CORONARY ARTERY DISEASE (CAD)

Coronary artery disease (CAD), also known as coronary heart disease, is one of the most common types of heart disease. It occurs when the major blood vessels that supply the heart—the coronary arteries—become narrowed or blocked. This reduced blood flow to the heart is primarily caused by a condition known as atherosclerosis, where plaque builds up on the artery walls. Plaque is made of fat, cholesterol, and other substances that make arteries stiff and narrow.

CAD typically develops slowly over time, and symptoms often appear only after the arteries are significantly narrowed. When blood flow to the heart muscle is restricted, it can cause chest pain (angina) or shortness of breath. In severe cases, a complete blockage of blood flow can lead to a heart attack. Treatment may include medications, lifestyle changes, and sometimes surgical procedures. Eating a balanced diet, staying active, managing stress, and avoiding tobacco use are vital to preventing CAD and managing its progression.

Common Symptoms of CAD

Symptoms of CAD occur when the heart isn’t receiving enough oxygen-rich blood. Key symptoms include:

• Chest pain or discomfort (angina): Often described as squeezing, tightness, pressure, or heaviness, usually in the center or left side of the chest. Pain may also radiate to the neck, arms, back, or jaw.

• Shortness of breath: A feeling of breathlessness, especially during activity.

• Fatigue: Unusual tiredness due to the heart's reduced pumping ability.

Sometimes, symptoms are only noticed during physical exertion. As the disease progresses, symptoms may worsen or occur more frequently. A full blockage can result in a heart attack, with symptoms such as:

• Pain in the chest or spreading to other parts of the body

• Cold sweats, nausea, or dizziness

• Shortness of breath or heartburn

Not everyone experiences typical symptoms, especially older adults, women, or people with diabetes.

Causes and Risk Factors

CAD results from plaque buildup in the arteries. Key causes and contributing factors include:

• High blood pressure

• High cholesterol (especially LDL)

• Diabetes or insulin resistance

• Smoking

• Lack of exercise and obesity

Risk factors you can’t control include age, sex (men are typically at higher risk), and family history. However, many risk factors are manageable through lifestyle changes. Additional contributing factors may include sleep apnea, chronic kidney disease, unhealthy diet, alcohol overuse, and elevated stress levels.

Possible Complications
If left untreated, CAD can lead to serious complications, such as:

• Heart attack

• Heart failure due to long-term damage

• Arrhythmias (irregular heartbeats)

• Ongoing chest pain (angina)

Diagnosis and Testing

Diagnosing CAD involves a physical exam, medical history, and several diagnostic tests:

• Blood tests for cholesterol and inflammation markers

• Electrocardiogram (ECG) to measure heart activity

• Echocardiogram and stress tests

• Nuclear imaging, CT scans, or cardiac catheterization for detailed artery visualization

Treatment Options

Treatment may include a combination of lifestyle changes, medications, and procedures:

• Cholesterol-lowering drugs (statins)

• Aspirin or blood thinners

• Beta blockers or calcium channel blockers

• ACE inhibitors or ARBs

• Nitroglycerin for chest pain

• Surgical procedures like stents or bypass surgery in severe cases

Effective management can significantly improve quality of life and reduce the risk of complications.