Coronary artery disease

Coronary artery disease (CAD) occurs when the coronary arteries, the blood vessels that supply blood to the heart, become narrowed. This narrowing can restrict blood flow to the heart, causing symptoms like chest pain or shortness of breath. Other names for coronary artery disease include coronary heart disease and ischemic heart disease.

Without treatment, coronary arteries can become completely or nearly completely blocked, a condition called a chronic total occlusion. At Penn Medicine, heart and vascular care specialists use their experience and the latest advances in treatment to help people with CAD live well.

Coronary artery disease often doesn’t cause noticeable symptoms in early stages. As the coronary arteries continue to narrow, the condition can cause more frequent and intense symptoms, including:

• Chest pain (angina), fullness or pressure
• Fatigue
• Heart palpitations, or sensations of a racing heartbeat
• Shortness of breath (dyspnea)
• Swelling in the hands or feet

Sometimes, the first symptom of coronary artery disease is a heart attack. Heart attacks may cause crushing chest pain, arm pain, shoulder pain, and shortness of breath. A heart attack is a medical emergency and requires timely care to minimize heart damage.

Coronary artery disease most often occurs when plaque builds up (atherosclerosis) in the coronary arteries. Several conditions or lifestyle habits can lead to this plaque buildup, including:

• Diabetes
• High blood pressure (hypertension)
• High cholesterol
• Physical inactivity
• Smoking
• An unhealthy diet

Coronary artery disease progression tends to be slow in most people, but it does vary from person to person. Many people have coronary artery disease for several years before they ever experience symptoms. The condition tends to progress more quickly in people who have multiple risk factors.

Lifestyle changes can slow the progression of coronary artery disease. Your doctor may suggest adopting habits such as:

• Eating a diet low in saturated fats, trans fats, and sugar
• Exercising several times a week
• Managing your blood pressure and cholesterol with the help of your healthcare provider

Some risk factors for coronary artery disease, such as age and family history, aren’t controllable. But there are some lifestyle changes that can lower your risk of developing coronary artery disease, including:

• Achieving and maintaining a healthy weight for your age, body type, and sex
• Controlling chronic conditions such as diabetes or high blood pressure
• Eating a nutritious diet high in lean protein, whole grains, healthy fat, fruits, and vegetables
• Exercising at a moderate intensity for at least 150 minutes per week
• Managing stress with healthy coping techniques, such as meditating or talking with trusted loved ones
• Lowering your alcohol intake and avoiding binge drinking
• Quitting smoking

Coronary artery disease can affect people in different ways, and choosing the right treatment isn’t always straightforward. Penn Medicine’s heart and vascular care specialists draw on years of clinical practice and knowledge of the latest technology and techniques to guide that decision-making. It’s why some of the most complex cases are referred here, when a clear, confident diagnosis makes all the difference.