Coronary Artery Disease (CAD)
Coronary Artery Disease occurs when atherosclerotic plaque narrows or blocks the arteries supplying the heart. Reduced blood flow can cause chest pain (angina), shortness of breath, or heart attacks. CAD is the leading cause of death worldwide, but it is largely preventable through risk-factor management and evidence-based therapies.
Causes & Risk Factors
- Elevated LDL cholesterol and lipoprotein(a)
- Hypertension and diabetes
- Smoking and secondhand smoke
- Obesity, sedentary lifestyle, high-stress environment
- Chronic kidney disease, inflammatory conditions (RA, lupus)
- Family history or premature CAD in first-degree relatives
- Male sex or post-menopausal females
Symptoms
- Chest pressure or squeezing, often radiating to arm, jaw, back
- Shortness of breath, fatigue, dizziness
- Indigestion-like discomfort, nausea, diaphoresis
- Silent ischemia (no symptoms) is common in diabetes
Seek emergency care for chest pain lasting >5 minutes, especially with sweating, vomiting, or radiation.
Diagnosis
- Risk assessment: ASCVD score, coronary calcium scoring (CAC)
- Labs: lipid panel, HbA1c, hs-CRP, lipoprotein(a)
- Electrocardiogram (ECG) for ischemia or previous infarction
- Stress testing: treadmill ECG, stress echo, nuclear perfusion, or stress MRI
- Coronary CT angiography (CCTA) for noninvasive plaque visualization
- Invasive coronary angiography and fractional flow reserve (FFR) when revascularization is considered
Treatment & Management
Lifestyle
- Adopt a Mediterranean or DASH-style eating pattern
- 150 minutes/week of moderate exercise plus resistance training
- Quit smoking and limit alcohol
- Prioritize stress management and 7–9 hours of sleep
Medications
- Antiplatelet therapy: Aspirin and/or P2Y12 inhibitor depending on risk
- Statins for LDL reduction; ezetimibe or PCSK9 inhibitors for further lowering
- ACE inhibitors/ARBs for BP control and endothelial protection
- Beta-blockers reduce myocardial oxygen demand post-MI or with angina
- SGLT2 inhibitors/GLP-1 agonists for cardio-renal protection in diabetes
- Nitrates, ranolazine for symptom relief
Procedures
- Percutaneous coronary intervention (PCI) with stent placement for flow-limiting lesions
- Coronary artery bypass graft (CABG) for multivessel or left main disease
- Enhanced external counterpulsation (EECP) for refractory angina
Living with CAD
- Monitor blood pressure, heart rate, weight, and symptom triggers
- Follow cardiac rehab programs after MI or revascularization
- Keep vaccinations up to date (influenza, COVID-19)
- Manage mental health; anxiety is common after cardiac events
- Carry nitroglycerin if prescribed and know how to use it
Complications
- Unstable angina or myocardial infarction
- Heart failure, arrhythmias, sudden cardiac death
- Stroke or peripheral arterial disease due to systemic atherosclerosis
Research & Future Directions
Novel therapies target inflammation (IL-1 blockers, colchicine), RNA-based lipid modulation, and digital twins for personalized risk prediction.
Experimental & Emerging Treatments
- PCSK9 Gene Silencing (inclisiran, lepodisiran): Small interfering RNA injections dramatically lower LDL and are being studied for long-term adherence benefits.
- Antisense Therapies for Lipoprotein(a): Agents like pelacarsen reduce Lp(a) levels, addressing a major inherited risk factor.
- Intravascular Lithotripsy & Bioresorbable Scaffolds: Advanced PCI tools treat calcified lesions or temporarily scaffold vessels while minimizing permanent implants.
- Cardiac Regeneration Trials: Stem-cell injections and myocardial patches aim to restore heart muscle function after infarction.
Track CAD with Diagnoza.care
Protect Your Heart with Diagnoza.care – Log blood pressure, lipids, exercise, medications, and chest-symptom episodes, schedule cardiology visits and imaging, capture side effects, and let the AI companion highlight trends that warrant earlier follow-up.
Medical Disclaimer: Informational only. Partner with your cardiologist to tailor diagnostics, medications, and interventions to your clinical profile.
Sources: American College of Cardiology, American Heart Association, European Society of Cardiology