Coronary artery disease

What is coronary artery disease?

Coronary artery disease (CAD) happens when the arteries that supply the heart muscle become narrowed by a build-up of fatty material called plaque (atherosclerosis). Reduced blood flow can cause chest pain (angina), breathlessness and, if a plaque ruptures and a clot forms, a heart attack. CAD is one of the leading causes of death worldwide.

Symptoms

• Chest pain, pressure or tightness, often brought on by exertion or stress and eased by rest

• Pain spreading to the arm, neck, jaw or back

• Breathlessness or tiredness on exertion

• Some people — particularly women, older adults and people with diabetes — may have atypical symptoms or none until a heart attack

Causes and risk factors

• High blood pressure

• High LDL cholesterol

• Diabetes

• Smoking or tobacco use

• Physical inactivity and excess weight

• Family history of early heart disease

• Increasing age

How is it diagnosed?

Diagnosis starts with your history and examination. Tests may include an ECG, blood tests, echocardiogram, stress testing, CT coronary angiography or invasive coronary angiography. Your doctor chooses tests based on your symptoms and risk.

Treatment options

• Lifestyle: stopping tobacco, heart-healthy diet, regular activity, weight management.

• Medicines: to relieve angina and to lower the risk of heart attack (for example antiplatelets, statins and blood-pressure medicines as prescribed).

• Procedures: angioplasty and stenting or bypass surgery for selected patients.

• Cardiac rehabilitation after a heart event or procedure.

• [EECP](/treatments/eecp-treatment) may be considered for persistent angina in selected patients when other options are unsuitable.

Living with CAD

CAD is a long-term condition. Taking medicines as prescribed, controlling risk factors and attending follow-up appointments can substantially reduce the risk of future heart problems.