Heart Disease - Coronary Artery Disease (CAD)Overview

Coronary artery disease (CAD; also called coronary heart disease, CHD) is the most common form of heart disease in America and Europe and is a serious health problem worldwide. The incidence of CAD is lower in Asian countries, particularly Japan, where diets are low in saturated fat and cholesterol.

Main Menu:

• Overview of CAD
• Risk Factors for CAD
• Symptoms/Screening for CAD
• Diagnosing CAD
• Myocardial Infarction (Heart Attack)
• Treating CAD
• Monitoring Patients with Cardiovascular Disease
• Rehabilitation for Patients with CAD

Overview of CAD

Coronary artery disease (CAD) usually results from atherosclerosis, a condition that occurs when arteries become narrow and hardened due to cholesterol plaque build-up. Further narrowing of the arteries may result from thrombi (blood clots) that form on the surfaces of plaques. Angina (chest pain) or dyspnea (shortness of breath) may be present.

Myocardial infarction (heart attack) can be a serious result of CAD, occurring when a blocked coronary artery causes death to a portion of the myocardium (heart muscle). Cardiac arrest may also result from CAD; 90% of sudden deaths occur in patients with two or more major arteries narrowed by atherosclerosis.

Statistics show CAD to be the leading cause of death among both men and women in the United States and in Europe. For example, approximately 12,800,000 Americans suffer from CAD and nearly 500,000 Americans die from heart attacks caused by CAD. Over 12 million Americans have a history of myocardial infarction or angina or both.

A recent survey reported by the American Heart Association reveals that the majority of American women do not understand the true threat of cardiovascular disease. Despite the fact that heart disease is the leading cause of death among women, a nationwide survey revealed that only 8% of women perceive heart disease as the greatest threat to their health. More than six out of 10 women falsely believe that they are more likely to develop cancer than heart disease.

Other statistics from the American Heart Association:

• Over 500,000 American women die of cardiovascular disease each year. This twice the number of deaths from all cancers combined (lung cancer, the leading cause of cancer deaths, claims approximately 65,000 deaths per year, and breast cancer kills around 40,000 women per year).
• One in five women have some form of heart or blood vessel disease.
• 38% of women who have heart attacks die within the first year compared to 25% of men.
• 35% of women have a second heart attack within six years of the first attack compared to 18% of men.
• Over 60,000 women die of stroke each year; approximately 60% of stroke deaths occur in women.

Similarly, two million Europeans die from CAD each year. Death rates from CAD are higher in Northern, Central and Eastern Europe and lower in Southern and Western Europe. For example, the death rate for men aged 35-74 living in Russia is eight times higher than in France and for women it is 12 times higher in Russia than in France. An estimated 480,000 Germans undergo cardiac catheter examinations each year, and many of these patients are at risk for CAD. Approximately 280,000 Germans also experience myocardial infarction annually, a symptom of CAD. Overall, an estimated 21% of European men and 22% of European women die from CAD.

Controllable risk factors for CAD include high blood cholesterol, hypertension, smoking, diabetes, obesity, lack of physical activity, and stress. Uncontrollable risk factors for CAD include gender, family history, race, and genetics.

Tests used to detect and diagnose CAD include physical exam, blood cholesterol tests, blood pressure measurements, electrocardiogram, stress test, chest x-ray, coronary angiography, echo cardiogram, cardiac magnetic resonance imaging, fast/multi-slice CT, and nuclear medicine imaging.

Treatment of CAD depends on severity. In select cases, CAD may be kept under control with diet/lifestyle changes or medication, including beta blockers, nitrates, calcium-channel blockers, and antiplatelets. Invasive treatment options for severe CAD include coronary angioplasty and coronary artery bypass graft. In all cases, once CAD is detected, the condition should be closely monitored and appropriate steps should be taken to prevent more serious conditions or death.

Updated: February 29, 2008