What is Coronary Artery Disease?
Coronary artery disease (CAD) results from the buildup of fatty deposits in the heart’s arteries. These deposits, called plaque, cause the arteries to narrow and become blocked. Blood and oxygen flow to the heart is reduced.
Some patients with CAD may have few or no symptoms. Sometimes a heart attack may be the first sign that a person has CAD.
Generally, angina is associated with CAD. Angina is best described as a gripping pain or pressure in the chest area. Doctors characterize angina in two ways:
- Stable angina is predictable chest pain that lasts a few minutes. It is triggered by physical exertion or emotional stress and usually is relieved by rest or medication.
- Unstable angina is chest pain that occurs unexpectedly, even when a person is at rest. It is a more serious condition than stable angina and can be a warning sign of a heart attack.
Other symptoms that may indicate angina or accompany the pain or pressure in the chest include:
- Shortness of breath
- Nausea, vomiting, and cold sweats
- A feeling of indigestion or heartburn
- Unexplained fatigue (more common in women)
- Dizziness or lightheadedness
Men are at greater risk for CAD. Women’s risk for heart disease increases after menopause.
CAD risk increases with age. Most people who die from heart disease (85%) are over age 65.
Genetics and Family History
Heart disease runs in families. You should be checked regularly if your parents or siblings developed heart disease at an early age. Genetics influence other CAD risk factors like diabetes and high blood pressure.
Race and Ethnicity
African-Americans run a higher-than-normal risk for heart disease. These risks are added to by high blood pressure, diabetes, and obesity.
- Smoking is the biggest risk for heart disease. Even light smoking and second-hand smoke can elevate blood pressure and make it more likely for fatty substances to develop in the arteries.
- Alcohol walks a fine line between good and bad when it comes to heart disease. While one or two drinks per day may boost good cholesterol levels, heavy drinking harms the heart.
- Diets that help control sources of cholesterol and restrict salt intake can promote good heart health.
- Physical inactivity makes a person almost twice as likely to suffer heart attacks compared with people who exercise regularly.
- Obesity, especially excess body fat around the waist, can increase the risk for heart disease.
- Unhealthy cholesterol and lipid levels make the blood more prone to leaving fatty deposits in the arteries.
- High blood pressure causes blood vessel damage, which can lead to a heart attack.
- Diabetes holds risks for high blood pressure, unhealthy cholesterol levels, blood clotting problems, and impaired nerve function, which all can damage the heart.
- Peripheral artery disease—where narrowing of the arteries affects the legs, feet, arms, and hands—typically predicts CAD.
- Depression has biologic effects on the heart, including blood clotting and heart rate.
Health Library Resources
How We Treat Coronary Artery Disease
Our cardiologists, doctors who specialize in treating the heart, will take your complete history and condition into account before they begin putting together tests that pinpoint the disease and the best way to treat it.
After we get a complete picture of your overall health and a sense of whether heart disease has affected your parents and siblings, you’ll be checked for high blood pressure, unhealthy cholesterol levels and symptoms of diabetes.
Tests to Diagnose CAD:
- Stress test
- CT scan
- Cardiac catheterization
Depending on how advanced your disease is and the extent to which it is keeping you from normal activities, our treatment options include medications, interventional procedures, and surgery. We may also recommend lifestyle changes and have a cardiac rehab expert help you make and stick to these changes.
Medications we use to treat CAD include:
- drugs that inhibit or break up blood clots
- drugs that prevent chest pain attacks
- drugs that reduce high blood pressure
- drugs that help stop arteries from narrowing
Usually these procedures are done using a single incision and a probe that’s threaded through blood vessels to an area that is narrowed or blocked. The procedure, called an angioplasty, may use a balloon to widen a narrowed artery. It may also involve putting in a spacer (also called a stent) that helps make the vessel wider. Our cardiologists use blood dyes and x-ray images of your circulatory system to guide the probe to problem areas.
The typical surgery for addressing advanced coronary artery disease is a coronary artery bypass graft surgery (CABG). It is a major surgery that involves rerouting blood through a lung-heart machine and stopping the heart while the surgical team grafts replacement blood vessels that carry blood around areas where heart vessels are blocked. Although CABG is a major heart surgery, it is fairly common, and our surgeons have strong expertise with this surgery. Doctors at UI Heart and Vascular Center typically perform between 150 and 200 CABG surgeries each year.
Many of our doctors who treat coronary artery disease are actively researching improved treatments for their patients. Frequently their patients are eligible to participate in research trials, which offer safe and effective drug treatments. Sometimes, new treatments are only offered to patients participating in a clinical trial. This means we are able to offer certain treatments that are not available elsewhere. Examples of ongoing trials include:
- Overcoming insulin resistance following a stroke
- Using aspirin to reduce heart events in the elderly
- Use of stem cells for improving exercise capacity for patients with chest pain
- Use of newer lipid-lowering drugs to combat hardening of the coronary arteries
Find a clinical trial now.
Arrange an Appointment
Schedule an appointment or get a second opinion. Same day appointments are available and new patients do not need a referral.
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using My Chart. You can also use MyChart to contact your care team, find
the results of tests, and renew certain prescriptions.
News and Features
Survivor Stories: Karen Zimmerman
She’s lost other relatives to heart disease and stroke, and Karen herself has undergone three angioplasty procedures and, most recently, a stent placement to help keep open a blocked coronary artery. She also has lived for years with high cholesterol.
Survivor Stories: Tina McCoy Hearn
“I was mowing the lawn and the pain in my chest was quite severe,” she says. “I had to stop what I was doing. I knew something wasn’t right.” Tina told her doctor, and within days she was scheduled for a cardiac catheterization. The procedure revealed she had severe blockage in her heart valves.
Benefits of a New Approach: Gaylord Davis
When looking for blockages in the heart, doctors have traditionally used the groin to insert a catheter (a long plastic tube) into the heart arteries. Afterwards, manual pressure is applied to the needle insertion point for 15 minutes and the patient has to lie flat for several hours to make sure there is no bleeding from the site. Now there’s a relatively new way to do the same thing—using the wrist instead of the groin.
Wrist Procedure Gets Heart Patient Back On the Road: Bill
Bill’s primary care doctor in Davenport suggested he get to University of Iowa Hospitals and Clinics right away. It was a good thing Bill followed that suggestion, because further testing revealed a severe heart blockage. Luckily for Bill, he was about to be offered a new procedure to fix the problem.
In the News