4 Symptoms of Coronary Artery Disease & How To Prevent Them

• Coronary artery disease is a condition that prevents the heart from receiving enough oxygen-rich blood, either due to narrowed arteries or blockages in coronary arteries.
• Coronary artery disease is one of the most common types of heart disease in the United States.
• While there isn’t a way to entirely prevent the disease, there are methods, treatment options, and medications that can help manage symptoms of coronary artery disease.

Coronary artery disease, otherwise known as CAD, is a heart condition that occurs when major blood vessels struggle to push enough blood, oxygen, and nutrients to the heart. According to the Centers for Disease Control and Prevention, it is the most common form of heart disease in the U.S. The condition may also be referred to as coronary heart disease.

Types of Coronary Artery Disease

There are a few forms of coronary artery disease: Stable ischemic heart disease, acute coronary syndrome, obstructive coronary artery disease, and non-obstructive coronary artery disease.

Stable Ischemic Heart Disease

This version of the disease progresses over several years due to narrowed arteries that limit oxygen-rich blood that to the heart. Stable ischemic heart disease is a chronic form of coronary heart disease where symptoms may be present and felt, but you can live with the condition.

Acute Coronary Syndrome

This version of the disease happens abruptly, as plaque buildup in the coronary arteries ruptures and creates a blockage to the heart, leading to a heart attack. Acute coronary syndrome is a medical emergency.

Obstructive Coronary Artery Disease

Obstructive coronary artery disease is specifically linked to the amount of plaque buildup in the arteries. This condition is diagnosed when plaque buildup is blocking over 50% of the arteries, narrowing them, or blocking blood flow.

Non-Obstructive Coronary Artery Disease

Non-obstructive coronary artery disease is diagnosed when plaque buildup in the arteries is less than 50%. While this is considered less severe than previous types, the condition should be monitored and treated to prevent further buildup. 

Symptoms of coronary artery disease may be mild or not even noticeable for an extended period, given that it can take years for arteries to narrow or plaque to accumulate to a level that causes a problem. Symptoms can include:

1. Chest pain (angina): This is the most common symptom. Angina typically occurs in the middle or left side of the chest and can be triggered by physical activity or emotional distress. The pain usually happens in a consistent pattern.
2. Shortness of breath: You may feel like you can’t breathe or struggle to catch your breath.
3. Fatigue: You may feel more tired than usual, given the heart isn’t receiving or pumping enough blood throughout the body.
4. Heart attack: This is the most alarming and apparent symptom of the disease and results from a blocked coronary artery that restricts blood flow to the heart. If you believe you’re having a heart attack, call 911 immediately. Signs of a heart attack may include:
   • Severe chest pain
   • Shortness of breath
   • Shoulder or arm pain
   • Excessive sweating

The leading cause of coronary heart disease is atherosclerosis, which is a gradual buildup of plaque in your body over a long period of time. When the plaque specifically builds up in your coronary arteries, this causes coronary heart disease. Currently, the specific cause of atherosclerosis is unknown, but the best chances of reducing it involve changing lifestyle factors such as not smoking, eating a healthy diet, and staying physically active. 

Risk factors that may contribute to atherosclerosis and eventual coronary artery disease include:

• Age: Men over the age of 45 and women over the age of 55 are more likely to develop atherosclerosis and coronary heart disease because as the body ages, genetic or poor lifestyle factors can cause plaque buildup to accelerate. 
• Family history: If this condition is present in one or more members of your family, you’re more likely to develop coronary heart disease due to inheriting genes that pass the condition along. 
• Poor lifestyle habits: Lack of regular physical activity, poor sleep hygiene, eating an unbalanced diet, and drinking or smoking in excess can put you at risk of developing coronary heart disease due to an increase in inflammation and stress on the body. Additionally, poor lifestyle habits can contribute to depression and elevated blood pressure or heart rate, putting excess pressure on the heart. 
• Chronic medical conditions: Battling ongoing high cholesterol, kidney disease, high blood pressure, diabetes, or anemia can put you at greater risk of developing coronary artery disease because the conditions put undo pressure or strain on the heart, likely weakening it over time. 
• Obesity: Being overweight is a risk factor for coronary heart disease due to the higher likelihood of fatty material building up in the arteries, potentially leading to blood clots.

If you believe you’re having a heart attack, call 911 right away, or have someone drive you to the nearest hospital if you do not have access to emergency medical services.

If you have one or more risk factors for coronary artery disease or notice potential symptoms, schedule an appointment with your primary care physician. Tests may need to be run to look for narrowed arteries and plaque buildup.

Coronary heart disease is normally diagnosed through two measures: a physical exam followed by various screenings and tests.

Physical Exam

To diagnose coronary artery disease, your primary care physician will perform a physical exam. The exam will typically include:

• Asking about your lifestyle
• Asking about your family and medical history
• Measuring your blood pressure
• Listening to your heart with a stethoscope
• Asking about symptoms you’re experiencing

Tests

If your doctor thinks there is potential for heart disease, they may recommend running a few tests to help diagnose the condition. These tests may include:

• Blood tests
• Heart MRI
• Chest X‑Ray
• Echocardiogram
• Cardiac catheterization
• Exercise stress test

The most common ways of treating coronary artery disease involve lifestyle changes, medications, and managing potential risk factors. In some cases, surgery or other medical procedures may be involved.

Lifestyle Changes

The first recommendation your healthcare provider will likely give is to make lifestyle changes to reduce your risk. Lifestyle changes often play a significant role in managing heart disease. Some changes that are recommended include:

• Stopping tobacco use: No longer smoking, vaping, or using tobacco products
• Changing your diet: altering your diet to focus on heart-healthy foods that are low in sodium, saturated fats, and sugar is recommended. The Mediterranean diet is one of the most recommended diets to help reduce the risk of heart attack or heart disease.
• Moderating alcohol usage: eliminating or limiting alcohol consumption.
• Staying physically active: exercising for about 30 minutes daily, five days a week. Walking, jogging, or other physical activities count towards this goal.
• Getting enough sleep: staying on a regular sleep schedule, avoiding naps when possible, and creating a restful sleep environment. 

Note: Your healthcare provider may be able to give specific recommendations or have resources to help you with these lifestyle changes, and you should consult your doctor before making any drastic lifestyle changes.

Risk Factor Management

Your healthcare provider may recommend targeting specific factors that put you at a higher risk for coronary artery disease. Specific conditions and factors that you may need to focus on include:

• Diabetes
• High blood pressure
• High cholesterol
• Obesity
• High triglycerides

Working to treat these conditions may significantly lower your risk.

Medications

Similar to risk factor management, your doctor may prescribe specific medications to help with conditions that put you at higher risk for coronary artery disease, as well as medications that prevent symptoms or causes. Some medications recommended may include:

• Medications for high blood pressure, such as ACE inhibitors or calcium channel blockers
• Medications for high cholesterol, such as Statins or PCSK9 inhibitors
• Medications to help prevent blood clots, such as blood thinners
• Medications to help manage angina, such as nitroglycerin

Your provider may also want to discuss changing or stopping medications that contribute to a higher risk, such as hormonal birth control. You’ll need to discuss with your provider if current medications you’re taking are worth the increased risk.

Surgeries or Procedures

In some circumstances, surgery or a procedure may be advised to treat coronary artery disease. Two of these options are:

• Coronary angioplasty: This procedure involves reopening a blocked artery to allow better blood flow and, in some cases, placing a stent in the artery to keep it open.
• Coronary artery bypass grafting: This surgery involves creating new routes to allow blood flow around blockages and back to the heart. This surgery is used for those with multiple blockages in the coronary arteries.

While there isn’t a way to 100% prevent coronary artery disease, there are prevention methods to lower your risk, such as:

• Stop smoking or using any tobacco products
• Eat heart-healthy foods
• Stay physically active
• Limit alcohol usage
• Get enough rest
• Manage conditions that contribute, such as diabetes or high blood pressure

If left untreated, there are complications that can arise from coronary artery disease, including:

• Chest pain (angina)
• Heart attack
• Heart failure
• Arrhythmias (irregular heart beats)

Currently there is not a cure for coronary artery disease. However, symptoms can be managed, and the disease slowed due to lifestyle changes and medications, along with other forms of treatment your doctor may recommend. 

Slowing the progression will highly depend on your age, risk factors, and other health conditions, as well as how far along the disease is when diagnosed. 

What are the warning signs of coronary artery disease?

Symptoms of coronary artery disease can include angina, shortness of breath, fatigue, and heart attack.

What is the average age someone develops coronary artery disease?

On average, people over the age of 65 are at a higher risk of developing or suffering fatal consequences of coronary artery disease.

What are the four stages of coronary artery disease?

The four stages of coronary artery disease are:

1. Normal (no plaque)
2. Mild plaque
3. Moderate plaque
4. Severe plaque