Coronary Artery Disease (CAD)

Among the most common type of heart disease, Coronary Artery Disease (CAD), is the leading cause of death for both men and women in the United States.

It occurs when the inner lining of the major blood vessels, also known as coronary arteries, supplying blood, oxygen and nutrients to the heart muscle become damaged, harden and narrow, restricting blood flow.

Gradually over time cholesterol-containing deposits, or plaque, buildup on or near the damaged site, which is also referred to as atherosclerosis.

Other factors increasing risk for CAD include:

  • Age
  • High blood pressure
  • Family history
  • High cholesterol
  • Smoking
  • Obesity
  • Inactive lifestyle
  • Poor diet
  • Stress
  • Diabetes or insulin resistance

Additional risk factors researchers continue to study include:

  • Sleep apnea
  • Alcohol
  • Autoimmune diseases (rheumatoid arthritis, lupus, inflammatory rheumatologic conditions)
  • Preeclampsia
  • High triglycerides

As buildup grows, less blood is allowed to flow through the arteries, depleting the heart muscle of much needed blood, oxygen and nutrients. This depletion can severely weaken the heart. If the surface of the plaque ruptures, platelets will clump at the site in an attempt to repair the artery. This can block the artery and lead to a heart attack.

Symptoms of Coronary Artery Disease may include:

  • Chest pain (angina)
  • Heart failure
  • Arrhythmia (abnormal heart rhythm)
  • Heart attack

Blockages that have been present for more than three months are referred to as chronic total occlusions (CTO). Traditionally a CTO was addressed utilizing coronary artery bypass grafting (CABG), or open-heart surgery, during which a vein or artery from another part of the body is used to create a new route to the coronary artery, “bypassing” the blocked area and creating a new path for blood to flow.

Another option for those who are not good candidates for CABG or open-heart surgery is CTO percutaneous coronary intervention (PCI).