David Hofman, MSN, FNP, APRN

• Angina, which is chest pain that occurs when the heart does not receive enough blood flow.
• Heart attack, which happens if the arteries leading to the heart are completely blocked.
• Arrhythmia, or irregular heartbeat, which can develop if the heart does not have enough blood supply.
• Heart failure, which may occur if a heart attack damages the heart and it becomes too weak to pump enough blood to the rest of the body.

Certain factors may increase risk for the disease, like smoking, lack of exercise, being overweight, high cholesterol, high blood pressure, and diabetes. CAD tends to develop over decades, so it can go undetected until it has become quite severe. A diagnosis may be established using such tests as:

• Electrocardiogram (ECG), which records the heart's electrical activity over a period of time. ECGs can detect whether there is enough blood flow to the heart or if a heart attack has occurred.
• Echocardiogram (echo), which creates images of the heart using sound waves. Echos can show whether the heart is able to pump blood normally.
• Stress tests, where an ECG or echo is combined with exercise, like riding a stationary bike or walking on a treadmill. This test is done to find out if the heart can function properly while performing a strenuous activity.

Treatments for the disease include medications such as vasodilators, like nitroglycerin, which dilates (widens) the coronary arteries. CAD may also be treated by a procedure called angioplasty with stent placement, where a balloon is inflated inside a diseased artery to flatten the plaque deposits against the artery walls, creating more room for blood to flow.

In some severe cases of the disease, multiple arteries may be blocked, and an open heart surgery called coronary artery bypass surgery may be necessary. This operation transplants a vessel from another part of the body to form a graft that goes past the narrowed arteries, thus enabling blood to flow around those arteries.

Heart attacks typically feel like pain or pressure in the chest that can radiate out to the back, arm, or jaw. Some other symptoms can include fatigue or weakness, shortness of breath, sweating, and nausea.

Treatment aims to increase blood flow to the heart muscle by opening up blocked blood vessels. Medications are sometimes used to dissolve clots in the arteries. Aspirin and other medications such as Plavix can thin the blood and make clots less likely to form. Dilators can widen blood vessels to make room for more blood to flow. Doctors can also use a procedure called catheterization to look at the blood vessels around the heart directly, place stents, or widen vessels using angioplasty. In extreme cases bypass surgery can be used to help blood flow better. After recovery, it is important to lead a healthy lifestyle and take any prescribed medications in order to protect the heart.