What Are Coronary Artery Disease and Heart Attack?

Coronary artery disease (CAD) happens when your arteries (large blood vessels) become narrowed or blocked. Usually, a waxy substance called plaque causes this blockage. CAD is the most common type of heart disease in the U.S. for people of all genders and a leading cause of heart attack and heart failure. This condition can cause severe complications, but the right care can be lifesaving.

Our expertise and experience enable us to diagnose and treat all stages of CAD, including complex and difficult-to-treat cases. We cover all your needs, from prevention to emergency treatment and advanced procedures. 

You can be confident you’re receiving exceptional heart care at Virginia Mason Franciscan Health. We’ve received national recognition for our care:

• U.S. News and World Report ranks our cardiac, heart and vascular surgery program No. 1 in Washington, Alaska, Montana, Idaho and Oregon for the 2023-2024 award period. 

• We’ve earned the top rating from the Society of Thoracic Surgeons for our excellence in coronary artery bypass grafting (CABG), the gold standard surgery to treat CAD. This distinction puts us in the top 10% of heart surgery programs in the U.S. in terms of quality outcomes.

You don’t have to travel far to access expert care for CAD. Our nationally recognized heart specialists are available in dozens of convenient locations across the region.

Many people do not have symptoms of CAD in the early stages. As it progresses and the arteries narrow, people may experience angina (chest pain), muscle pain and fatigue. However, some people do not know they have CAD until they have a heart attack.

Symptoms of a heart attack can differ for each person. Seek emergency care if you experience:

• Chest pain, pressure or burning
• Cold sweats
• Dizziness or feeling faint
• Fatigue and low stamina (energy)
• Indigestion or stomach pain
• Jaw or neck pain
• Nausea
• Shortness of breath

Atherosclerosis (plaque buildup inside your arteries) is the leading cause of CAD. Millions of U.S. adults have atherosclerosis and don’t know it. Plaque builds up over many years, causing your arteries to narrow. Gradually, your heart and other vital organs get less of the oxygen-rich blood they need.

A plaque blockage in your artery is the most common cause of a heart attack. With a blocked artery, your heart cannot get the oxygen it needs. Less common causes of a heart attack include:

• Coronary artery embolism (blood clot in your artery)
• Spasm and tightening of your coronary artery that blocks blood flow
• Spontaneous coronary artery dissection (SCAD), a tear inside your coronary artery

Factors that can make you more likely to develop CAD or have a heart attack include:

• Unhealthy cholesterol levels: Having high LDL (bad) cholesterol or low HDL (good) cholesterol raises your risk of developing CAD.
• Genetics: People with a family history of heart disease may be more likely to develop CAD.
• Smoking: Smoking or being exposed to secondhand smoke can damage blood vessels and cause atherosclerosis.
• Diabetes: People with Type 2 diabetes are more likely to have CAD than people without this disease.
• High blood pressure: Having high blood pressure (hypertension) is a major risk factor for CAD.
• Obesity: CAD or heart attack is more likely to affect people with obesity.
• Physical inactivity: Not getting regular exercise increases your risk of CAD.
• Diet: Eating foods high in saturated fat or refined carbohydrates can lead to plaque buildup in your arteries.
• Lack of sleep: If you regularly do not get at least seven hours of quality sleep, you may have a higher risk of heart attack and CAD. People with sleep apnea also have an increased risk.
• Age: Men over age 45 and women over 55 are more likely to have CAD and experience a heart attack.
• Air pollution: Long-term exposure to pollution or toxins in the air could raise your risk of CAD.
• Stress: Long-term stress can lead to trouble sleeping, high blood pressure, lack of exercise and other CAD risk factors.

Experts often diagnose CAD with cardiac imaging tests. Our specialists provide noninvasive nuclear cardiology tests that pinpoint potential problems with your heart’s blood flow. We also offer cardiac catheterization to assess how your heart is working. Read more about diagnosis and testing for heart disease. 

If you have risk factors for CAD or a heart attack, you may benefit from screening. Detecting CAD in its early stages can help you slow the progression of the disease and prevent a heart attack. Our preventive cardiology program features cardiologists, nutritionists and nurses who provide a complete risk assessment and help you optimize your heart health.

Treatment for CAD depends upon many factors, such as your age, health history and the stage of CAD. Treating a heart attack in progress is an emergency, and our emergency teams are ready to help 24 hours a day, seven days a week.

At Virginia Mason Franciscan Health, you receive customized care to help you prevent CAD or stop it from progressing. Our multispecialty heart team works together to create a treatment plan that will give you the best possible results. We provide compassionate care and support after a heart attack to help you live the healthiest life possible. Your treatment may include:

• Support for lifestyle changes: Our team works with you to make heart-healthy changes, such as an eating or exercise plan. We may also refer you to other specialties, such as sleep medicine, if you have sleep apnea symptoms.
• Medications: We assess your CAD risk and choose a medication that meets your needs. You may need a medicine that treats high cholesterol or blood pressure or widens your coronary arteries. If you are taking blood thinners, specialists in our anticoagulation clinics provide ongoing care to optimize your dosage and minimize side effects. 
• Cardiac surgery: The Society of Thoracic Surgeons awarded our team its 3-star rating (the highest possible) for our expertise in coronary artery bypass grafting (CABG). Also known as heart bypass surgery, CABG bypasses blocked arteries caused by CAD.
• Rehabilitation: Cardiac and pulmonary rehabilitation is a vital part of recovery after a heart attack or cardiac surgery. Cardiologists, rehabilitation specialists and nurses empower you to take charge of your heart health.
• Clinical trials: As a leading research-based institution, we participate in national and international clinical trials for heart disease. You may have access to these groundbreaking treatments before they’re widely available.

Contact us to learn more about heart care or to schedule an appointment.