02. Coronary Artery Disease (CAD)


CAD Warning Signs
CAD Risk Factors
Diagnosing CAD
CAD Treatment Options

Because the heart is a muscle, it needs oxygen and nutrients to function properly. The arteries that provide blood to the heart are called “Coronary Arteries” and are located directly on the heart.

Coronary Artery Disease (CAD) happens when a build-up of cholesterol, or plaque, occurs in one or more of the coronary arteries. This build-up can cause the artery to narrow, limiting the amount of blood being delivered to the heart. If the artery becomes completely blocked, a heart attack occurs and a section of the heart muscle becomes damaged due to lack of oxygen and nutrients, ultimately weakening the entire heart.

CAD Warning Signs

If the build-up reduces blood flow slightly, there may be no symptoms while at rest, but will become more noticeable with increased activity or stress. Call your doctor if you are experiencing any of these signs with increased activity or stress:

  • Chest pressure
  • Nausea
  • Vomiting
  • Shortness of Breath
  • Cold sweat
  • Pain in upper back, neck, jaw, or stomach

If these warning signs are severe, even while resting, it could indicate that you are having a heart attack and should seek immediate emergency medical attention.

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CAD Risk Factors

There are several risk factors that contribute to CAD. Some risk factors, like having a family history of heart disease, being male, or a postmenopausal female, cannot be changed. Fortunately, many of them can be controlled through lifestyle changes and can reduce a person’s risk of heart disease. Consult your doctor before beginning any exercise or diet plan.

Any of the risk factors listed below may increase your chance of developing CAD:

  • Diabetes
  • Family history of heart disease (close relative diagnosed with heart disease, especially before age 50)
  • High cholesterol levels
  • High blood pressure
  • Lack of exercise/inactivity
  • Obesity (being overweight)
  • Smoking
  • Prolonged or frequent high stress

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Diagnosing CAD

If a patient has any of the symptoms listed above, their doctor may choose to run some diagnostic tests to confirm whether or not they have CAD.

Exercise Electrocardiogram (ECG or EKG)
Also known as a “Stress Test” or “Treadmill Test,” the ECG is the most common diagnostic test used to determine CAD. Small patches called Electrodes are placed on the patients skin. Wires are connected to the electrodes from a machine that turns the heart’s electrical signals into lines on special graph paper.

A resting ECG is usually performed first, then the patient is asked to perform a moderate amount of activity like walking on a treadmill or riding a stationary bicycle. The results of the resting and exercise ECG are compared. An ECG can tell the doctor:

  • How fast the heart was beating
  • Whether the heart was beating normally
  • If there was any damage to the heart

Cardiac Catheterization
Also known as an “Angiogram,” a Cardiac Catheterization may be performed if the ECG indicates that the patient’s heart isn’t getting enough oxygen.

This test is performed under local anesthetic in the Coronary Catheterization Laboratory, which is a room in the hospital that contains a specialized x-ray machine. A dye or other type of contrast material is injected into the coronary arteries while x-rays are taken. The x-ray machine captures images of the dye as it moves through the arteries, revealing areas that are narrowed or blocked.

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CAD Treatment Options

Based on the severity of symptoms and results of the diagnostic tests performed, the doctor will recommend the best treatment option for their patient. Treatment options can range from a combination of any of the following:

  • Lifestyle changes such as changing the type of foods you eat, increasing activity/exercise, and giving up smoking.
  • Taking medication to relieve chest pain and help expand the coronary arteries to restore appropriate blood flow.
  • Percutaneous Coronary Intervention (PCI) procedures such as Angioplasty and Stent Implantation.
  • Coronary artery bypass (open heart) surgery for more severe cases of CAD.

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Read: Chapter 03. Peripheral Vascular Disease (PVD)

Information presented in this Patient Healthcare Guide is for educational purposes only and is not intended to diagnose, treat, or prevent disease, and should not be used in place of a visit to your doctor or healthcare provider. Discuss this information with your physician or healthcare provider to determine what is right for you.