Understanding Coronary Artery Disease
A comprehensive guide to help you understand how coronary artery disease develops, its warning signs, and the treatment options available to you.
What is Coronary Artery Disease?
Coronary Artery Disease (CAD), also called coronary heart disease or ischemic heart disease, is the most common type of heart disease in the United States. It occurs when the coronary arteries — the blood vessels that supply oxygen-rich blood to your heart muscle — become narrowed or blocked.
This narrowing is usually caused by atherosclerosis, a process where fatty deposits called plaque build up inside the artery walls over many years. As plaque accumulates, it reduces blood flow to the heart, which can cause chest pain (angina), shortness of breath, or even a heart attack.
How Coronary Artery Disease Develops
Endothelial Damage
The inner lining of the artery (endothelium) becomes damaged by factors like high blood pressure, smoking, high cholesterol, or diabetes. This damage allows fatty substances to enter the artery wall.
Fatty Streak Formation
LDL cholesterol ("bad" cholesterol) accumulates in the damaged area. White blood cells try to clean up the cholesterol, forming foam cells that create a fatty streak.
Plaque Development
Over time, more cholesterol, calcium, and cellular debris accumulate, forming a larger plaque. A fibrous cap develops over the plaque.
Narrowing & Complications
The plaque grows and narrows the artery, reducing blood flow. If the fibrous cap ruptures, a blood clot can form and suddenly block the artery, causing a heart attack.
Risk Factors for Coronary Artery Disease
Risk Factors You Can't Change
- • Age: Risk increases with age (men 45+, women 55+)
- • Gender: Men have higher risk earlier in life
- • Family history: Having close relatives with early heart disease
- • Ethnicity: Some ethnic groups have higher risk
Risk Factors You Can Control
- • Smoking: Quitting dramatically reduces risk
- • High blood pressure: Target below 130/80
- • High cholesterol: Especially high LDL
- • Diabetes: Blood sugar control is crucial
- • Obesity: Especially abdominal fat
- • Physical inactivity: Regular exercise helps
- • Unhealthy diet: High in saturated fat, sodium
- • Stress: Chronic stress affects heart health
Symptoms of Coronary Artery Disease
CAD can develop silently for years without symptoms. When symptoms do occur, they may include:
Chest Pain (Angina)
Pressure, tightness, or squeezing in the chest, often triggered by physical activity or stress
Shortness of Breath
Difficulty breathing, especially during exertion or when lying down
Fatigue
Unusual tiredness, especially with physical activity
Heart Palpitations
Feeling like your heart is racing, fluttering, or skipping beats
Radiating Pain
Discomfort that spreads to the arm, neck, jaw, shoulder, or back
Nausea or Dizziness
Feeling lightheaded or sick to your stomach
Important: If you experience sudden, severe chest pain, pain spreading to your arm or jaw, or difficulty breathing, call 911 immediately. These could be signs of a heart attack.
How is CAD Diagnosed?
Dr. Bleszynski uses several tests to diagnose coronary artery disease:
- Electrocardiogram (ECG/EKG): Records your heart's electrical activity to detect abnormalities
- Stress Test: Monitors your heart during exercise to see how it responds to increased demand
- Echocardiogram: Uses ultrasound to create images of your heart's structure and function
- Coronary Calcium Score: CT scan that measures calcium deposits in your coronary arteries
- Coronary Angiogram: X-ray imaging with contrast dye to visualize blockages in the arteries
- Blood Tests: Measure cholesterol, blood sugar, and markers of heart damage
Treatment Options
Lifestyle Changes
The foundation of CAD treatment includes:
- • Quitting smoking
- • Heart-healthy diet
- • Regular exercise
- • Weight management
- • Stress reduction
- • Limiting alcohol
Medications
Common medications for CAD include:
- Statins: Lower cholesterol and stabilize plaque
- Aspirin: Prevents blood clots
- Beta-blockers: Slow heart rate and reduce blood pressure
- ACE inhibitors/ARBs: Lower blood pressure and protect the heart
- Nitroglycerin: Relieves chest pain by opening blood vessels
Interventional Procedures
When medications and lifestyle changes aren't enough:
- PCI / Coronary Stenting — Opens blocked arteries and places stents to keep them open
- CTO Revascularization — Advanced techniques for completely blocked arteries
- Coronary Bypass Surgery — Creates new routes for blood to flow around blockages
Did You Know?
- 🫀CAD is the leading cause of death in the United States
- 📊About 18.2 million American adults have CAD
- ✨Up to 80% of heart disease is preventable with lifestyle changes
Concerned About Your Heart Health?
Dr. Bleszynski can evaluate your risk factors and develop a personalized plan to protect your heart.
Schedule Evaluation(702) 805-5678