According to the National Heart, Lung and Blood Institute, coronary heart disease, or atherosclerosis of the coronary arteries, is the leading cause of death for both men and women in the United States. Coronary artery disease, or coronary heart disease, is an atherosclerosis-related disease in which plaque builds up in the coronary arteries. Atherosclerotic coronary artery disease occurs when atherosclerosis narrows the arteries close to the heart, which can cause angina or a heart attack.
Causes
Arteries are blood vessels that carry oxygen and nutrients from the heart to the rest of the body. If too much pressure is placed on the arteries or if they are damaged, it can make the walls thick and stiff, causing them to restrict blood flow to other organs and tissues. This process is called arteriosclerosis. Atherosclerosis is a type of arteriosclerosis. Atherosclerosis refers to the buildup of fats or plaque, which can restrict blood flow. Plaque is made up of fat, cholesterol, calcium and other substances found in the blood. Coronary artery disease begins with damage to the inner layer of a coronary artery. Damage to arteries may also be caused by smoking, high blood pressure, high cholesterol levels or a high cholesterol diet, and diabetes.
Major Risk Factors
Most risk factors for atherosclerotic coronary artery disease can be controlled to help prevent or delay development. Some of the major risk factors include unhealthy blood cholesterol levels; elevated blood pressure levels; smoking; diabetes or insulin resistance; being overweight or obese; metabolic syndrome; lack of physical activity; an unhealthy diet, such as eating a diet high in salt, saturated fat, trans fat, cholesterol and sugar; age---risk increases after the age of 55; and a family history of early heart disease.
Symptoms
Atherosclerosis does not typically cause any symptoms until it severely narrows or totally blocks an artery. Signs and symptoms depend on which arteries are affected. Symptoms may also get worse as the buildup of plaque continues to narrow coronary arteries. When coronary arteries are narrowed or blocked by plaque, a common symptom is angina. Another common symptom of blocked coronary arteries may include shortness of breath and arrhythmias.
Diagnosis
Atherosclerotic coronary artery disease can be diagnosed based on medical and family histories, risk factors, and results from a physical exam and diagnostic tests. A physical exam may include listening to arteries for abnormal sounds and a weak or absence pulse. Diagnostic testing can include lab work, an electrocardiogram, stress testing, an echocardiogram, a chest X-ray, a computed tomography scan and an angiogram.
Treatment
Lifestyle changes, medicine and medical procedures are used to treat atherosclerotic coronary artery disease. Lifestyle changes include following a heart-healthy diet low in saturated and trans fat, cholesterol and salt as well as limiting alcohol intake, quitting smoking, reducing stress, losing weight if overweight and exercising regularly. Medicine may be prescribed to lower cholesterol and blood pressure and to help prevent blood clot formation. Medical procedures may also be performed to treat severe atherosclerotic coronary artery disease, such as an angioplasty, a coronary artery bypass graft, a carotid endarterectomy or carotid artery surgery.
