Coronary Artery Disease

Coronary artery disease develops when the major blood vessels ― the coronary arteries ― that supply your heart with blood, oxygen and nutrients become damaged or diseased. Cholesterol-containing deposits, or plaque, in your arteries, and inflammation, are usually to blame for this disease.

When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain, shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.

Because coronary artery disease often develops over decades, you may not notice a problem until you have a significant blockage or a heart attack. But there's plenty you can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.

Risk factors

Risk factors for coronary artery disease include:

• Age — simply getting older increases your risk of damaged and narrowed arteries.
• Sex — men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.
• Family history — a family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before 55, or if your mother or a sister developed it before 65.
• Smoking — people who smoke have a significantly increased risk of heart disease. Exposing others to your secondhand smoke also increases their risk of coronary artery disease.
• High blood pressure — uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel for blood to flow.
• High blood cholesterol levels — high levels of cholesterol in your blood can increase the risk of plaque formation and atherosclerosis - the buildup of plaque in and on your artery walls. High cholesterol can be caused by a high level of low-density lipoprotein cholesterol, known as LDL or "bad" cholesterol. A low level of high-density lipoprotein cholesterol, known as HDL or "good" cholesterol, also can contribute to the development of atherosclerosis.
• Diabetes — diabetes is associated with an increased risk of coronary artery disease. Type 2 diabetes and coronary artery disease share similar risk factors, such as obesity and high blood pressure.
• Excess weight or obesity — excess weight typically worsens other risk factors.
• Physical inactivity — lack of exercise also is associated with coronary artery disease and some of its risk factors, as well.
• High stress — unrelieved stress can damage your arteries and worsen other risk factors for coronary artery disease.
• Unhealthy diet — eating too much food that has high amounts of saturated fat, transfats, salt and sugar can increase your risk of coronary artery disease.

If you have risk factors for coronary artery disease, such as high blood pressure, high cholesterol, tobacco use, diabetes, a strong family history of heart disease or obesity, talk with one of Mayo Clinic Health System's Cardiology providers. He or she may want to test you for coronary artery disease, especially if you have signs or symptoms of narrowed arteries.

Treatment

Treatment for coronary artery disease usually involves lifestyle changes, and drugs and certain medical procedures, if necessary.

Lifestyle changes

Committing to these healthy lifestyle changes can go a long way toward promoting healthier arteries:

• Quit smoking
• Eat healthy foods
• Exercise regularly
• Lose excess weight
• Reduce stress

Angioplasty and stent placement

Coronary angioplasty is a procedure used to open clogged heart arteries. Angioplasty uses a tiny balloon catheter that is inserted in a blocked blood vessel to widen it and improve blood flow to your heart.

Angioplasty is often combined with the placement of a small wire mesh tube called a stent. The stent props the artery open, decreasing its chance of narrowing again. Most stents are coated with medication to keep your artery open.

Angioplasty may be a treatment option if you have:

• Tried medications or lifestyle changes, but these steps have not improved your heart health.
• Worsening chest pain.
• A heart attack. Angioplasty can quickly open a blocked artery, reducing damage to your heart.

Coronary artery bypass surgery

Coronary bypass surgery redirects blood around a section of blocked or partially blocked arteries in your heart to improve blood flow to your heart muscle. The procedure involves taking a healthy blood vessel from your leg, arm or chest, and connecting it beyond the blocked arteries in your heart. This allows blood to flow around the blocked or narrowed coronary artery.

You may need coronary artery bypass surgery if:

• The main artery that brings blood to the left side of your heart is narrow.
• Your heart muscle is weak.
• You have diabetes and multiple severe blockages in your arteries.

Learn more about Mayo Clinic Health System's minimally invasive and innovative bypass surgery offerings.

Cardiovascular surgery is performed by Mayo Clinic Health System's world-class surgical team in Eau Claire, Wisconsin, or at Mayo Clinic in Rochester, Minnesota. Your local cardiology experts can manage your consultations and diagnostic tests, as well as preoperative and postoperative care. This approach ensures you receive the best heart care while minimizing travel and keeping you close to home and family. Mayo Clinic Health System is with you every step of the way, no matter the level of care needed in your health journey.