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Coronary Artery Disease, Ambulatory Care


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. You may not have any symptoms of CAD. It is important for you to manage CAD even if you feel well. CAD can lead to a heart attack if it is not managed.

Common symptoms include the following:

  • Chest pain (angina), causing burning, squeezing, or crushing tightness in your chest
  • Pain that spreads to your neck, jaw, or shoulder blade
  • Nausea, vomiting, sweating, fainting, and hands and feet that are cold to the touch

Call 911 for 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

Treatment for CAD

may include any of the following:

  • Blood pressure medicines are given to lower your blood pressure. ACE inhibitors help keep your blood vessels relaxed and open to help keep blood flowing into your heart. Beta-blockers keep your heart pumping strongly and regularly so it does not work too hard to get oxygen.
  • Cholesterol medicines help lower 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. Platelets 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.
  • 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 graft surgery (CABG) is open heart surgery. Healthcare providers take arteries or veins from other areas in your body and use them to bypass or go around the blocked arteries of your heart.

Cardiac rehabilitation:

Your healthcare provider 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. Healthcare providers will also check to make sure any medicines you are taking are working.

Manage CAD to prevent a heart attack:

  • Do not smoke. Nicotine can damage blood vessels and make it more difficult to manage your CAD. Smoking also increases your risk for heart attack. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
  • 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 healthcare provider about the kind of exercise you should do and how to get started.
  • Maintain a healthy weight. If you are overweight, talk to your healthcare provider 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.
  • Limit or do not drink alcohol. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Manage other health conditions. Follow your healthcare provider'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.
  • 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.

Follow up with your healthcare provider as directed:

You may need to return for other tests. You may also be referred to a cardiac surgeon. Write down your questions so you remember to ask them during your visits.

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.

© 2016 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.

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.