What is coronary artery disease?
Coronary artery disease (CAD) is the most common form of heart disease. It occurs when one or more of the coronary arteries becomes narrow or blocked. Normally, blood flows through blood vessels like water through a hose. In coronary artery disease, major blood vessels that supply blood, oxygen and nutrients to the heart become damaged or diseased . This damage causes the vessels to become narrow, stiff or blocked. The process is often called hardening of the arteries or atherosclerosis.
CAD can cause:
There are three types of coronary artery disease, they include:
- Obstructive: Blood vessels have significantly narrowed or blocked.
- Non-obstructive: Blood vessels have narrowed because they have branched off to smaller vessels or is due to the heart muscle squeezing too tightly on the vessels.
- SCAD: Spontaneous coronary artery dissection (SCAD) refers to the tearing of blood vessels in the heart. Learn more about SCAD.
Who is at risk?
Risk factors for heart disease are conditions or habits that make it more likely that you will get heart disease. Some risk factors for coronary artery disease can be changed and others cannot.
Risk factors you can change:
- high blood pressure
- high blood cholesterol and triglycerides
- unhealthy weight
- unhealthy diet
- too much alcohol
- not enough physical activity
- smoking or chewing tobacco
Risk factors you cannot change:
- Age – the older you are, the higher your risk of heart disease.
- Sex – Your risk of heart disease and stroke increases after menopause.
- Family history –if you have a close relative who has experienced heart disease at an early age, you are at an increased risk. In addition, women who have had pre-eclampsia during pregnancy have an increased risk.
- Indigenous heritage – First Nations, Metis and Inuit peoples have a higher risk of heart disease than the general population. They are more likely to have high blood pressure (hypertension) and diabetes. Both conditions can cause heart disease.
- South Asian and African heritage – people of African or South Asian background have a higher risk of heart disease. They are more likely to have high blood pressure (hypertension), diabetes or other risk factors for heart disease at a younger age.
- Personal circumstances - Personal circumstances and environmental factors have an influence on your health. This includes things such as access to healthy food, safe drinking water, health services and social services.
Over many years, plaque builds up on artery walls. Plaque is a sticky, yellow substance made of fatty substances like cholesterol, as well as calcium and waste products from your cells. It narrows and clogs the arteries, slowing the flow of blood. This condition is called atherosclerosis, which may begin as early as childhood. It can occur anywhere in the body, but it usually affects large and medium-sized arteries.
Sometimes plaque in an artery can rupture. The body's repair system creates a blood clot to heal the wound. But the clot can block the artery, leading to either a heart attack or stroke.
The factors that cause plaque to build up are:
- Damage or injury to the inner layer of the coronary arteries caused by the risk factors listed above.
- Plaque accumulating at the site of the injury in a process called atherosclerosis or hardening of the arteries.
Early warning signs may include:
They can also include the symptoms that are most associated with angina:
- A squeezing, suffocating or burning feeling in your chest that tends to start in the centre of your chest but may move to your arm, neck, back, throat or jaw.
Women are more likely to experience non-traditional symptoms such as:
- vague chest discomfort
- sleep difficulties
If left untreated, CAD can lead to other serious problems such as heart attack, stroke or even death.
Your doctor will start by taking a medical history, doing a physical exam and ordering some chest X-rays. Your doctor may also want to do some of these other tests:
- electrocardiogram (ECG/EKG)
- stress test
- nuclear stress test (also called: thallium scan, cardiolite scan, nuclear perfusion imaging, myocardial perfusion scan or myocardial perfusion imaging [MPI], radionuclide test).
There is no cure for CAD, but there are many treatments, including medications, surgery and lifestyle changes, that can slow down its progress.
Medications used to treat coronary artery disease include:
Surgical and non-surgical procedures
Your doctor may also suggest these procedures:
You can lower your risk of other heart diseases and stroke by knowing and controlling your blood pressure, diabetes and blood cholesterol. It is also important to lead a healthy lifestyle:
- Be smoke-free
- Be more active
- Eat a healthy balanced diet – there are some specific diets you can follow that have been proven to reduce the risk of heart disease.
- Aim for a healthy weight
- Drink less alcohol
- Manage stress
Living with coronary artery disease
It’s normal to feel worried or afraid after a diagnosis of coronary artery disease. Find someone you can turn to for emotional support like a family member, friend, doctor, mental health worker or support group. Talking about your emotions and feelings could be an important part of your journey to recovery.
- The recovery & support section is full of practical advice and tips to support you on your recovery journey.
- Find peer support resources here.
- Download or order our free book Living Well With Heart Diseases.
- Join our community of survivors by signing up for our recovery newsletter. You will get the latest research news, information, tips and strategies to help you manage your recovery.
Heart & Stroke has funded important research on coronary artery disease and vascular disease between 2013 and 2018. We are committed to supporting research and expanding our knowledge on CAD. Learn more about our research commitments and breakthroughs.
Testing for coronary heart disease (Peter Munk Cardiac Centre)
To find useful services to help you on your journey with heart disease, see our services and resources listing.