Key Takeaways:

• Coronary artery disease is the most common type of heart disease.
• CAD is when the coronary arteries are damaged due to plaque buildup along the walls of the arteries.
• The most common causes of CAD are diabetes and smoking.
• A person could have no signs of CAD or some my have shortness of breath or chest pain.
• CAD can be treated with catheterization and stents. 

St. Joseph’s/Candler Cardiologist Dr. William Crosland explains how this very common condition is diagnosed and treated

Heart disease is the leading cause of death in men and women and of most racial and ethnic groups. What’s the most common type of heart disease? Coronary artery disease.

Coronary artery disease (CAD) occurs when the coronary arteries become inflamed and narrowed due to plaque buildup along the walls of the arteries. This buildup creates blockages, limiting or stopping blood flow to the heart.

There are three coronary arteries that reach over the heart to supply it with blood. They are called the coronary arteries because it looks similar to a crown on your head when you look at the heart, describes Dr. William Crosland, interventional cardiologist with St. Joseph’s/Candler Physician Network – Cardiology Associates.

CAD affects more than 20 million adults in the United States, or about 1 in 20 adults.

What causes CAD?

The two most common causes of CAD are diabetes and smoking, Dr. Crosland says. In fact, coronary disease is one of the leading causes of death in people with diabetes. Genetics may also play a role in CAD.

You can reduce your risk of developing CAD by not smoking or quitting smoking, and if you have diabetes, controlling your A1C. High cholesterol also can lead to CAD, so reducing cholesterol with diet, exercise, medication and other lifestyle modifications can help, Dr. Crosland adds.

What are the symptoms?

Symptoms of CAD can vary depending on the severity of the disease. Some people have no symptoms. Others may see their primary care doctor or cardiologist for shortness of breath or chest pain with exertion, Dr. Crosland says. In severe cases, CAD can lead to heart attack.

How is CAD diagnosed?

There are several tests that can look at your heart for blockages, arrhythmias and other conditions. The best test to look for blockages is heart catheterization.

This is a very common diagnostic procedure performed at The Heart Hospital at St. Joseph’s Hospital.

“In the cath lab, we will typically do any where between 10 and 20 heart catherizations a day,” Dr. Crosland says. “We will then typically fix around 40 percent of those same day. There are a lot of heart catheterization and coronary interventions being done in this hospital.”

A heart catheterization is when a thin tube, called a catheter, is guided into the coronary arteries in your heart. Contrast is injected into each artery, and similar to an X-ray, images are taken of the arteries and heart at multiple different views, Dr. Crosland says.

Those images will help the cardiologist see any blockages and determine if immediate treatment is needed to open up blood flow.

How do you treat CAD?

If you heart catheterization finds blockages, the interventional cardiologist can fix it at the same time as the diagnostic test. Using a sturdy-guided catheter and thin wire, the cardiologist can open up the blockage by placing a stent in the artery, which is like a very fine chicken mesh, Dr. Crosland describes.

The stent helps open the blood vessel, and over the span of a year, a small skin layer will grow over the stent and embed it within the wall of the artery.

“That allows us to help stop heart attacks and helps us stabilize coronary disease in people who are having shortness of breath and chest pain,” Dr. Crosland says. “After most procedures, their chest pain and shortness of breath have resolved; they feel they have more energy; and they are able to do more things than they were able to before.”

In some cases, a patient can go home following a heart catheterization and stent placement. However, some providers may want to keep you overnight for observation.

How do you prevent CAD from happening again or not at all?

Just because you are feeling better isn’t a “get out of jail free card.” You can develop a new blockage or even a blockage inside the stent, Dr. Crosland says.

Whether you are recovering from CAD or trying to prevent it in the first place, it’s important to practice a healthy lifestyle, especially not smoking, eating a balanced diet, regular exercise, and if you have diabetes, controlling your blood sugar.

“Listen to your body. I think when you exercise, everybody has some degree of shortness of breath,” Dr. Crosland says. “But, if your shortness of breath is out of proportion to your physical activity, or if you are finding that despite a healthy lifestyle, you are continuing to have symptoms or your symptoms worsen, you should get it looked at before it becomes too late. Working with your primary care physician or cardiologist is a helpful way to do that.”

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