Coronary Artery Disease (CAD)

Coronary artery disease (CAD) is a condition in which the arteries supplying blood to the heart become narrowed or blocked, reducing the amount of oxygen reaching the heart muscle. It is commonly referred to as blocked heart arteries or coronary heart disease. In most cases, it develops gradually over many years due to the buildup of cholesterol and fatty deposits within the artery walls.

The heart is a constantly working muscle and requires its own blood supply to function properly. This blood is delivered through the coronary arteries. When these arteries narrow, especially during physical activity, the heart may no longer receive enough oxygen. Over time, this can lead to chest pain, shortness of breath, or a heart attack.

Coronary artery disease is one of the most common heart conditions worldwide, and early diagnosis is important.

What causes coronary artery disease?

The main cause of CAD is a process called atherosclerosis, also known as hardening of the arteries. In this process, cholesterol, fat, calcium, and inflammatory cells gradually accumulate within the artery wall. Over time, the inside of the artery becomes narrower and blood flow decreases.

Smoking, high cholesterol, high blood pressure, and diabetes are among the most important risk factors. Obesity, physical inactivity, unhealthy diet, and chronic stress may also increase the risk.

A family history of early heart disease is also important. Some individuals develop coronary artery disease at a younger age because of genetic predisposition.

What are the symptoms?

The most common symptom of coronary artery disease is chest pain. Patients often describe it as pressure, tightness, heaviness, or burning in the center of the chest.

Symptoms usually appear during physical activity such as walking or climbing stairs and may improve with rest. In some patients, the pain can spread to the left arm, back, neck, or jaw.

Shortness of breath, fatigue, and reduced exercise capacity are also common. Some patients, especially those with diabetes, may have little or no chest pain and present mainly with shortness of breath or weakness.

In some individuals, the first sign of coronary artery disease may be a heart attack. For this reason, new or worsening chest symptoms should not be ignored.

How is it related to heart attacks?

Coronary artery disease is the leading cause of heart attacks. A heart attack occurs when a plaque inside the artery suddenly ruptures and a blood clot forms, completely blocking blood flow.

When this happens, part of the heart muscle is deprived of oxygen and becomes damaged. Symptoms such as prolonged chest pain, sweating, nausea, and shortness of breath require urgent medical attention.

Early treatment is critical to protect the heart muscle and reduce permanent damage.

How is coronary artery disease diagnosed?

Diagnosis begins with evaluating symptoms and risk factors. Physical examination, blood pressure measurement, and an ECG are usually the first steps.

Blood tests may be used to check cholesterol levels, blood sugar, and markers of heart injury. An exercise stress test can help evaluate how the heart responds during physical activity.

Echocardiography is used to assess heart function and valve structure. Coronary CT angiography can visualize the coronary arteries noninvasively.

In cases requiring more detailed evaluation, coronary angiography may be performed. During this procedure, thin catheters are inserted through the wrist or groin artery to directly visualize the coronary arteries.

How is it treated?

Treatment depends on the severity and extent of the disease. Lifestyle modification and medications form the foundation of treatment.

Quitting smoking, regular exercise, healthy nutrition, and weight control are very important. Blood pressure, cholesterol, and diabetes should be carefully managed.

Medications may include blood thinners, cholesterol-lowering drugs, blood pressure medications, and treatments that reduce the workload of the heart.

Some patients may require coronary stenting. In this procedure, the narrowed artery is opened using a balloon and a stent. In patients with more extensive or complex disease, bypass surgery may be recommended.

Stent or bypass surgery?

The choice between stenting and bypass surgery depends on the extent of artery disease, the patient’s age, the presence of diabetes, and heart function.

Some patients with limited narrowing can be treated successfully with stents, while others benefit more from bypass surgery.

The goal is to choose the safest and most effective long-term treatment for each individual patient.

Can coronary artery disease be completely cured?

Coronary artery disease is usually a chronic condition that develops gradually over many years. Treatment can slow disease progression and help control symptoms.

With appropriate treatment and healthy lifestyle changes, many patients continue to live active lives for years.

Is exercise dangerous?

Appropriate exercise is beneficial for most patients. Regular walking and controlled physical activity can support heart health.

However, exercise programs should be tailored to the individual’s heart condition. Patients with chest pain should avoid uncontrolled intense exercise.

Cardiac rehabilitation programs may be helpful after a heart attack or stent procedure.

When should medical attention be sought?

New chest pain, pressure during exertion, or shortness of breath should be evaluated.

Chest pain that does not improve with rest, especially when associated with sweating, nausea, or fainting, may indicate a heart attack and requires urgent medical attention.

Symptoms that recur after stent placement or bypass surgery should also be evaluated.