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Coronary artery disease is a narrowing or blockage of coronary arteries, primarily due to plaque buildup — a process called atherosclerosis. This can lead to reduced blood flow to the heart muscle, increasing the risk of heart disease and heart attack, or myocardial infarction. 

Coronary artery disease, a form of heart disease, develops gradually. Risk factors include high blood pressure, high cholesterol, smoking, diabetes, obesity and a sedentary lifestyle.

Coronary arteries are on the surface of the heart and supply oxygen-rich blood to the heart muscle. When they are narrowed, the heart muscle may not receive enough oxygen, causing symptoms such as chest pain (angina) and shortness of breath. For many, the first sign of coronary artery disease is a heart attack. If a piece of the plaque buildup breaks off and travels to the brain, it can cause a stroke.

Coronary artery disease, a term often used interchangeably with coronary heart disease, is the most common type of heart disease. Over time, coronary artery disease can weaken the heart muscle and lead to heart failure

About 1 in 20 adults over the age of 20 have coronary artery disease, but many don’t know it until they feel chest pain, according to the National Heart, Lung, and Blood Institute.

Norton Heart & Vascular Institute is a leader in coronary artery disease treatment. Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital have been accredited by the American College of Cardiology as chest pain centers with primary PCI, meaning they are available around the clock to perform percutaneous coronary interventions.

Norton Heart & Vascular Institute physicians are at the forefront of cardiovascular care such as the CathWorks system for faster PCI treatment. They lead numerous clinical trials into new and experimental treatments. That means patients can get early access to leading-edge therapies, and once the treatments are approved for broad use, our physicians are already deeply experienced.

Types of Coronary Artery Disease

According to the National Heart, Lung, and Blood Institute, there are three general types of coronary artery disease.

  • Obstructive coronary artery disease: 50% or more of a large coronary artery is blocked.
  • Nonobstructive coronary artery disease: Blood flow in a large coronary artery is blocked less than half.
  • Coronary microvascular disease: This refers to blockage in the tiny arteries within the heart muscle. 

Coronary Artery Disease Risk Factors

Some of the risk factors for coronary artery disease can be controlled, while others cant.

Modifiable Risk Factors

Quitting smoking, eating a balanced diet, exercising regularly and managing stress can address many of the modifiable risk factors for coronary artery disease. 

  • High blood pressure puts added force against the artery walls and leads to damage.
  • High cholesterol, specifically, elevated low-density lipoprotein (LDL) cholesterol. Low levels of high-density lipoprotein (HDL) cholesterol also contribute to plaque buildup that narrows arteries. 
  • Smoking damages the lining of arteries and increases blood pressure.
  • Diabetes and high blood sugar levels contribute to atherosclerosis.
  • A sedentary lifestyle can exacerbate other risk factors, such as high blood pressure, high cholesterol and diabetes.
  • A diet high in saturated fats, cholesterol, and sodium contributes to plaque buildup.
  • Obesity increases the risk of high blood pressure, diabetes and high cholesterol.
  • Excessive alcohol consumption can lead to high blood pressure and cardiovascular issues.
  • Stress can damage arteries and worsen other risk factors.

Nonmodifiable Risk Factors

  • Risk of coronary artery disease increases as you get older. Plaque buildup typically starts in childhood and increases as you age.
  • A family history of early heart disease or stroke is something to discuss with your medical provider.
  • Men have a higher risk of coronary artery disease at a younger age, though risk for women increases after menopause.
  • If you are African American, your risk may be higher due to a prevalence of hypertension and diabetes.

Know the Signs of a Heart Attack

Heart attack symptoms aren’t always what you may think, especially in women.

Coronary Artery Disease Symptoms

  • Chest pain (angina)
  • Shortness of breath
  • Heart attack symptoms, such as pressure or tightness in the chest, arm, or shoulder
  • Fatigue
  • Nausea or indigestion
  • Dizziness or lightheadedness
  • Heart palpitations

Coronary Artery Disease Treatment

If you are at risk for coronary artery disease, your provider may encourage you to get a special CT scan that measures calcium levels in your coronary arteries. Calcium is a component of arterial plaque.

Other tests include a computed tomography–fractional flow reserve (CT-FFR) . This tool uses CT imaging to create a 3D image that shows the extent of blood flow restriction through any potential blockages.

If you are diagnosed with a mild form of the disease or are at risk, treatment options can include lifestyle changes, such as exercise, a healthier diet and quitting smoking. Medication may be prescribed to address potential underlying causes. Medication to treat coronary artery disease typically involves two types of drugs: antiplatelets to prevent blood clots, and statins to protect the blood vessels.

A minimally invasive procedure — percutaneous coronary intervention, or PCI, may be needed to open narrowed or blocked coronary arteries. A more invasive option is coronary artery bypass grafting — open heart surgery that takes a vein or artery from elsewhere in your body and moves it to your heart to create a pathway around a blocked artery.

About Norton Heart & Vascular Institute

Norton Heart and Vascular Institute offers advanced care at all of our adult-service hospitals to save hearts and lives.

Awards and Accreditations

  • All of Norton Healthcare’s adult-service hospitals in Louisville have received Chest Pain Center accreditation from the American College of Cardiology (ACC).
  • Norton Audubon Hospital has been named a HeartCare Center National Distinction of Excellence year after year by the American College of Cardiology. This is the only hospital in Louisville to be recognized for this distinction.
  • Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital all are recognized as having ACC Chest Pain Center with Primary PCI accreditation.
  • Norton Audubon Hospital earned ventricular assist device (VAD) accreditation from DNV and the Centers for Medicare & Medicaid Services.

Leading the Region in Advanced Care

  • First in Louisville to implant a dual-chamber leadless pacemaker
  • First in Louisville to use PASCAL and MitraClip to replace and repair heart valves
  • First health care system in Louisville to offer CathWorks FFRangio System in a minimally invasive procedure used to treat clogged arteries and advance heart disease
  • Highest survival rate in the nation for  extracorporeal membrane oxygenation (ECMO) interventions treating heart failure
  • Among the highest survival rates in the nation for treatment of cardiogenic shock in heart failure
  • Over 100 transcarotid artery revascularization (TCAR) procedures performed for heart disease patients
  • System with the most facilities across the city of Louisville with the ability treat a life-threatening heart attack
  • More than 100 board-certified physicians and advanced practice providers with specialized heart and vascular training and experience at nearly 30locations in Louisville and Southern Indiana

Comprehensive Heart Care for the Whole Person

Norton Heart & Vascular Institute offers patient resources to support you and your family, including free classes for people of all ages who want to improve cardiovascular health or are living with a heart condition.

  • Cardiac rehabilitation: Our cardiac rehabilitation providers are leaders in developing and applying innovative techniques that can help you recover and resume your life.
  • Connecting Hearts for Support group: The group provides education and support to individuals who have had a heart attack, are living with a heart condition or are at risk for cardiovascular disease.
  • Heart health screenings: Prevention is the best way to manage heart disease, and screenings are available to detect early signs of cardiac and vascular disease and identify risk factors.