Coronary artery disease
Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD),[13] myocardial ischemia,[14] or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart.[5][6][15] It is the most common of the cardiovascular diseases.[16] Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death.[17] A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.[4] Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest.[4] Shortness of breath may also occur and sometimes no symptoms are present.[4] In many cases, the first sign is a heart attack.[5] Other complications include heart failure or an abnormal heartbeat.[5]
| Coronary artery disease | |
|---|---|
| Other names | Atherosclerotic heart disease,[1] atherosclerotic vascular disease,[2] coronary heart disease[3] |
 | |
| Illustration depicting atherosclerosis in a coronary artery | |
| Specialty | Cardiology, cardiac surgery |
| Symptoms | Chest pain, shortness of breath[4] |
| Complications | Heart failure, abnormal heart rhythms, heart attack, cardiogenic shock, cardiac arrest[5] |
| Causes | Atherosclerosis of the arteries of the heart[6] |
| Risk factors | High blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol[6][7] |
| Diagnostic method | Electrocardiogram, cardiac stress test, coronary computed tomographic angiography, coronary angiogram[8] |
| Prevention | Healthy diet, regular exercise, maintaining a healthy weight, not smoking[9] |
| Treatment | Percutaneous coronary intervention (PCI), coronary artery bypass surgery (CABG)[10] |
| Medication | Aspirin, beta blockers, nitroglycerin, statins[10] |
| Frequency | 110 million (2015)[11] |
| Deaths | 8.9 million (2015)[12] |
Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, depression, and excessive alcohol consumption.[6][7][18] A number of tests may help with diagnoses including: electrocardiogram, cardiac stress testing, coronary computed tomographic angiography, and coronary angiogram, among others.[8]
Ways to reduce CAD risk include eating a healthy diet, regularly exercising, maintaining a healthy weight, and not smoking.[19][9] Medications for diabetes, high cholesterol, or high blood pressure are sometimes used.[9] There is limited evidence for screening people who are at low risk and do not have symptoms.[20] Treatment involves the same measures as prevention.[10][21] Additional medications such as antiplatelets (including aspirin), beta blockers, or nitroglycerin may be recommended.[10] Procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) may be used in severe disease.[10][22] In those with stable CAD it is unclear if PCI or CABG in addition to the other treatments improves life expectancy or decreases heart attack risk.[23]
In 2015, CAD affected 110 million people and resulted in 8.9 million deaths.[11][12] It makes up 15.6% of all deaths, making it the most common cause of death globally.[12] The risk of death from CAD for a given age decreased between 1980 and 2010, especially in developed countries.[24] The number of cases of CAD for a given age also decreased between 1990 and 2010.[25] In the United States in 2010, about 20% of those over 65 had CAD, while it was present in 7% of those 45 to 64, and 1.3% of those 18 to 45;[26] rates were higher among men than women of a given age.[26]
