Coronary Artery Disease: A Summary

Coronary artery disease (CAD) is a chronic disease in which blood flow is obstructed through the coronary arteries that supply the heart with oxygen-rich blood. This obstruction is caused by a disease known as atherosclerosis, which is sometimes called "hardening of the arteries." An estimated 13.2 million Americans suffer from CAD. Also referred to as coronary heart disease, CAD is the most common form of cardiovascular disease in the United States today.

Atherosclerosis is gradual, often taking decades before the affected person is in danger of cardiovascular problems. First, the inner lining of the artery (e.g., the endothelium) is damaged. This causes white blood cells to gather at the site of the injury. This in turn provokes an inflammatory immune response that causes further damage to the artery wall. Over time, the endothelium is compromised and large, toxic LDL cholesterol molecules can penetrate into the artery wall. The white blood cells and cholesterol combine to form a lipid foam. In the early stages of atherosclerosis, these fatty streaks are present on the arterial wall as plaque deposits. Over time, the plaque may calcify, or form A heart attack happens every 29 seconds and is usually due to coronary artery disease (CAD).a hardened "shell." This reduces the supple artery's ability to contract and expand and narrows the artery, thus reducing the amount of blood that can flow through it. If the plaque deposit ruptures, a blood clot can form at the site of the rupture, or pieces of the plaque can travel through the arteries until they eventually cause a blockage. A heart attack and cardiac arrest may result.

Untreated, CAD usually continues to worsen. Many CAD patients have symptoms such as chest pain (angina) and fatigue, which occur when the heart isn't receiving adequate oxygen. As many as 50 percent of patients, however, have no symptoms until a heart attack occurs.

Strategies to help reduce risk factors for CAD, or slow its progression if it has already begun, include:

* Learning your family medical history
* Eating a heart-healthy diet
* Improving your cholesterol ratio
* Controlling homocysteine levels
* Exercising regularly
* Controlling diabetes
* Controlling high blood pressure
* Achieving and maintaining a healthy weight
* Managing stress
* Quitting smoking (or not starting to smoke)
* Controlling chronic depression

Treatment options for CAD include medication, balloon angioplasty (with or without stenting), atherectomy and bypass surgery.