Coronary artery disease (narrowing of the arteries)

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Overview

Coronary artery disease (CAD), or coronary heart disease, develops when the coronary arteries become too narrow or cholesterol blockages develop in the walls. The coronary arteries are the blood vessels that supply oxygen and blood to the heart.


CAD tends to develop when cholesterol builds up on the artery walls, creating plaques. These plaques cause the arteries to narrow, reducing blood flow to the heart, or can cause inflammation in and hardening of the walls of the blood vessel. A clot can sometimes obstruct blood flow, causing serious health problems.


Coronary arteries form the network of blood vessels on the surface of the heart that feeds it oxygen. If these arteries narrow, the heart may not receive enough oxygen-rich blood, especially during physical activity.


CAD can sometimes lead to a heart attack. According to the Centers for Disease Control and Prevention, it is the most common type of heart  Source in the United States, where it accounts for more than 655,000 deathsTrusted Source every year.


Symptoms

In some cases, symptoms may be very noticeable. But, you can have the disease and not have any symptoms. This is more often true in the early stages of heart disease.


Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. The pain may feel different from person to person.


It may feel heavy or like someone is squeezing your heart. You may feel it under your breast bone (sternum). You may also feel it in your neck, arms, stomach, or upper back.

The pain most often occurs with activity or emotion. It goes away with rest or a medicine called nitroglycerin.

Other symptoms include shortness of breath and fatigue with activity (exertion).

Some people have symptoms other than chest pain, such as:


Fatigue

Shortness of breath

General weakness


Causes

CHD is the leading cause of death in the United States for men and women.


CHD is caused by the buildup of plaque in the arteries to your heart. This may also be called hardening of the arteries.


Fatty material and other substances form a plaque buildup on the walls of your coronary arteries. The coronary arteries bring blood and oxygen to your heart.

This buildup causes the arteries to get narrow.

As a result, blood flow to the heart can slow down or stop.

A risk factor for heart disease is something that increases your chance of getting it. You cannot change some risk factors for heart disease, but you can change others.


Risk factors

There are many risk factors for CAD and some can be controlled but not others. The risk factors that can be controlled (modifiable) are: High BP; high blood cholesterol levels; smoking; diabetes; overweight or obesity; lack of physical activity; unhealthy diet and stress.

Coronary artery disease is caused by atherosclerosis. Atherosclerosis is the buildup of plaque inside your arteries. Plaque consists of cholesterol, fatty substances, waste products, calcium and the clot-making substance fibrin. As plaque continues to collect on your artery walls, your arteries narrow and stiffen.

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Complications

CAD happens when coronary arteries struggle to supply the heart with enough blood, oxygen and nutrients. Cholesterol deposits, or plaques, are almost always to blame. These buildups narrow your arteries, decreasing blood flow to your heart. This can cause chest pain, shortness of breath or even a heart attack.

Prevention

Take these steps to help prevent heart disease.


If you smoke, stop. There are many resources available to help you stop smoking.

Learn how to eat a heart-healthy diet by making simple substitutions. For example, choose heart-healthy fats over butter and other saturated fats.

Get regular exercise, ideally at least 30 minutes most days. If you have heart disease, talk with your provider about starting an exercise routine.

Maintain a healthy body weight.

Lower high cholesterol with lifestyle changes, and if needed, statin medicines.

Lower high blood pressure using diet and medicines.

Talk with your provider about aspirin therapy.

If you have diabetes, keep it well-managed to help prevent heart attack and stroke.