Coronary artery disease (CAD) develops when the arteries that supply blood to the heart narrow or become blocked. This narrowing is usually caused by atherosclerosis, a buildup of plaque made of cholesterol, fat, calcium, and other substances along the artery walls. A complete blockage may cause a heart attack. Reduced blood flow limits the oxygen that reaches the heart muscle; this can lead to chest pain (angina), shortness of breath, fatigue, or an irregular heartbeat. Here’s information on techniques for treating coronary artery disease and how your options depend on disease severity, your symptoms, and your overall health:
How Does Medication Management Work?
Medication is commonly used to treat coronary artery disease, so doctors may prescribe one or more drugs to manage symptoms, slow disease progression, and reduce strain on the heart. Some common medication options for CAD include:
- Beta-blockers: These medications slow the heart rate and lower blood pressure, reducing how hard the heart must work.
- Blood Pressure Medications: ACE inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers help relax blood vessels and lower pressure on artery walls.
- Statins: Statins lower low-density lipoprotein (LDL) cholesterol, which contributes to plaque formation.
- Nitroglycerin: This medication widens blood vessels to improve blood flow during angina episodes.
Medication helps many people manage CAD, but it may not be enough for more advanced disease. When arteries are severely narrowed, a cardiologist may recommend a minimally invasive procedure to restore blood flow.
When Is Balloon Angioplasty Necessary?
Balloon angioplasty is a minimally invasive procedure used to open narrowed or blocked coronary arteries. A doctor may recommend it when symptoms continue despite medication or when testing shows a significant blockage. During the procedure, a cardiologist inserts a thin, flexible tube called a catheter through an artery in the wrist or groin. Imaging guides the catheter to the narrowed artery. A small balloon at the catheter’s tip is inflated at the site of the blockage.
This balloon compresses the plaque against the artery wall, widening the passage so blood can flow more freely. The balloon is deflated and removed afterward, and a stent is often placed to help keep the artery open. A stent is a small, expandable mesh tube that, in an angioplasty, is mounted on the balloon catheter. When the balloon inflates, the stent expands and presses against the artery wall. It remains in place permanently to support the artery and maintain blood flow.
There are two main types of stents: bare-metal or drug-eluting stents. Bare-metal stents provide structural support only, while drug-eluting stents are coated with medication that is slowly released into artery walls. This medication helps limit the tissue growth that can re-narrow an artery treated for atherosclerosis. Drug-eluting stents are the more common choice today, but your cardiologist will determine which type suits your condition. After stent placement, patients typically take antiplatelet medication to help prevent blood clots from forming inside the stent.
When Is Bypass Surgery Necessary?
Angioplasty with stenting is not suitable for every patient, so for advanced diseases, cardiologists may discuss coronary bypass surgery. Coronary artery bypass grafting (CABG) may be more appropriate for people with blockages in multiple arteries or in the left main coronary artery. During bypass surgery, a surgeon takes a healthy blood vessel from the leg, arm, or chest. The surgeon then attaches the vessel to create a new path for blood around the blocked section. Surgeons may perform an endarterectomy alongside bypass surgery to remove plaque when an artery has long, widespread plaque buildup.
Learn To Manage Coronary Artery Disease
Coronary artery disease is a chronic condition that requires ongoing care, so treatment plans may include medication, angioplasty with stent placement, or advanced bypass surgery. The most appropriate approach depends on the location and severity of blockages and your symptoms. While heart-healthy habits, including a balanced diet, regular physical activity, and avoiding tobacco, support long-term heart health, a cardiologist gives you personalized medical advice. Schedule an appointment with a cardiologist to learn about your overall heart health.
