coronary artery disease

Think of the coronary arteries as the small fuel lines that feed the heart muscle itself. In coronary artery disease, these lines slowly fur up on the inside with fatty deposits, so the heart — the pump that drives everything else — can no longer get all the blood it needs, especially when it has to work harder.

More precisely, coronary artery disease is the narrowing or obstruction of the coronary arteries, almost always due to atherosclerosis: cholesterol, inflammatory cells and fibrous tissue accumulate in the wall and form plaques. As these plaques grow, the channel for blood narrows and flow falls. When demand outstrips supply, the muscle becomes ischemic, producing symptoms such as angina.

The disease ranges from silent, slowly progressive narrowing to sudden, life-threatening events. A stable narrowing may cause predictable exertional chest pain, while a plaque that ruptures can trigger a clot and an acute coronary syndrome. It is among the most common causes of death worldwide, but it is also highly modifiable through risk-factor control, medication and, where needed, procedures.

Coronary artery disease and ischemic heart disease are often used interchangeably; strictly, the first names the arterial pathology while the second names its consequence for the heart muscle.