Coronary artery disease (CAD), also known as ischemic heart disease (IHD),
is a group of diseases that includes:
sudden cardiac death.
It is within the group of
cardiovascular diseases of which it is the most common type.
A common symptom is chest
pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.
Occasionally it may feel like
heartburn. Usually symptoms
occur with exercise or emotional
stress, last less than a few minutes, and get better with rest.
of breath may also occur and sometimes no symptoms are present.
The first sign is occasionally a heart attack.
Other complications include
Risk factors include:
high blood pressure,
lack of exercise, obesity,
high blood cholesterol, poor diet, and excessive
alcohol, among others.
Other risks include
The underlying mechanism involves
of the heart.
A number of tests may help with diagnoses including:
coronary computed tomographic angiography, and
coronary angiogram, among others.
Prevention is by eating a healthy diet, regular exercise, maintaining a healthy weight and
Sometimes medication for diabetes, high cholesterol, or high blood pressure are also used.
There is limited evidence for screening people who are at low risk and do not have symptoms.
Treatment involves the same measures as prevention.
Additional medications such as
beta blockers, or
nitroglycerin may be recommended.
Procedures such as
percutaneous coronary intervention (PCI) or
coronary artery bypass surgery (CABG) may be used in severe disease.
In those with stable CAD it is unclear if PCI or CABG in addition to the other treatments improve
or decreases heart attack risk.
In 2013 CAD was the
most common cause of death globally, resulting in 8.14 million deaths (16.8%) up from 5.74
million deaths (12%) in 1990.
The risk of death from CAD for a given age has decreased between 1980 and 2010 especially in
The number of cases of CAD for a given age has also decreased between 1990 and 2010.
In the United States
in 2010 about 20% of those over 65 had CAD, while it was present in 7% of those 45 to 64, and
1.3% of those 18 to 45.
Rates are higher among men than women of a given age.
| View an animation of cholesterol and CAD
Coronary heart disease is a common term for the
buildup of plaque in the heart’s arteries that could lead to heart attack. But what about coronary
artery disease? Is there a difference?
The short answer is often no — health professionals frequently use the terms interchangeably.
However, coronary heart disease , or CHD, is actually a result of coronary artery disease, or CAD,
said Edward A. Fisher, M.D., Ph.D., M.P.H., an American Heart Association volunteer who is the Leon
H. Charney Professor of Cardiovascular Medicine and also of the Marc and Ruti Bell Vascular Biology
and Disease Program at the NYU School of Medicine.
With coronary artery disease, plaque first grows within the walls of the coronary arteries until
the blood flow to the heart’s muscle is limited.
an illustration of coronary arteries. This is also called
ischemia. It may be chronic, narrowing of the coronary artery over time and limiting of the blood
supply to part of the muscle. Or it can be acute, resulting from a sudden rupture of a plaque and
formation of a thrombus or blood clot.
The traditional risk factors for coronary artery disease are high
LDL cholesterol, low
high blood pressure, family history,
smoking, being post-menopausal for women and being older than 45 for men, according to Fisher.
Obesity may also be a risk factor.
“Coronary artery disease begins in childhood, so that by the teenage years, there is evidence
that plaques that will stay with us for life are formed in most people,” said Fisher, who is former
editor of the American Heart Association journal, ATVB. “Preventive measures instituted early are
thought to have greater lifetime benefits.
Healthy lifestyles will delay the progression of CAD, and there is hope that CAD can be regressed
before it causes CHD.”
Living a healthy lifestyle that incorporates
weight management and getting plenty of
physical activity can play a big role in avoiding CAD.
“Coronary artery disease is preventable,” agreed Johnny Lee, M.D., president of New York
Heart Associates, and an American Heart Association volunteer. “Typical warning signs are
chest pain, shortness of breath, palpitations and even fatigue.”
If you feel any of these symptoms, don’t delay — call 9-1-1.
This content was last reviewed July 2015.