Coronary artery disease (CAD) overview

Coronary Artery Disease (CAD) includes diseases of the arteries that supply the heart muscle with blood. It is responsible for more than half of all cardiovascular events in men and women under the age of 75 years.

CAD, which is sometimes called coronary heart disease or ischemic heart disease, is most often caused by atherosclerosis. Atherosclerotic plaque forms when cholesterol and other fatty material are deposited within the arterial wall. Plaque deposits narrow the coronary arteries that supply the heart, thereby reducing blood flow to the heart muscle. If plaque ruptures, it can trigger the formation of a blood clot and completely obstructs the flow of blood to the heart.

CAD also has many non-atherosclerotic causes, including genetic abnormalities of the coronary vessels, systemic vasculitis, and radiation-induced coronary disease.

When coronary arteries are narrowed or blocked, oxygen-rich blood cannot reach the heart muscle, resulting in chest pain, also called angina or myocardial infarction. Over time, CAD may weaken the heart muscle and lead to serious pumping problems and abnormal heart rhythms.

Therapeutic approaches for CAD include the use of 3 strategies:

First, treatment to reduce the heart’s workload
Second, improving coronary artery blood flow
Third, slowing down or reversing the build-up of atherosclerotic plaques

The heart’s workload can be reduced by controlling the BP and using drugs such as beta blockers or calcium-channel blockers that keep the heart from pumping as hard.

Coronary blood flow can be improved by surgical procedures such as a percutaneous coronary intervention or coronary artery bypass grafting.A coronary artery thrombus may sometimes be dissolved by drugs, also improving coronary circulation.

Modifying the diet, exercising regularly, and appropriate pharmacological therapy can slow down or help reverse atherosclerosis.

Coronary artery disease (CAD) overview

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Review Date: 7/14/2024

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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