They may cause a blockage in your artery and keep blood from flowing to your heart.

  • Blood thinners keep clots from forming in your blood. Clots may cause heart attacks, strokes, or death. This medicine makes it more likely for you to bleed or bruise.

Which procedures are used to treat CAD?

  • Angioplasty may be done to open an artery blocked by plaque. A tube with a balloon on the end is threaded into the blocked artery. Once the tube is in the artery, the balloon is inflated. As the balloon inflates, it presses the plaque against the artery wall to open the artery. A stent may be placed in your artery to keep it open.

  • Coronary artery bypass surgery (CABG) is open heart surgery. Caregivers take arteries or veins from other areas in your body and use them to bypass or go around the blocked arteries of your heart.

What is cardiac rehabilitation?

Your caregiver may recommend that you attend cardiac rehabilitation (rehab). This is a program run by specialists who will help you safely strengthen your heart and reduce the risk of more heart disease. The plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Caregivers will also check to make sure any medicines you are taking are working.

What are the risks of CAD?

A blockage may prevent blood from flowing to your heart properly and cause chest pain. Poor blood flow to your heart may also lead to a heart attack or heart failure. These health problems can be life-threatening.

How can I manage CAD?

  • Exercise regularly. Exercise at least 30 minutes each day, on most days of the week. Exercise helps to lower high cholesterol and high blood pressure. It can also help you maintain a healthy weight. Ask your caregiver about the kind of exercise you should do and how to get started.

  • Maintain a healthy weight. If you are overweight, talk to your caregiver about how to lose weight. A weight loss of 10% can improve your heart health.

  • Eat heart-healthy foods. Include fresh fruits and vegetables in your meal plan. Choose low-fat foods, such as skim or 1% fat milk, low-fat cheese and yogurt, fish, chicken (without skin), and lean meats. Eat two 4-ounce servings of fish high in omega-3 fats each week, such as salmon, fresh tuna, and herring. Avoid foods that are high in sodium, such as canned foods, potato chips, salty snacks, and cold cuts. Put less table salt on your food.

  • Do not smoke. Smoking increases your risk of a heart attack. If you smoke, it is never too late to quit. Ask your caregiver for information if you need help quitting.

  • Limit alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

  • Manage other health conditions. Follow your caregiver's advice on how to manage other conditions that can affect your heart health. These include diabetes, high blood pressure, and high cholesterol. You may need to take medicines for these conditions and make other lifestyle changes. Talk to your caregiver if you are depressed. He may recommend treatment for your depression.

  • Ask if you should have a flu vaccine. The flu can be dangerous for a person who has CAD. The flu vaccine is available every year in the fall.

Where can I find more information?

  • American Heart Association
    7272 Greenville Avenue
    Dallas , TX 75231-4596
    Phone: 1- 800 - 242-8721
    Web Address: http://www.heart.org

When should I contact my caregiver?

Contact your caregiver if:

  • You have chest pain that is more frequent or you have chest pain at rest.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if you have any of the following signs of a heart attack:

  • Squeezing, pressure, fullness, or pain in your chest that lasts longer than a few minutes or returns

  • Discomfort or pain in your back, neck, jaw, stomach, or arm

  • Shortness of breath or breathing problems

  • A sudden cold sweat, lightheadedness, dizziness, or nausea, especially with chest pain or trouble breathing

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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