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Damage or injury to the inner layer of a coronary artery initiates CAD, sometimes as early as childhood. The damage may be caused by various factors, including:

  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Radiation therapy to the chest, as used for certain types of cancer

Damage to the inner wall of an artery leads to fatty deposits (plaques) made of cholesterol and other cellular waste products to accumulate at the site of injury in a process called atherosclerosis. Rupture of the surface of these plaques causes blood cells called platelets to clump at the site to try to repair the artery. Heart attack can occur due to this dumping.


Narrowed coronary arteries are unable to supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise. Initially, the decreased blood flow may not cause any coronary artery disease symptoms. But, you may develop coronary artery disease symptoms as the plaques continue to build up in your coronary arteries. The symptoms are:

  • Chest pain (angina). It is typically a feeling of pressure or tightness in your chest, as if someone were standing on your chest. This symptom, called as angina, is usually triggered by physical or emotional stress. It abolishes within minutes after stopping the stressful activity. This pain may be fleeting or sharp and noticed in the abdomen, back or arm in some people, especially women.
  • Shortness of breath. You may develop shortness of breath or extreme fatigue with exertion if your heart can’t pump enough blood to meet your body’s needs.
  • Heart attack. Heart attack ensues if a coronary artery becomes completely blocked. Heart attack classically presents with crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. Less typical signs and symptoms are present in women. Sometimes a heart attack occurs without any apparent signs or symptoms.


Upon presentation to doctor, a medical history will be taken, a physical exam will be conducted routine blood tests will be ordered. Doctor may suggest one or more diagnostic tests as well, including:

  • Electrocardiogram (ECG). It is an electrical recording of the signals as they travel through your heart. Evidence of a previous heart attack can be revealed by an ECG. If the signs and symptoms of your atherosclerosis is more evident during exercise, your doctor may ask you to walk on a treadmill or ride a stationary bike during an ECG.
  • Blood tests. Blood is tested for elevation of certain heart enzymes that slowly leak out into your blood if your heart has been damaged by a heart attack.
  • Abnormal heart rhythms (arrhythmias). Electrical “short circuits” can develop if your heart muscle is damaged from a heart attack. These can cause abnormal heart rhythms, some of which can be serious, even fatal.
  • Stress test. Stress test is also an exercise stress test. It is used to gather information about how well your heart works during physical activity. By doing exercise on bike or treadmill your heart pump harder and faster than it does during most daily activities. Testing of the heart during and after exercise can reveal problems within your heart that might not be noticeable otherwise. The procedure usually involves walking on a treadmill or riding a stationary bike while your heart rhythm and blood pressure and breathing are monitored. In some types of stress tests, pictures will be taken of your heart, such as during a stress echocardiogram (ultrasound) or nuclear stress test. In patients who are unable to exercise due to some or other reason, a medication that mimics the effect of exercise on heart is used to make it pump harder.
  • Chest X-ray. Images of your heart and lungs is displayed by this test. Also, other conditions can be looked into that might explain your symptoms and to see if you have an enlarged heart.
  • Echocardiogram. It is a type of ultrasound examination of your heart to produce images of the heart. These images are seen by the doctor to identify heart attack-related problems, including whether there are areas of your heart not getting enough blood or heart muscle that’s been damaged by poor blood flow. Sometimes, an echocardiogram is performed during a stress test.
  • Nuclear stress test. This test is performed to assess blood flow to your heart muscle at rest and during stress. It is similar to a routine stress test but uses a radioactive substance.
  • Coronary angiography. Narrowing or blockade in coronary arteries can be revealed by this test. The test involves injecting a liquid dye into the arteries of your heart through a long, thin tube (catheter) that’s fed through an artery, usually in your leg, to the arteries in your heart. The arteries become visible on X-ray, as the dye fills your arteries. Any area of blockage can then be revealed.
  • Cardiac computerized tomography (CT) scan. During performance of this test, you lie on a table inside a doughnut-shaped machine. Inside the machine there is an X-ray tube which rotates around your body and collects images of your heart and chest. These images can show if any of your heart’s arteries are narrowed or if your heart is enlarged.
  • Cardiac MRI: In this test, the patient is made to lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. Signals are produced when radio waves are broadcast toward these aligned particles. These signals vary according to the type of tissue they are. The signals create images of your heart.


Complications of coronary artery disease are:

  • Chest pain (angina). Your heart may not receive enough blood when your coronary arteries are narrow and demand is greatest — particularly during physical activity. This can cause chest pain (angina) or shortness of breath.
  • Heart attack. Complete blockage of your heart artery may trigger a heart attack if a cholesterol plaque ruptures and a blood clot forms. The lack of blood flow to your heart may damage to your heart muscle. The pace of getting treatment decides amount of damage.
  • Abnormal heart rhythms (arrhythmias). Electrical “short circuits” can develop if your heart muscle is damaged from a heart attack. These can cause abnormal heart rhythms, some of which can be serious, even fatal.
  • Heart failure. It is a condition where the damaged tissue in your heart can’t do an adequate job of pumping blood out of your heart. Reduced pumping activity reduces blood flow to tissues and organs and may produce shortness of breath, fatigue, and swelling in your ankles and feet.

Some of the complications of hypertensive retinopathy include:

  • Loss of vision
  • Central and branch, retinal vein and/or artery occlusion (CRVO or CRAO)
  • Ischemic optic neuropathy or damage to the optic nerve
  • Vitreous haemorrhage or bleeding in the vitreous humour


Treatment of coronary artery disease varies depending on the situation. The patient might be treated with medications, undergo an invasive procedure or both — depending on the severity of the condition and the amount of damage to heart.


More heart tissue loses oxygen and deteriorates or dies with each passing minute after a heart attack. Restoration of blood flow quickly is the main way to prevent heart damage. Medications given to treat a heart attack include:


Effects of PCOS can be offset by paying attention to the foods you eat and your activity levels:

  • Aspirin. It reduces blood clotting, thus helping maintain blood flow through a narrowed artery.
  • Thrombolytics. Also called clotbusters, these drugs help dissolve a blood clot that’s blocking blood flow to your heart.
  • Superaspirins. These are aspirin like drugs with improved ability to prrevent clot forming, and include clopidogrel.
  • Blood-thinning medications. Medications like heparin might be given to make your blood less “sticky” and less likely to form more dangerous clots.
  • Pain relievers. Heart attack is associated with intense chest pain and you may receive a pain reliever, such as morphine, to reduce your discomfort.
  • Nitroglycerin. This medication temporarily opens arterial blood vessels, improving blood flow.
  • Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure making your heart’s job easier.
  • Cholesterol-lowering medications. Unwanted blood cholesterol levels are lowered by these medications.
Surgical and other procedures

Additionally, to medications, one of the following procedures might be done to treat your heart attack:

  • Angioplasty and stenting. These are used when unstable angina or lifestyle changes and medications don’t effectively treat your chronic, stable angina.
  • Coronary artery bypass surgery. This is done when stenting doesn’t help. It is a major surgery on heart arteries and involves creating a graft bypass using a vessel from another part of your body or a tube made of synthetic fabric. With this procedure, blood flow is maintained around the blocked or narrowed artery.

After these medications/procedure, the blood flow to your heart is restored and your condition is stable.

Lifestyle Measures for Prevention

Lifestyle changes can help you prevent or delay the occurrence of heart attack due to coronary artery disease:

  • Stop smoking.
  • Exercise most days of the week.
  • Eat healthy foods.
  • Lose extra pounds and maintain a healthy weight.
  • Manage stress.
  • If you have high cholesterol, high blood pressure, diabetes or another chronic disease, work with your doctor to manage the condition and promote overall health.
  • If you have high cholesterol, high blood pressure, diabetes or another chronic disease, work with your doctor to manage the condition and promote overall health.