Coronary artery disease is the most common type of heart disease. It results from atherosclerosis — the gradual buildup of plaques in blood vessels.
Over time these plaques — deposits of fat, cholesterol, calcium and other cellular sludge from your blood — can narrow your coronary arteries, so less blood flows to your heart muscle. Diminished blood flow to your heart can cause chest pain (angina). A sudden, complete blockage can lead to a heart attack.
The problem is that many people who have this form of heart disease aren't aware they have it. Coronary artery disease, or coronary heart disease, develops slowly and silently, over decades. It can go virtually unnoticed until it produces a heart attack.
How do you know whether you have this silent, potential killer? Your doctor can help answer that question based on test results and your level of risk. Risk factors for coronary artery disease include family history of heart disease, high blood cholesterol, high blood pressure, smoking, obesity and physical inactivity.
You can prevent or slow coronary artery disease by taking steps to improve the health of your heart and blood vessels. Drugs and surgical techniques can repair narrowed coronary arteries, but the best long-term solution is to make lifestyle choices that can control risk factors for coronary artery disease.
Signs and symptoms
Coronary artery disease varies both in signs and symptoms and in severity. It may produce no symptoms, or it can produce chest pain of varying degrees as well as shortness of breath. It may also result in a heart attack.
Like any muscle, your heart needs a steady supply of oxygen-rich and nutrient-rich blood to function. Your coronary arteries encircle your heart like a crown and branch off into your heart muscle, supplying it with blood.
If your coronary arteries become narrowed, they can't supply enough oxygenated blood to your heart when it's beating hard, as when you exert yourself. An insufficient blood supply to the heart or other organs is called ischemia. When it affects the heart, it is known as cardiac ischemia. Cardiac ischemia can result in:
No symptoms. This is referred to as silent ischemia. Blood supply to your heart may be restricted due to coronary artery disease, but you don't feel any adverse effects.
Chest pain. If your coronary arteries can't supply enough blood to meet the oxygen demands of your heart, the result may be chest pain called angina. It's often described as a pressure or tightness in the chest — as if someone were standing on your chest. Angina is usually brought on by physical or emotional stress. The pain typically goes away within minutes after stopping the stressful activity.
Shortness of breath. Some people may not be aware they have coronary artery disease until they develop symptoms of heart failure — extreme fatigue with exertion, shortness of breath and swelling in their feet and ankles. Heart failure occurs when your heart becomes so weakened from insufficient blood supply or from a heart attack that it can't pump enough blood to meet your body's needs.
Heart attack. A heart attack results when an artery to your heart muscle becomes completely blocked and the part of your heart muscle fed by that artery dies. This is usually caused by a blood clot or other blockage in an already narrowed coronary artery. Pain from a heart attack is often described as crushing and may feel similar to angina, but it lasts longer.
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