by Jon-Cecil Walkes, M.D.

The American Heart Association estimates that more than 16 million Americans suffer from coronary artery disease. It is the number one killer of both men and women in the U.S.

Coronary artery disease (CAD), or coronary heart disease, is a common term for the buildup of plaque in the heart’s arteries that could lead to heart attack. These fatty deposits may develop in childhood and continue to thicken and enlarge throughout life. Called atherosclerosis, this thickening narrows the arteries and can decrease or block the flow of blood to the heart. It is the most common cause of heart disease.

It is important to understand the causes and symptoms of CAD and to know that there are actions you can take to reduce your risk of a heart attack from the disease. 

Coronary arteries supply blood to the heart muscle. Like all other tissues in the body, the heart muscle needs oxygen-rich blood to function, and oxygen-depleted blood must be carried away. The coronary arteries run along the outside of the heart and have small branches that supply blood to the heart muscle. Therefore, any coronary artery disorder or disease can reduce the flow of oxygen and nutrients to the heart and that may lead to a heart attack and possibly death. 

The symptoms of coronary heart disease will depend on the severity of the disease—and they must be taken seriously. Some people with CAD have no symptoms, some have episodes of mild chest pain and some have more severe chest pain.

If too little oxygenated blood reaches the heart, a person will experience chest pain called angina. When the blood supply is completely cut off, the result is a heart attack, and the heart muscle begins to die. 

So it is important to recognize symptoms of coronary artery disease that can include:  

• Heaviness, tightness, pressure or pain in the chest behind the breastbone
• Pain spreading to the arms, shoulders, jaw, neck or back
• Shortness of breath
• Weakness and fatigue

Controlling risk factors is the key to preventing illness and death from CAD. There are several conditions and behaviors that increase the risk of CAD such as smoking, physical inactivity, obesity and having diabetes or hypertension. Family history of CAD is always a consideration and should be discussed with a physician. Additionally, being post-menopausal for women and being older than 45 for men are traditional risk factors.

There are several treatments that may be prescribed for CAD, including oral medications that can decrease blood clotting, reduce cholesterol levels and lower blood pressure. These medications, and changes in lifestyle and behavior, could help reduce risk and lessen the onset of chest pain.  Other treatments include coronary artery stenting and coronary artery bypass surgery (CABG.)  All of these treatment options may be used alone or together in the treatment of coronary artery disease.

Your risk of coronary artery disease can be minimized by controlling the risks factory that are within your control. Living a healthy lifestyle that incorporates proper nutrition, weight management and getting some physical activity can play a big role in avoiding or delaying the progression of CAD. Preventive measures instituted early are thought to have greater lifetime benefits.

Most importantly, call 9-1-1 for yourself or anyone who is experiencing symptoms of chest pain, shortness of breath, palpitations or fatigue. Do not delay. Calling 9-1-1 at the first signs of a heart attack could save a life because reducing time to medical treatment is the primary factor in surviving a heart attack. 

Jon-Cecil Walkes, M.D.

Dr. Jon-Cecil Walkes is a board-certified cardiothoracic surgeon and medical director of Cardiothoracic and Vascular Surgery at St. Joseph Medical Center.