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What is coronary artery disease?

Coronary artery disease (CAD) is the accumulation of fatty deposits in the inner layer of the coronary arteries. The fatty deposits may begin to develop in childhood and they continue to thicken and enlarge during a person’s lifetime. This thickening, known as atherosclerosis, narrows the arteries and can decrease or block the flow of blood to the heart.

The American Heart Association estimates that more than 16 million Americans suffer from coronary artery disease—the No. 1 killer of both men and women in the U.S.


Coronary artery disease symptoms vary based on the severity of the disease. Some people with CAD have no symptoms, while others can experience mild to severe chest pain.

The chest pain, also called angina, is the result of too little oxygenated blood reaching your heart. When the blood supply is completely cut off, the result is a heart attack and the heart muscle begins to die. Some people can have a heart attack and never recognize the symptoms; this is called a “silent” heart attack.

When symptoms of coronary artery disease are present, they may include:

  • Shortness of breath
  • Weakness and fatigue
  • Pain radiating in the arms, shoulders, jaw, neck and/or back
  • Heaviness, tightness, pressure and/or pain in the chest behind the breastbone
Risk factorsRisk factors for CAD often include:

  • Obesity
  • Smoking
  • Diabetes
  • Physical inactivity
  • A diet high in saturated fats (found in many animal products, including meat and cheese)
  • High blood pressure (hypertension)
  • High and low LDL cholesterol, high triglyceride levels

Controlling risk factors is the key to preventing illness and death from CAD.


In addition to a complete medical history and physical examination, diagnostic procedures for coronary artery disease may include any, or a combination of, the following:

Electrocardiogram (ECG or EKG) — This is a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
Stress test (also called treadmill or exercise ECG) — This test is given while a patient walks on a treadmill to monitor the heart during exercise. Breathing and blood pressure rates are also monitored. A stress test may be used to detect coronary artery disease, and/or to determine safe levels of exercise following a heart attack or heart surgery.
Cardiac catheterization — With this procedure, X-rays are taken after a contrast agent is injected into an artery to locate the narrowing, occlusions and other abnormalities of specific arteries.
Nuclear scanning — During this procedure, radioactive material is injected into a vein and observed using a camera as it is taken up by the heart muscle. This indicates the healthy and damaged areas of the heart.