What is coronary artery disease?

Coronary artery disease, also known as coronary heart disease, is the accumulation of fatty deposits in the coronary arteries, which are the major blood vessels that supply blood to the heart. This buildup narrows the arteries and can decrease blood flow to the heart. The result can be chest pain and heart attack. Almost 16 million Americans have coronary artery disease—the leading cause of death for adults.

Any disorder or disease of the coronary arteries can have serious health implications, because blood flow to your heart can be compromised. If your heart receives too little blood, you will likely have chest pain (angina). If the supply of blood is cut off completely, you will have a heart attack.

Coronary artery disease causes

Coronary artery disease can be caused by:

• High LDL (low-density lipoprotein) cholesterol
• High triglyceride levels
• Reduced HDL (high-density lipoprotein) cholesterol
• High blood pressure
• Diabetes
• Physical inactivity
• Smoking
• Obesity
• A diet high in saturated fat

These are modifiable risk factors that you can control. Risk factors you cannot control include family history, age and sex. Males are at higher risk than females.

Coronary artery disease symptoms

Symptoms of coronary artery disease vary from no symptoms to episodes of mild chest pain and severe chest pain. More specifically, symptoms can include:

• Heaviness, tightness, pressure and pain in the chest and behind the breastbone
• Pain radiating in the arms, shoulders, jaw, neck or back
• Shortness of breath
• Weakness and fatigue

Coronary artery disease diagnosis

Tests used to diagnose coronary artery disease include:

• Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart
• Exercise stress test – A test performed on a treadmill or stationary bicycle to measure heart, lung and muscle function during physical activity. You are attached to an electrocardiogram (EKG/ECG) to record electrical activity of the heart.
• Cardiac catheterization – A procedure to check for problems in coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.
• Nuclear stress test – A scan that measures the blood flow to the heart muscle during rest and during activity or stress to determine if areas of the heart muscle have low blood flow or are damaged

Coronary artery disease treatment

Your physician may prescribe medications to treat coronary artery disease. These medications work by increasing blood flow to the heart muscle, decreasing heart rate and decreasing blood pressure. Medications commonly prescribed include:

• Antiplatelet drugs
• Anticoagulants
• Antihyperlipidemics (cholesterol-lowering drugs)
• Antihypertensives (blood pressure-lowering drugs)

If medications aren’t effective, your physician may recommend a cardiac catheterization to determine if you have blockages, where they are and how large they are. In this minimally invasive procedure, a long, thin tube (catheter) is inserted into an artery in your groin or arm, then advanced to your heart. Contrast solution is injected into the arteries of your heart, and X-rays are taken to check for a blockage (angiogram). If blockage is found, then a coronary angioplasty (also called a percutaneous coronary intervention or PCI) can be performed. This procedure can include removing a clot by suctioning it out, opening the blocked artery with balloon angioplasty or placing a stent to restore blood flow to the heart muscle.

The Ohio State University Wexner Medical Center is a high-volume center for cardiac catheterization procedures, performing more than 5,000 procedures each year. Our physicians have distinctive experience and expertise in cardiac catheterization procedures.

Coronary artery bypass graft (CABG) may be required to remove a blockage in a blood vessel to your heart.

Robotic heart surgery, which requires only small incisions in the chest wall, is available at here as well.