Symptoms of Coronary Artery Disease, the Leading Cause of Death in America

Coronary artery disease is the most common type of heart disease, and is the leading cause of death in the Untied States for both men and women.

What is Coronary Artery Disease?

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Coronary artery disease occurs when the arteries that provide blood to the heart muscle (the coronary arteries) become smaller and hardened. This is secondary to a buildup of a material called "plaque" on the inner walls. This buildup of plaque is called "atherosclerosis."

Plaque consists of fat, cholesterol, calcium and other substances from the blood. Plaque buildup in the arteries often starts in childhood. As a person becomes older, it is normal to have some hardening of the arteries.

When the plaque increases and hardens, the insides of the coronary arteries get smaller and less blood can flow through them.  In time, blood flow to the heart muscle is reduced and, because blood carries much-needed oxygen, the heart muscle does not receive the amount of oxygen it needs.

Decreased or cutoff blood flow and oxygen supply to the heart muscle can cause conditions such as angina and even lead up to a heart attack.

Common Signs And Symptoms of Coronary Artery Disease

The severity of symptoms can vary widely.  Chest pain is one of the two most common symptoms of coronary artery disease (also called "CAD").  Shortness of breath is another symptom.

In some people, the first sign of CAD is a heart attack. A heart attack occurs when plaque in a coronary artery breaks apart, causing a blood clot to form and block the artery.

Who Is At Risk for Coronary Artery Disease?

Approximately 13 million people in the United States suffer from coronary artery disease. Each year, more than 500,000 Americans die from CAD.

Several factors increase the risk of developing CAD. The more risk factors you have, the greater chance you have of developing coronary artery disease. Some CAD risk factors, such as age, can’t be modified, but others can.

Risk Factors That Can Be Changed with Behavior Modification or Improved with Medical Care:

• High blood cholesterol
• High blood pressure
• Cigarette smoking
• Diabetes
• Overweight or obesity
• Lack of physical activity

Risk Factors That You Cannot Control:

• Age. As you age, your risk for CAD increases. In men, risk increases after age 45. In women, risk increases after age 55.
• Family history of early heart disease. Heart disease diagnosed before age 55 in father or brother. Heart disease diagnosed before age 65 in mother or sister.

Other Coronary Artery Disease Risk Factors

According to some recent research studies, high blood levels of C-reactive protein (CRP) may be associated with an increased chance of developing CAD and suffering a heart attack. CRP is a protein in the blood that shows the presence of inflammation. Inflammation is the body’s response to injuries or infections. CRP levels rise when there is inflammation. The inflammation process appears to add to the chances of developing plaque in arteries. Research is underway to find out if reducing inflammation and lowering CRP levels can also reduce the risk of developing CAD and having a heart attack.

How Is Coronary Artery Disease Diagnosed?

There is no single test to diagnose coronary artery disease. Your doctor will ask about your medical history and your family’s medical history, assess your risk factors, and do a physical exam and several tests. These procedures are used to:

• Decide if you have CAD
• Determine the extent and severity of the disease
• Rule out other possible causes of your symptoms

Based on the results of these procedures, your doctor may order one or more of the following tests:

• ECG or EKG (electrocardiogram). This test measures the rate and regularity of your heartbeat.
• Echocardiogram. This test uses sound waves to create a picture of the heart. The picture is more detailed than an x-ray image.
• Exercise stress test
• Chest x ray
• Cardiac catheterization
• Coronary angiography
• Nuclear heart scan
• Electron beam computed tomography
• Other tests that your doctor may order:
  • A fasting glucose test to determine your blood sugar level
  • A fasting lipoprotein profile to check your cholesterol levels