Cardiology · Patient education

Coronary Artery Disease (With or Without Stents)

Coronary artery disease (CAD) means the arteries that feed your heart muscle are narrowed by plaque. It can cause chest pain or a heart attack. Medicines, healthy habits and, for some people, a stent or bypass can lower risk and ease symptoms.

Your heart muscle gets oxygen from small arteries on its surface, called coronary arteries. Over years, a fatty material called plaque can build up inside them. This is called atherosclerosis.

Plaque makes the arteries narrower, so less blood can reach the heart, especially when you're active. If a plaque breaks open, a blood clot can form and suddenly block the artery. That causes a heart attack.

CAD is the most common type of heart disease in the United States and a leading cause of death for both men and women.

Many people with CAD live active lives with treatment. For some, the first sign is a heart attack, which is why prevention matters.

  • Stable CAD (stable angina): chest discomfort that comes on with activity or stress and eases with rest or medicine, in a predictable pattern.
  • Acute coronary syndrome: unstable angina or a heart attack. This is an emergency.
  • CAD treated with a stent: a small mesh tube placed in a narrowed artery during a catheter procedure to hold it open.
  • CAD treated with bypass surgery: a surgeon uses a blood vessel from elsewhere in the body to route blood around a blockage.
  • CAD managed with medicines only: many people do well without a procedure.

  • High LDL cholesterol
  • High blood pressure
  • Diabetes
  • Smoking or vaping nicotine
  • Extra weight and not much physical activity
  • Family history of early heart disease
  • Getting older; men are at risk earlier, and women's risk rises after menopause
  • Chronic kidney disease, long-term stress and poor sleep

Some people have no symptoms. Others notice:

  • Chest pressure, squeezing, tightness or burning (angina), often with activity
  • Discomfort in the arm, shoulder, jaw, neck, back or upper belly
  • Shortness of breath with activity
  • Unusual tiredness, nausea or a cold sweat; women, older adults and people with diabetes may have these instead of classic chest pain
  • At your visit, your provider checks your blood pressure, pulse and weight, listens to your heart and lungs and to the arteries in your neck, and checks the pulses in your legs and feet for signs of narrowed arteries elsewhere.

Your provider starts with your symptoms, risk factors and exam. An ECG (heart tracing), done in our office, is a common first test.

Lab tests your provider may order include: a lipid panel, A1C or blood sugar, a comprehensive metabolic panel (kidney and liver function), a complete blood count (CBC), and thyroid tests. If a heart attack is suspected, troponin blood tests are done urgently in an emergency setting.

Other tests may include a stress test, echocardiogram, coronary CT scan, calcium score or cardiac catheterization. We don't do imaging at our office; we refer you to a trusted cardiology partner or outside center and review the results with you.

Treatment aims to ease symptoms and lower the chance of a heart attack. Your plan may include:

  • Medicines to lower cholesterol (usually a statin), control blood pressure and blood sugar, and ease angina. Some people carry Nitrostat (nitroglycerin) for chest pain; we go over exactly how and when to use it with you.
  • Antiplatelet medicine to help prevent clots, such as aspirin, Plavix (clopidogrel), Effient (prasugrel) or Brilinta (ticagrelor).
  • Living with a stent: after a stent, most people take two antiplatelet medicines for a period of time to keep the stent from clotting. Never stop or pause these medicines, even for a dental or other procedure, without first talking with your cardiologist. Stopping too early can cause a sudden, dangerous clot in the stent.
  • Tell every doctor and dentist that you have a stent and which blood-thinning medicines you take.
  • Cardiac rehab: a supervised exercise and education program after a heart attack, stent or bypass.
  • Quitting smoking, heart-healthy eating, regular activity, healthy weight and good sleep.
  • Watching for bleeding, since antiplatelet medicines make you bruise or bleed more easily.

CAD is a long-term condition. A stent or bypass opens or bypasses a blockage, but it doesn't cure the underlying disease, so medicines and habits stay important.

Many people feel better and stay active with treatment. Your risk depends on many things, and no one can promise a specific result.

Call 911 right away for: chest pain or pressure lasting more than a few minutes or that goes away and comes back; chest pain that doesn't ease with rest or with nitroglycerin as your provider directed; pain spreading to the arm, jaw, neck or back; shortness of breath, cold sweat, nausea or lightheadedness; fainting; or black, tarry stools or vomiting blood while on blood thinners. Don't drive yourself.

Call us at (818) 660-2977 if your angina is happening more often or with less activity, if you bruise or bleed more than usual, or if a doctor or dentist asks you to stop a blood thinner (and also call your cardiologist before stopping).

Your primary care team at Moaddel Medical manages your cholesterol, blood pressure and diabetes, orders your lab tests and keeps your medicine list up to date.

We coordinate with a cardiology partner for stress tests, stents and specialty care, and we help you follow your antiplatelet plan safely around other procedures.

We're at 7230 Medical Center Dr, Suite 100, West Hills, CA 91307.

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Questions about coronary artery disease (with or without stents)?

Start with a visit at Moaddel Medical, 7230 Medical Center Dr, Suite 100, West Hills, CA 91307. We'll review your concerns and plan next steps together.

Book a visitCall (818) 660-2977

Education only. This information is for general education and is not medical advice. It does not replace a visit with a qualified health care provider. If you think you may have a medical emergency, call 911 right away.

Sources

Last reviewed: Pending medical review